Treatment of superficial venous insufficiency with polidocanol foam

Sclerotherapy has emerged as an effective minimally invasive treatment for patients with chronic venous disease, including treatment of the entire length of the incompetent saphenous vein. The purpose of this review was to present evidence on safety, efficacy and long-term results of treatment with polidocanol endovenous microfoam, and to compare results to those obtained with physician compounded foam and other non-invasive techniques for the treatment of superficial venous insufficiency. A comprehensive review of the literature was performed on polidocanol foam sclerotherapy, focusing on effectiveness, durability and complications of polidocanol endovenous microfoam versus physician compounded foam, used for saphenous vein ablation, varicose tributary and perforator vein treatment and in patients with venous leg ulcers. The use of polidocanol foam is safe. There were no serious neurologic or cardiac adverse events with the use of PEM. Polidocanol 1% endovenous microfoam was not statistically different from endovenous thermal ablation for venous closure and deep vein thrombosis risk for chronic venous insufficiency treatment, based on a network meta-analysis of published evidence. Polidocanol 1% endovenous microfoam was statistically significantly differentiated from physician-compounded foam, with higher odds of vein closure. This literature review supports the efficacy of polidocanol foam as a versatile and primary treatment modality in C2 to C6 patients for superficial venous insufficiency.