Fellows Course: Varithena Foam Sclerotherapy Case Studies

Varithena: A Polidocanol Microfoam for Saphenous Reflux

Varithena is an FDA approved 1 percent polidocanol injectable microfoam indicated for incompetent great and accessory saphenous veins with associated varicosities, CEAP class C2 to C6, treating tortuous vessels above and below the knee without incisions or tumescent anesthesia.

Safety Data: DVT Rates in Perspective

An overall 4.7 percent DVT rate in trials sounds concerning, but pooled data showed most thrombi were distal, detected around seven days, and resolved or stabilized by 30 days regardless of anticoagulation, leaving a less than 1 percent proximal symptomatic DVT risk.

Injection Technique and Compression Protocol

Technique involves wedging the leg at 45 degrees to drain the vein, injecting proximal thigh segments first for maximal wall contact before distal calf segments, isolating perforators, and compressing near the junction, followed by 48 hours of bandaging and two weeks of stockings.

Two Patient Cases and Dosing Limits

A woman with leg swelling and a woman with painful, bleeding anterior knee varicosities both improved substantially by three months using roughly 10 to 15 cc’s total, near the 15 cc per treatment maximum, split between axial segments and visible varicosities.