Common "home-made" sclerofoams loose their effectivity with increasing vein diameters. The foam will float on blood, distribute in uncontrolled patterns, require several injection sessions and thus sclerotherapy is inferior to thermal occlusion. We showed this correlation in 2005 in a small (and soon abandoned) series of cases which had laser treatment of a 10 cm GSV junction segment combined with GSV microfoam below. Yes, it is time saving - but at clearly inferior rates of primary and long-term success.
As far as data are known from the newly approved "Varithena" microfoam (BTG), this modality does not solve the problem of low foam viscosity, short half-life and suboptimal clinical effects.
Currently we develop a totally different sclerofoam with a variable viscosity for clinical use in saphenous veins with a very long half-life but rapid disintegration when exeeding junction levels. The difference is based on physical (not chemical) aspects. Due to this main feature, clinical application was feasible in a few selected cases, indicating effectivity levels equal to radiofrequency.
A controlled clinical multicenter study started in 2016.