Common homemade sclerofoams lose their effectiveness as the vein diameter increases. The foam will float on blood, distributing in uncontrolled patterns, requiring several injection sessions. 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 is known from the newly approved ‘Varithena’ microfoam (BTG), this method does not solve the problem of low foam viscosity, short half-life and suboptimal clinical effects.
Currently we are developing a completely different sclerofoam with a variable viscosity for clinical use in saphenous veins with a very long half-life but rapid disintegration when exceeding 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 effectiveness levels equal to radiofrequency.
A controlled clinical multicenter study started in 2016.