Evaluation of published reports of foam sclerotherapy: what do we know conclusively?

Objectives: The aim was to evaluate the published literature to assess what is conclusively known about optimal technique and outcome for foam sclerotherapy. Methods: A literature search was performed for randomised controlled trials, meta-analyses and observational studies using appropriate statistical techniques with survival analysis for long-term outcome. Results: Foam is more effective than liquid for ultrasound-guided sclerotherapy. Both sclerosants commonly used are equally effective for sclerotherapy for small veins. Ultrasound signals appear in the systemic circulation in most patients after foam sclerotherapy but do not appear to be associated with serious complications. Conclusion: Little else is known about the optimal preparation of foamed sclerosants and the best technique for administering foam for sclerotherapy. Long-term studies are required to determine outcome for various techniques. There is an opportunity for many controlled trials to assess results.