Endovenous chemical (and physical) treatments for varices: what's new?

The constant evolution of endo-venous ablative techniques for varicose veins arises from the need for: better patient's comfort, reduced incidence of side effects, better results at short-, mid- and long-term follow-up, as well as reduction of operating time and technical simplicity. All these goals have been aimed at but so far no new technology has been able to achieve them all or to demonstrate it, furthermore the increase of price must be compensated by a considerable improvement of results and a serious reduction of side effects to be incrementally cost effective. We present in this article several recent evolutions of sclerotherapy (chemical ablation). New technologies include: proprietary ready-made foam (Varithena®) foam sclerotherapy with catheter and tumescence, foam + Holmium laser (LAFOS®), liquid sclerosant with rotating wire (clarivein®), liquid sclerosant + endo-venous clip (V-Block®) and endovenous cyano-acrylate glue (Venaseal™).