What is Varithena?

 

Let’s break it down. We use Varithena (polidocanol injectable foam) in sclerotherapy, a procedure that treats veins just below the skin's surface. With sclerotherapy, tiny needles provide access to the vein and then a substance called a sclerosing agent is injected into the vein's interior wall. This substance causes the vein to become sticky and seal shut, and the troublesome vein disappears. Blood then finds a healthy path back to the heart. Patients often experience an immediate relief of symptoms, and there is little risk of complication.

Varithena is the only FDA-approved foam sclerosant. Foam sclerotherapy has been used widely in the phlebology (vein specialty) community for more 15 years. The "Tessari method," the practice of adding a gas to a liquid to create bubbles, has been the most common technique for producing foam for use in sclerotherapy. This technique involves manually mixing a small volume of liquid sclerosant with a volume of room air or other gas using two syringes and a three-way tap, or stopcock. Preparations created this way are referred to as "physician-compounded foam," and they are illegal.

 

While physician-compounded, non-proprietary foam is inexpensive to make, medical experts caution that there are risks: there have been a number of published cases of air emboli (small bubbles of gas in the bloodstream) from so-called "homemade foam" leading to neurological events in patients, including migraines, vision changes, strokes, and death. No physician-compounded foam has been approved by the U.S. Food and Drug Administration.

 

Technically speaking

Varithena is a proprietary foam preparation that was approved by the FDA in 2013 after rigorous safety testing on thousands of people. It is a chemical foam solution indicated to close the Great Saphenous Vein (GSV) and related tributaries. It is a proprietary mixture of 1% polidocanol, 65% oxygen, 35% carbon dioxide, and less than .8% of nitrogen.

 

When a physician creates their own foam, they use room air, which can contain as much as 78% nitrogen. While oxygen and carbon dioxide are rapidly absorbed into the blood stream, nitrogen is very slowly absorbed, and those bubbles can persist and possibly cause a gas embolism and obstruct an important blood vessel. In comparison, Varithena has extremely low nitrogen.

 

Varithena's primary safety feature is the consistency of its bubbles: each one is between 100-500 microns, with uniform density and stability. The standardized compound is much more predictable for vein doctors to use on their patients and there have been no strokes or air embolisms associated with Varithena treatment.

 

If you have questions about Varithena, sclerotherapy, or other vein treatments, please contact us at the Vein Healthcare Center!