Foam phlebectomy is a technique combining foam sclerotherapy and ambulatory into a single procedure. Combining both procedures into one offers many advantages over utilizing either procedure as a standalone technique. The advantages of foam phlebectomy are many and allows the treatment of most patients in a single session. Ambulatory phlebectomy is improved with the presence of foam as segments of vein missed with phlebectomy are adequately treated by the foam. The presence of foam in the veins allows the us of ultrasound to assist with guidance of the phlebectomy for segments of vein the prove difficult to find and remove. Sclerotherapy is improved as the tumescent anesthesia compresses the vein walls giving better foam contact with the vein wall. The foam is then easily removed during the phlebectomy which limits the amount of foam travels back to the heart. Additionally the need for microthrombecomy is reduced because residual veins are decompressed. Overall bleeding problems post phlebectomy are lower as well.
Current physiologic testing for ulcer perfusion may fail to identify patients with ischemia
Short distance claudication and rest pain secondary to thrombosed popliteal artery aneurysm treated endovasculary.
67 year old male, type1 diabetic, with painful ulceration at the tip of the second toe. Patient did not toe amputation.