Underutilization of Foam Sclerotherapy

In this episode, Dr. Chris Pittman joins Dr. Aaron Fritts to discuss the underutilization of foam sclerotherapy. Dr. Pittman tells us about how he started his vein treatment centers and about his upcoming reality TV show. We introduce the basics of foam sclerotherapy for varicose veins and how the procedure has been developed. Dr. Pittman shares some reasons why he thinks foam sclerotherapy is not as popular in the United States.

We review when to use the three types of sclerosants, hypertonic saline, sotradecol, and polidocanol as well as the difference between compounded and non-compounded sclerosants. Dr. Pittman tells us the best way to get foam sclerotherapy training. We discuss the four components for evaluating a patient who may have venous disease, and we explain how to do a hose trial and make the proper notes for insurance claims. We discuss the treatment process from when the patient arrives and some of the details of thermal ablation.

We discuss the importance of an effective treatment and why there should be at least two rounds of foam treatment. We explain some of the key points to discuss with patients to manage expectations prior to treatment. We discuss the fundamentals of foam sclerotherapy, what post-procedure follow-up looks like, and how long after to wear stockings after the treatment. We explain how the shift from fee-for-service to fee-for-value has changed some of the ways treatments are done.