Incidence of Side Effects Using Carbon Dioxide–Oxygen Foam for Chemical Ablation of Superficial Veins of the Lower Extremity

ObjectivesTo determine the incidence of side effects following treatment of varicose veins with carbon dioxide–oxygen (CO2/O2) foam sclerotherapy, and to compare results with historical controls using CO2- or air-based foams.DesignCohort study with prospective data collection, private clinic setting.PatientsThe patient population consisted of one hundred patients, 95% women, age 52 SD 13 years-old, CEAP class C2EpAsPr.MethodsPatients underwent ultrasound-guided foam sclerotherapy following thermal ablation of saphenous trunks; 1–3% polidocanol and 70%CO2–30%O2 gas were mixed in a 1:4 proportion. Volume injected averaged 22 SD 11 (range: 2–46) mL. Vital signs were monitored for 1 h; side effects were recorded up to 24 h post treatment. Incidence of side effects was compared to CO2- and air-based foam data.ResultsHeart rate decreased from 73 SD 11 at the start to 68 SD 9 bpm (p < 0.001, paired t-test) following the procedure. Systolic and diastolic pressures, 127/75 SD 18/14 mmHg, respiratory rate, 15 SD 4 rpm and pO2, 98 SD 2%, did not change significantly. Itching (7) or leg pain (24) reporting was similar to that for air-based foam (p = NS). Lack of reported chest tightness and/or dry cough was superior to our previous data with CO2 or air foam (p < 0.05). Reporting of dizziness (1) was less than that for air-based foam (p = 0.002). The incidence of visual disturbance (2%), was comparable with that for CO2 (3%) or air (8%) foam, but too few cases were available for meaningful statistical analysis.ConclusionsFoam sclerotherapy using CO2/O2 foam was well tolerated by patients and resulted in fewer side effects than similar treatment using air foams.