Successful Ultrasound Guided Foam Sclerotherapy; Hack to How Much Foam to Inject; The Spasm Test

How much foam should I inject? To abolish superficial venous reflux, getting the right amount of foam sclerosant of sufficient concentration into the vein is super important. So I turned to my colleague and friend, Enric Roche, for his thoughts and he told me about the spasm test. Haven't heard about the foam spasm test? Well, nor had I. So Enric made a video about it for me and it's such an elegantly simple trick, I'm going to share it with you. Thank you Enric for your permission to do so. So all vein experts agree that the hallmark of foam sclerotherapy success is intense spasm in the vein. Successful destruction of the endothelium causes contraction of the smooth muscle in the media of the vessel. If endothelial destruction is complete and of sufficient length along the vessel, the blood and the sclerosin is literally squeezed out of the vessel. Most experts advise watching for the typical appearance of the white dot on ultrasound caused by the small amount of echogenic foam left in the contracted vessel. But those new to foam sclerotherapy may be unsure how to interpret the ultrasound appearance. That's where the spasm test comes in. Enric describes a positive and negative spasm test. Injection of sufficient volume and strength of foam sclerosant will cause such intense spasm that gentle traction on the plunge of the syringe to produce suction will either withdraw nothing at all or at most only a small amount of white foam. However, a negative spasm test which is associated with insufficient endothelial destruction and little or no muscle spasm and contraction will withdraw blood or blood stained or pink foam. If the spasm test is negative, then the treatment is judged to be inadequate. Something has to be done. Remedial actions might be injection of more sclerosant, changing to a stronger strength of solution, or changes in the position of the leg. Put simply, if you can suck back blood or pink foam, You haven't done enough. It's such a simple trick, why not add it to your foam sclerotherapy practice? As always, check out the links below and please share or leave a comment to let me know that someone finds this useful. It really does help my channel. Thank you for watching. Find all my free guides here https://www.veincare.academy/freebies Stay informed by allowing me to send you my newsletter - no spam, just high quality content straight to you and you can reply directly into my personal inbox https://www.veincare.academy/subscribe-now Dr Enric Roche on LinkedIn https://www.linkedin.com/in/enric-roche-md-phd-4aa16a16/ Dr Haroun Gajraj on LinkedIn https://www.linkedin.com/in/dr-haroun-gajraj/ 👉 Check out these links 🔗🔗🔗 👀 👀 🔗 https://www.veincare.academy/bas-2025-annual-conference 🔗 https://www.veincare.academy/ 🔗 https://www.veincare.academy/freebies 🔗 https://www.veincare.academy/blog 🔗 https://www.veincare.academy/subscribe-now 🔗 https://www.veincare.academy/bas-2024-annual-conference-video-recording 🔗 https://www.veincare.academy/bas-2025-annual-conference 🔗 https://www.veincare.academy/free-guide-to-short-wave-diathermy 🔗 https://www.veincare.academy/free-guide-how-to-inject-leg-spider-veins-and-blue-veins-by-microsclerotherapy Free Guide on how to inject spider veins - https://www.veincare.academy/free-guide-how-to-inject-leg-spider-veins-and-blue-veins-by-microsclerotherapy Disclaimer: Health professionals should only provide treatments for which they have proper training and knowledge. This video serves only as a source of additional information to healthcare professionals and the public