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In-Office Minimally Invasive

Medically Reviewed By:

2026-09-07

Varithena® (Polidocanol Endovenous Microfoam)


Varithena® Foam Vein Treatment in Sarasota & Bradenton


A Vein Treatment That Reaches Where a Catheter Can’t.

Varithena® is a prepared medical foam used to close a diseased vein in the leg. It is made from polidocanol — the same medication used in traditional vein injections — but it is delivered as a controlled, uniform microfoam rather than a liquid. The foam fills the vein, moves the blood out of the way as it travels, and holds contact with the vein wall. The vein reacts, seals shut, and blood immediately reroutes into healthy veins nearby. Over the following months, your body absorbs the closed vein.

What makes foam different from the more familiar vein treatments is what it does not require. There is no laser and no radiofrequency heat. There is no tumescent anesthesia — the series of numbing injections placed along the entire length of the vein that heat-based treatments need to protect surrounding tissue. Varithena is delivered through a single small catheter or needle stick, in our office, under ultrasound guidance. Most patients walk out and return to their normal day.

At Vascular Wellness Institute, foam is one of several ways we can close a diseased vein, and it is not automatically the right one. Which method we recommend depends on what your ultrasound shows: how large the vein is, how deep it sits, how curved or branched it is, and how close it runs to a nerve. Foam is often our preference for veins that are twisted, branched, sitting just beneath the skin, or left over from a previous procedure — situations where a catheter cannot easily be threaded through and where heat carries more risk than benefit.

What Varithena Treats

  • Incompetent greater saphenous veins — the main superficial vein running up the inside of the leg
  • Incompetent accessory saphenous veins
  • Visible varicose veins arising from the greater saphenous vein system, both above and below the knee
  • Twisted or heavily branched veins that a catheter cannot pass through
  • Veins that have reopened or recurred after a previous vein procedure

Varithena is approved by the FDA for the treatment of incompetent greater saphenous veins, accessory saphenous veins, and visible varicosities of the greater saphenous vein system above and below the knee, where it improves both the symptoms of superficial venous incompetence and the appearance of visible varicose veins.

What to Expect

Your visit begins with an ultrasound to map the vein and confirm the plan. A small amount of local anesthetic numbs the single access point. Your physician then places a fine catheter or needle into the vein and injects the foam while watching it travel on the ultrasound screen — the foam is visible in real time, so its path and its stopping point are controlled throughout.

The treatment itself usually takes thirty to forty-five minutes, including preparation and imaging. Afterward, you will wear compression stockings and walk right away. Walking is not optional here — it is part of the treatment, because keeping blood moving through the deep veins is what protects you afterward. Your physician will tell you how long to wear compression and when to resume specific activities. Most patients are asked to avoid long periods of sitting or standing still, air travel, and strenuous exercise for a short period.

You may be asked to return for a follow-up ultrasound to confirm the vein has closed, depending on the vein treated. Visible surface veins usually continue to fade for several months, and some patients need a second session or a follow-up procedure to finish the job — that is normal and is planned for, not a sign that anything went wrong.

How Foam Compares to Heat-Based Treatment

Patients often ask whether foam is a lesser option than laser or radiofrequency. The evidence does not support that framing. A 2024 systematic review and meta-analysis comparing polidocanol microfoam against endovenous thermal ablation found no statistically significant difference between the two for vein closure. The same analysis confirmed that commercially prepared microfoam performs substantially better than foam mixed by hand in the office, which is a meaningful distinction and one reason we use the prepared product.

In 2026, an expert panel of the American Vein and Lymphatic Society reviewed the published evidence and concluded that saphenous vein closure rates and clinical outcomes with polidocanol microfoam are similar to those achieved with thermal ablation, and that foam has distinct advantages in specific situations — including reducing the risk of nerve injury that heat can cause when a vein runs close to a nerve.

The right procedure depends on your anatomy and the clinical goals you wish to achieve.

Anesthesia Type

Local

Typical Duration

30-45 minutes

Performed At

Office

Recovery Time

Same day — walking immediately, normal activity within 24 hours

Frequently Asked Questions

  • Is Varithena the same thing as the injections used for spider veins? +

    It is the same family of medication but a different treatment. Spider vein injections use a small amount of liquid solution in tiny surface veins. Varithena uses a prepared foam, delivered under ultrasound guidance, to close a large deep-lying vein that is the underlying source of the problem. Many patients need both — the foam to fix the cause, and surface injections afterward to clear what remains.

  • Does it hurt? +

    Most patients describe mild discomfort rather than pain. There is a small pinch when the access point is numbed, and some people feel a brief tightness or aching along the vein as the foam works. Because there are no numbing injections along the length of the leg, many patients find foam more comfortable than heat-based treatment. Soreness along the treated vein for a week or two afterward is common and responds to over-the-counter pain relievers.

  • How does Varithena compare to laser or radiofrequency ablation? +

    Published comparisons show similar vein closure rates and similar symptom improvement between microfoam and heat-based ablation. Foam has practical advantages for veins that are twisted, branched, very close to the skin, or running near a nerve. Heat-based treatment may be the better choice for a straight, accessible vein. Your ultrasound determines the recommendation, and your physician will explain why one was chosen over the other. At Vascular Wellness Institute, we offer both heat-based vein closure and microfoam.

  • Will insurance cover it? +

    Coverage depends on your plan and on whether the treatment is being done for medical reasons rather than appearance. Most plans, including Medicare, cover vein closure when there is documented reflux on ultrasound, symptoms such as pain, swelling, or skin changes, and usually a trial of compression stockings first. Our staff verifies your benefits and obtains any required prior authorization before you are scheduled, so you know where you stand before the day of treatment.

  • What are the risks? +

    Foam treatment has a well-established safety record, but no procedure is without risk. Reported side effects include bruising, tenderness along the treated vein, skin discoloration that usually fades, inflammation of a surface vein, and — less commonly — a blood clot in a deeper vein. Some patients report a brief visual disturbance or headache shortly after treatment. Your physician will review the complete list with you at your consultation and explain the specific precautions taken to reduce each risk.