Manuel Carbonell: Modern Phlebology Should Not Be a Competition of Devices and Technology
Manuel Carbonell, Director at the Center of Phlebology, shared a post on LinkedIn:
” ‘Sclerotherapy begins and ends phlebology.’
– John Bergan
Today I would like to share a clinical case that reflects something that is still often underestimated within our specialty:
Ultrasound-guided foam sclerotherapy: the ‘Cinderella’ of phlebology
Patient with chronic venous insufficiency treated with ultrasound-guided foam sclerotherapy using 5% polidocanol.
Technique:
- 5% polidocanol
- Total of 12cc of foam
- 6cc injected at 10 cm of the saphenofemoral junction
- 6cc injected at the distal third of the thigh
The post-treatment image corresponds to the first week follow-up.
Clinical evolution:
- No significant pain
- No need for anti-inflammatory medication
- Excellent tolerance
- Marked symptom reduction
- Very satisfied patient
At a time when so much attention is focused exclusively on thermal technologies and increasingly sophisticated devices, it is worth remembering that ultrasound-guided foam sclerotherapy remains, in experienced hands and with proper patient selection, an extraordinarily valuable tool.
Modern phlebology should not become a competition of devices and technology, but rather the art of choosing the right treatment for the right anatomy and the right patient.
Ultrasound-guided foam still offers important advantages:
- Minimally invasive
- Rapid recovery
- Very low post-procedural pain
- Repeatable when necessary
- Significantly lower costs
- Excellent tolerance in selected patients
Probably the ‘Cinderella’ of phlebology… yet often one of the most elegant and efficient tools we have.”

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