Middle cerebral air embolism after foam sclerotherapy

In the recent past, eight cases of transient ischaemic attack or cerebral vascular accident related to foam sclerotherapy have been reported. The following case is reported to add to the world clinical experience and raises the concern that foam sclerotherapy should continue to be evaluated and reported rigorously to establish the incidence of potentially devastating complications. While waiting for clinical studies to further establish best practice in this area of treatment, it may be in our patients' best interests to reserve the option of foaming sclerosants for selected rather than routine cases of venous insufficiency.