Sclerotherapy of varicose veins



Refers to a procedure used to treat blood vessels or blood vessel malformations and also those of the lymphatic system.

The procedure involves injecting a medication into the vessels, which makes them shrink.

It is used for children and young adults with vascular or lymphatic malformations.

In adults, sclerotherapy is often used to treat spider veins, smaller varicose veins, hemorrhoids and hydroceles.

In ultrasound-guided sclerotherapy, an ultrasound is used to visualize the underlying vein so the physician can deliver and monitor the injection.

Modern techniques including ultrasonographic guidance and foam sclerotherapy.

Injecting veins with a sclerosing solution causes the target vein to shrink, and then dissolve over a period of weeks as the body naturally absorbs the treated vein.

A non-invasive procedure that takes only about 10 minutes to perform.

Downtime is minimal, in comparison to an invasive varicose vein surgery.

It is pref2242ed over laser for eliminating large spider veins and smaller varicose leg veins.

A sclerosing solution closes the feeder veins under the skin that are causing spider veins to form, thereby making a recurrence of the spider veins in the treated area less likely.

Injections of sclerosant are injected into the surface veins of the involved leg.

The leg is then compressed with either stockings or bandages that they wear usually for two weeks after treatment.

Patients are also encouraged to walk regularly during that time, and it may require at least two treatment sessions to significantly improve the appearance of their leg veins.

The procedure can also be performed using microfoam sclerosants under ultrasound guidance to treat larger varicose veins,

Foam sclerotherapy involves injecting foamed sclerosant drugs within a blood vessel using a pair of syringes – one with sclerosant in it and one with gas.

The sclerosant drugs (sodium tetradecyl sulfate or polidocanol) are mixed with air or carbon dioxide in a syringe or by using mechanical pumps.

Foam sclerosant drug is more efficacious than the liquid one in causing sclerosis, and is useful for treating longer and larger veins.

Sclerotherapy has greater benefits than surgery in the short term management of varicose veins, but surgery has greater benefits in the longer term.

Reviews indicate that sclerotherapy is better than surgery in terms of treatment success, complication rate and cost at one year, but surgery is better after five years.

Complications of sclerotherapy are rare.

Complications include: venous thromboembolism, visual disturbances, allergic reaction, thrombophlebitis, skin necrosis, and hyperpigmentation or a redness at the treatment area.

If the sclerosant is injected outside the vein, tissue necrosis and scarring can result.

Most complications are due to an inflammatory reaction to the sclerotherapy agent in the area surrounding the injected vein.

Systemic complications may occur when the sclerosant travels through the veins to the heart, lung and brain.

Foam sclerotherapy associated with neurologic symptoms such as scotomas, migraine, and stroke in 2% of patients.

Foam induced microembolism to the lung a common complication.

Foam sclerotherapy may result in neurologic complications in patients with patent foramen ovale and right to left shunts.

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