Sclerotherapy

A sclerotherapy procedure is a relatively simple one that involves the injection of a special liquid into problem veins. This causes the vein to scar or clot which in turn, causes blood flow to reroute itself down healthier veins. Sclerotherapy procedures for the aesthetic reduction of varicose veins are usually the shortest, while treatment for CVI may involve injections into a number of different veins.

How Does Sclerotherapy Work?

Here’s a breakdown of a sclerotherapy procedure.

1. Your doctor will conduct an initial consultation during which they will take a full and comprehensive medical history including the results of any previous similar treatments. They will also perform a physical exam and evaluate the state of the veins involved. It is possible that your doctor may recommend ultrasound imaging of your legs to get a better understanding of the condition and structure of your veins. Ultrasound-guided sclerotherapy is a relatively new innovation that enables your doctor to locate and treat veins that are not visible through the surface of your skin. For this reason, the ultrasound guided procedure is normally not recommended if you are having sclerotherapy for cosmetic reasons.

2. Sclerotherapy is an outpatient procedure that is usually carried out without the aid of anaesthesia. However, although no anaesthetic is applied before the procedure some solutions do incorporate a mild anaesthetic to alleviate discomfort during and after the injection.

3. In order to start the procedure, your doctor will get you to lie on your back and elevate your legs. Preparation is similar to any other needle injection, with the area first being treated with alcohol before a very thin needle is inserted into the vein that is being targeted.

4. The liquid is then inserted into the vein. This solution is designed to irritate the vein and force it to swell. This shuts off the blood flow and redirects it into other veins.

5. You may experience some mild discomfort directly after the injection including a mild stinging or minor cramps.

6. Once the solution is inserted, the needle is withdrawn and the doctor will massage the area to disperse blood flow and the solution itself.

Are There Different Types of Sclerotherapy?

While the structure of a sclerotherapy procedure always remains essentially the same, there are two main types of solution used. Which one is applied will depend on your own unique medical circumstances.

• Liquid sclerotherapy: This is the standard sclerotherapy procedure, but a range of different solutions may be used depending on several factors such as allergies and reactivity. These solutions include detergents, salts and sugars. While this may sound a little strange, it is important to keep in mind that the goal of the therapy is to prompt an irritant response in the veins being targeted, so solutions that can promote such a reaction without collateral damage are employed. Sclerotherapy procedures have been carried out since 1930 and hence all solutions used in them have a long track record of success and are very safe.

• Foam sclerotherapy: The second and less-commonly used form of sclerotherapy involves the use of a solution which is known as 'flam sclerosant', which is mixed with CO2 and air via the syringe to maximize the effect of the sclerosant within the vein. It works by displacing more blood within the targeted vein and allowing for a more complete contact between the solution and the venous lining. This form of treatment is generally recommended if you are targeting larger and longer varicose veins.

What Should I Expect?

Sclerotherapy is considered to be a fairly safe procedure and significant complications are rare. Common temporary side effects include bruising, minor skin sores and darkened skin as well as the possible appearance of tiny blood vessels. The vast majority of these will clear in a few days or at least a few weeks. However, some of these effects can take much longer to clear up entirely, ranging from several months to several years.

Though major complications are rare, there are some potential risks which cause symptoms that should never be ignored. If a blood clot forms, it may require a follow-up visit in order to be drained. This is normally not a big problem, however, if your clot travels to a deeper vein, it can cause a condition known as deep vein thrombosis (DVT). Though it is very rare, DVT can lead to a pulmonary embolism which requires emergency treatment. If you find blood on your hand after coughing, experience chest pain, feel dizzy or have trouble breathing, you should contact a medical professional immediately.

Small air bubbles in the bloodstream can also cause a range of minor disturbances including nausea and visual problems. These will normally resolve themselves within a short period, but any problems with leg and arm movement should not be ignored.

Post-Surgery Results

The full benefits of a cosmetic sclerotherapy may take as much as six weeks to be completely apparent. Larger veins however can take much longer to fade. Your doctor will carry out follow-up checks to see if further treatments are required, but there generally needs to be a minimum six weeks waiting period between each procedure.