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Overview

 

What is Sclerotherapy of Varicose Veins and Spider Veins ?

Sclerotherapy is a minimally invasive treatment used to treat varicose and spider veins. The procedure involves the injection of a solution directly into the affected veins, causing them to shrink and eventually disappear.


What are some common uses of the procedure ?

Sclerotherapy is used to improve the cosmetic appearance of spider veins and to relieve some of the symptoms associated with spider veins, including aching, burning, swelling and night cramps. It is the primary treatment for small varicose veins in the legs.


How does the procedure work ?

When the sclerosing solution is injected directly into the spider or varicose veins, it irritates the lining of vein, which causes it to swell and stick together. Over time, the vessel turns into scar tissue that fades from view.


How is the procedure performed ?

This procedure is often done on an outpatient basis.

Using a very fine needle, your interventional radiologist will inject the vein-dissolving solution into the varicose and spider veins. As the procedure continues, you will feel small needle sticks and possibly a mild burning sensation. The number of veins treated in one session varies, and depends on the size and location of the veins.

The procedure is usually completed within 30 to 45 minutes.


What are the benefits vs. risks ?

Benefits


  • Each sclerotherapy session typically results in elimination of 50 to 80 percent of the injected veins.


Risks


  • Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
  • Risks include the formation of blood clots in the veins, severe inflammation, adverse allergic reactions to the sclerosing solution and skin injury that could leave a small but permanent scar.


Sclerotherapy procedures


In typical outpatient sclerotherapy treatment, the patient changes into a pair of shorts at the doctor's office and lies on an examination table. After cleansing the skin surface with an antiseptic, the doctor injects a sclerosing agent into the veins. This agent is eliminated when the skin is stretched tightly over the area with the other hand. The doctor first injects the larger veins in each area of the leg, then the smaller ones. In most cases, one injection is needed for every inch of spider vein; a typical treatment session will require five to 40 separate injections. No anesthetic is needed for sclerotherapy, although the patient may feel a mild stinging or burning sensation at the injection site.

The liquid sclerosing agents that are used most often to treat spider veins are polidocanol (aethoxysklerol), sodium tetradecyl sulfate, and saline solution at 11.7% concentration. Some practitioners prefer to use saline because it does not cause allergic reactions. The usual practice is to use the lowest concentration of the chemical that is still effective in closing the veins.

A newer type of sclerosing agent is a foam instead of a liquid chemical that is injected into the veins. The foam has several advantages: It makes better contact with the wall of the vein than a liquid sclerosing agent; it allows the use of smaller amounts of chemical; and its movement in the vein can be monitored on an ultrasound screen. Sclerosing foam has been shown to have a high success rate with a lower cost, and causes fewer major complications.

After all the veins in a specific area of the leg have been injected, the doctor covers the area with a cotton ball or pad and compression tape. The patient may be asked to wait in the office for 20–30 minutes after the first treatment session to ensure that there is no hypersensitivity to the sclerosing chemicals. Most sclerotherapy treatment sessions are short, lasting from 15 to 45 minutes.It is not unusual for patients to need a second treatment to completely eliminate the spider veins; however, it is necessary to wait four to six weeks between procedures.







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