SCLEROTHERAPY

SCLEROTHERAPY

Sclerotherapy is a procedure which is used to treat blood vessels or blood vessel malformations (vascular malformations) and also, those of the lymphatic system. A medicine is injected into the vessels, to make them shrink. This procedure is for children and adults, with vascular or lymphatic malformations. In adults, it is often used to treat spider veins, smaller varicose veins and hemmoroids.

Sclerotherapy is often done under ultrasound guidance after venous abnormalities have been diagnosed with duplex ultrasound.

Injecting the unwanted veins with a sclerosing solution, causes the target vein to immediately shrink and then dissolve over a period of weeks, as the body naturally absorbs the treated vein. Sclerotherapy is a non-invasive procedure, taking only about 10 minutes to perform. The downtime is minimal, in comparison to an invasive varicose vein surgery.

Sclerotherapy is the “gold standard” and is preferred over laser for eliminating large spider veins and smaller varicose leg veins.
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Please read the information below to make an informed decision of whether or not to have sclerotherapy performed. If you have questions or do not understand the potential risks, please do not hesitate to ask us.

What is Sclerotherapy?

Sclerotherapy is a popular method for eliminating varicose veins and superficial telangiectasia's ("spider veins") in which a solution called a "sclerosing agent" is injected into the veins.

Does Sclerotherapy work for everyone?

The majority of persons who have sclerotherapy will see good improvement, typically 50-70% improvement after a couple treatments. Unfortunately, there is no guarantee that it will be effective in every case. Approximately ten percent (10%) of veins treated do not disappear after six (6) treatments. In very rare instances, the patient's condition may become worse after sclerotherapy treatment.

How many treatments will I need?

The number of treatments needed to clear or improve the condition differs from patient to patient depending on the extents of varicose and spider veins present. Most patients will have two (2) to three (3) treatments but some will need more.

What are the most common side effects experienced with Sclerotherapy?

1.  Itching: Depending upon the type of solution used, you may experience mild itching along the vein route. This itching normally lasts one (1) to two (2) hours but may persist for a day or so.

2.  Transient Hyperpigmentation: Approximately ten percent (10%) of patients who undergo sclerotherapy notice a discoloration of light brown streaks after treatment. In almost every patient, the veins become darker immediately after the procedure. In rare instances, this darkening of the vein may persist for four (4) to twelve (12) months. Typically, 98% of cases with hyperpigmentation resolve after 1 year.

3.  Sloughing: Sloughing occurs in less than one percent (1%) of the patients who receive sclerotherapy. Sloughing consists of a small ulceration at the injection site, which heals slowly over one to two months. A blister may form, open and become ulcerated. The scar that follows should return to a normal color. This usually represents injection into or near a small artery and is not preventable.

4.  Allergic Reactions: Very rarely a patient may have an allergic reaction to the sclerosing agent used. The risk of an allergic reaction is greater in patients who have a history of allergies.

5.  Pain: Some patients may experience moderate to severe pain and some bruising, usually at the site of the injection. The veins may be tender to the touch after treatment and an uncomfortable sensation may run along the vein route. This pain is usually temporary, in most cases lasting one to at most seven days.

6.  Telangiectatic Matting: This term refers to the development of tiny new blood vessels in the treated area. This temporary phenomenon occurs two (2) to four (4) weeks after treatment and usually resolves within four (4) to six (6) months. It occurs in up to eighteen percent (18%) of women on estrogen therapy and in two percent (2%) to four percent (4%) of all patients.

7.  Ankle Swelling: Ankle swelling may occur after treatment of blood vessels in the foot or ankle. It usually resolves in a few days and is lessened by wearing the prescribed support stockings.

8.  Phlebitis: Phlebitis is a very rare complication seen in approximately one (1) out of every one thousand patients treated for varicose veins greater than three (3) to four (4) millimeters in diameter. The possible dangers of phlebitis include a pulmonary embolus or blood clot, which travels to the lungs and post-phlebitis syndrome, which can result in permanent swelling of the legs.

What are the possible complications if I do not have Sclerotherapy?

In cases of large varicose veins, greater than three (3) to four (4) mm in diameter, spontaneous phlebitis and/or thrombosis may occur with the associated risk of pulmonary emboli. Additionally, large skin ulcerations may develop in the ankle region of patients with long-standing varicose veins with underlying venous insufficiency. Rarely, these ulcers may hemorrhage or become cancerous.

Are there other procedures to treat varicose veins and telangiectasia's? What are their side effects?

Because varicose and telangiectatic leg veins are not life-threatening conditions, treatment is not mandatory in every patient. Some patients may get adequate relief of symptoms from wearing graduated support stockings. Ambulatory phlebectomy is a procedure where certain types of veins can be removed through small surgical incisions. The complications of this procedure are similar to sclerotherapy with the addition of small surgical scars.

Vein stripping and/or ligation may also be utilized to treat large varicose veins. This may require a hospital stay and is performed while the patient is under general anesthesia. Risks of vein stripping and/or ligation include permanent nerve paralysis in up to thirty percent (30%) of patients, possible pulmonary emboli, infection, and permanent scarring. General anesthesia has some associated serious risks as well.

What if I experience a problem after receiving sclerotherapy?

If you notice any type of adverse reaction, please call the office immediately.
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