Is sclerotherapy an effective method of treating varicose veins?
Is it necessary to wear compression stockings following the occlusion of limb small vessels?
How long should a patient avoid exposure to sun following sclerotherapy for spider veins?
What is the difference between sclerotherapy with foam and with injected solutions?
Our Clinic will answer all the difficult questions you may have.
Compression sclerotherapy (usually referred to as infiltration or injection) is a method comprising chemical obliteration of abnormal veins. Recently, this method has received great recognition among patients. Such procedure involves injection of sclerosing agent directly into the veins (or vein networks). Sclerosant may be administered as a solution or foam. It irritates vein endothelium and consequently triggers a cascade of processes which finally lead to the vessel fibrosis. For the smallest vessels (spider veins and reticular veins of small diameter), low concentration of solution is required while in case of larger changes (varicose veins) the highest concentrations of drugs are used accordingly to vein’s diameter and sinuosity. Several weeks (months) following the procedure, injected small vessels and veins fade gradually while a small proportion of them would completely disappear.
Sclerotherapy has a number of benefits. Thus, it is considered to be the most universal method of venous insufficiency treatment. Modifications of sclerotherapy offered by the Clinic of Phlebology-NASMED (microsclerotherapy, direct vision or ultrasound guided sclerotherapy using a needle with solution or foam, tumescent enhanced sclerotherapy and finally ultrasound guided and tumescent enhanced sclerotherapy using intravascular catheter with foam) allow for the usage of this technique in the treatment of venous insufficiency at nearly all its stages. It may be applied even in the most serious cases with an example being treatment of patients with venous lower leg ulcers.
Clinic of Phlebology-NASMED applies the highest standards of compression sclerotherapy. We perform a broad range of vein obliteration procedures using high-resolution ultrasound. It should be highlighted that the prices of procedures in the Clinic of Phlebology do not include the number of ampoules used (patient should give a special attention to this point).
Sclerotherapy is performed with success when the physician, who knows the principles of venous circulation, disconnects the network of abnormal vessels according to the areas involved in the pathological process as well as patient’s individual needs (different for each patient).
An attribute ‘compression’, added to the word sclerotherapy, is not used accidentally. Following the majority of procedures performed in our Clinic, it is required to wear compression garment. We offer the products of the highest quality. Furthermore, everyone can choose from the products of various colours, materials and models. We encourage you to check our offer in the COMPRESSION THERAPY department.
Nowadays, VenaSeal, i.e. ‘superglue’ treatment of abnormal venous trunks, is the only minimally invasive procedure of lower limbs varicose veins treatment which does not require compression in post-procedure period. Such procedure is a completely new method of non-thermal varicose vein occlusion worldwide. It comprises the intravascular administration of special medical adhesive using narrow catheter. Such procedure lasts 30-45 minutes. It is performed under controlled and precise conditions. Furthermore, it is performed in a manner which is not painful for the patient. It is also ultrasound guided. You will be given more information on this procedure in the VENASEAL tab.
If you decide to undergo sclerotherapy, you should be aware of certain inconveniencies and limitations associated with this method. Patient should be provided all the information by the physician. Of importance (equally important as the procedure itself) is also proper evaluation of patient’s eligibility for sclerotherapy by a specialist.
Below you will find a list of guidelines, important from practical perspective, which are of importance while selecting the centre in which sclerotherapy would be performed.
– Prior to each session of compression sclerotherapy (both sclerotherapy for spider veins as well as the largest varicose veins), it is required to perform Doppler ultrasound of lower limbs by a specialist who holds the most recent knowledge of the current methods of treatment, their specific character and limitations
– There are some contraindications to perform sclerotherapy (their list is presented below)
– In case of the largest changes on lower limbs (trunk varicose veins or those appearing in the region of their branches, large in diameter and of unfavourable appearance), long-term effectiveness of echosclerotherapy is rather limited, especially when a needle is used. (For the largest varicose veins an estimated percentage of unblocked veins is even more than 30%!)
– There are some regions on lower limbs for which elimination of spider veins is associated with high risk (e.g. region of ankle).
– Results of treatment are often visible following 2-6 sessions, which are performed at intervals of 2-5 weeks. It is usually dependent on proper selection of drugs, sclerotherapy method and, above all, knowledge of the principles of its performance.
– In the majority of cases, it is required to wear compression garment following sclerotheapy, mainly compression stockings, most preferably those of the 2nd compression class (specific indications are adjusted to the changes observed on limbs, type of procedure, season etc.)
– Sclerotherapy for small vessels (spider veins and venulectasias) is performed simultaneously with the elimination of microtelangiectasias using Veinwave system or adequate transdermal laser.
– Sclerotherapy (especially microsclerotherapy) should be most preferably performed in months where temperature is below 20-25 degrees; furthermore, no visits to hot countries should be planned within 2-4 weeks after the procedure.
– Sclerotherapy is also successfully applied (however rarely) to other regions of the body (e.g. region of perineum, dorsal surfaces of hands or to close subcutaneous veins of mammary glands); however, it should not be forgotten that adequate imaging tests (Doppler ultrasound, CT scan and MRI) are performed prior to the qualification to such procedures.
– Sclerotherapy which is performed incorrectly by inadequately experienced physician who does not know the principles of venous hemodynamics (rules of blood circulation in human body), may cause harm, even deteriorating the condition of lower limb or another injected area.
A list of typical compression sclerotherapy contraindications include:
– diagnosed allergies to injected obliterating agents
– long-term immobilization or physical disability
– acute deep or superficial venous thrombosis
– large limb swelling precluding from effective compression therapy
– severe local or systemic infections
– advanced arteriosclerosis of lower limbs (in case of such patients, VenaSeal is a method of choice)
– pregnancy
Following post-procedure period, patient should be informed of the necessity of regular visits, every several months. Compared to classic surgical methods, there is a number of benefits resulting from sclerotherapy (i.a. lack of skin incisions, inconsiderable pain, quick recovery to mobility, short duration of the procedure, low cost, minimal risk of nerve branches damage, low-level bruising). Therefore, it is worth to consider this method of treatment. You should ask the physician about it!
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