Sclerotherapy is a procedure to treat vascular and lymphatic malformations; in adults, it can be used to treat varicose veins and hemorrhoids. It is done under ultrasound guidance, injecting a solution into the vessels to cause them to shrink. Sclerotherapy has actually been around for over a century to treat varicose veins. Everything you need to know—how it works, risks, and benefits—is right here in this article. Don’t take this in place of a doctor’s advice, but it’s a good place to start with some basic information.

Sclerotherapy: The Procedure
There are a couple different methods on how a sclerotherapy procedure to be performed; sclerotherapy is preferred over laser therapy any day by most physicians and patients.

Injection with a sclerosing solution. This causes the target vein to shrink as soon as the solution is inside. Over a period of a couple weeks, the vein will absorb the solution in a completely natural way. This solution also closes the veins that are making the spider veins (varicose veins), called feeder veins. The result is a less likely chance to have a recurrence of the spider veins. After the solution is injected, the legs are compressed with stockings or bandages for a couple weeks. Daily activities should be, and are recommended to be, continued, especially walking. It isn’t unusual for a patient to get two treatment sessions before significant results appear.

Microfoam sclerosants. This is used in conjunction with ultrasound guidance to treat larger varicose veins. The ultrasound guidance maps out the vessels and the whole procedure is monitored, injection and all. Once again, a follow up appointment is necessary with an ultrasound to determine if the vessels were closed off. The foam solution is made of foamed sclerosant drugs mixed with a gas to increase the surface area of the drug; it is injected into the vessel with a syringe.

Steps Before Surgery
Determining whether or not a sclerotherapy procedure will be performed will be decided in a consultation with a dermatologist or vein specialist. Those who are pregnant, bedridden, and most people who have had a blood clot previously won’t be considered. Also, if the vein could possibly be used in a surgical bypass procedure, such as the great saphenous vein in the leg, it will not be deemed eligible for sclerotherapy. Once it is decided that you will have the procedure, you will be advised to avoid certain medications, as determined by the physician. It is important to inform him or her of all the medications you are on. Avoid putting on lotion before the surgery. Also, some over-the-counter medications are usually recommended to be avoided 72 hours before surgery: Ibuprofen, Aspirin, Motrin, and others of that sort.

Risks and Side Effects of Sclerotherapy
While complications are rare with sclerotherapy, they can occur. Usually they are a result of an extreme inflammatory reaction. Possible side effects include: venous thromboembolism (sort of like a blood clot), visual disturbances, allergic reaction, thrombophlebitis (inflammation of the vein), skin necrosis (necrosis means death), and hyperpigmentation. Larger veins may become lumpy and hard and take months to dissolve. A side effect that is not necessarily serious is a red or raised spot on the injection site. Itching that can occur will be mild and should go away after about 2 days; bruising may appear but it is not serious either. Tiny veins may appear around the injection site, known as neovascularization; they should be gone in 3-12 months after the treatment.

Seek medical attention immediately if any of the following side effects occur: inflammation near the groin, a suddenly swollen leg, or the formation of small ulcers near the injection site.

Last updated on Jan 7th, 2011 and filed under Plastic Surgery. Both comments and pings are currently closed.

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