Ultrasound Guided Sclerotherapy

ULTRASOUND GUIDED SCLEROTHERAPY (UGS) is a modern technique for treating advanced varicose veins. UGS is a versatile procedure that can treat saphenous veins, perforating veins, and smaller tributary (branch) veins. It is often used in combination with other treatments such as endovenous laser treatment and standard sclerotherapy.

The duplex ultrasound precisely displays the abnormal veins, as well as adjacent structures such as deep veins and arteries.

The phlebologist injects the abnormal veins while observing the process on the ultrasound monitor. UGS is particularly useful in targeting abnormal vessels that are located deep and are therefore not visible. Once injected, the treated vessel will be absorbed by the body and disappear with time. A number of injections will be required along the length of the vein to achieve complete closure. Another significant advantage of this method is that it allows the phlebologist to monitor the effect of each injection, while ensuring the safety of all adjacent structures. The use of sclerosant as foam, rather than solution, has made this procedure much more effective.

The treatment may take up to half an hour. Following the procedure, patients are fitted with graduated compression stockings and asked to go for a 30–40 minute walk to promote blood flow in the deeper veins. 

Medical stockings are usually worn for up to 2 weeks after treatment and patients are advised to walk for 45 minutes a day. 

Side-effects of ultrasound guided sclerotherapy include 

  • Bruising which is temporary and resolves on its own within 2-3 weeks. No treatment is advised. 
  • Aches and pains in the leg occur frequently in the days after treatment. The discomfort is usually very mild and responds to simple analgesia such as Paracetamol or Ibuprofen.
  • More severe pain and redness is rare but can be caused by "phlebitis" which is inflamation along the treated vein. This usually responds quickly to prescription anti-inflammatories so all patients with more severe pain are advised to return to see your treating doctor so that the appropriate treatment can the prescribed. 
  • Trapped blood which feels like hardened lumps where the treated veins were. This is a temporary effect that always goes away over time. This can be hastened by letting out the blood at the followup appointments which our doctors routinely do. Letting out this blood also reduced the risk of getting post-sclerotherapy pigmentation. 
  • Post sclerotherapy pigmentation is an uncommon side effect that can take some months to go away. It presents as a discolouration along the line of the treated vein. It can be minimised by having blood let out of areas of trapped blood. It is extremely rare for this to persist for more than 12 months. 
  • Incomplete initial closure of the vein, which sometimes occurs. This is usually is managed by re-treatment  with ultrasound guided sclerotherapy which our doctors do usually at no charge.

Complications of ultrasound guided sclerotherapy are rare and include

  • Deep venous thrombosis which is a clot in the deep veins of the leg. This serious complication is very rare after sclerotherapy but can lead to clots in the lungs (Pulmonary Embolus) which can be life-threatening. 
  • Migraine and visual aura after treatment is rare and resolves quickly upon resting.
  • Allergic Reaction to the sclerosing agent occurs in 1 in 1000 cases and usually presents as an immedicate anaphylatic reaction. Our doctors are trained and have experience in the management of this reaction.
  • Intra-arterial injection is extemely rare and our doctors take great care to ensure that the needle is placed accurately within the targetted vein. 
  • A number of cases of stroke have been reported world-wide after sclerotherapy. 

 

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Before Treatment After Treatment