Sclerotherapy

Sclerotherapy, sometimes termed micro-sclerotherapy or direct-vision sclerotherapy, is the technique of injecting a sclerosing agent into abnormal veins using a fine needle. A number of sclerosing agents are available for this procedure. Once

injecting

injected into the vein, sclerosants irritate the inner vein lining, leading ultimately to vein closure. External compression with medical stockings is essential to achieving the best outcome. Successfully treated veins will fade as they are gradually removed by the body. In many patients, sclerotherapy can relieve the symptoms caused by varicose veins. With this procedure, veins can be dealt with at an earlier stage, helping to prevent further complications.

Some veins may need to be injected more than once for optimum results. Generally, normal activities can be resumed straight after sclerotherapy. 

The procedure is performed in the doctor´s office and usually causes minimum, transient discomfort. Sclerotherapy is considered the gold standard in treatment of spider veins of the legs. Laser treatment of "spider" leg veins has been shown to be less effective, more expensive and have greater rates of complications that sclerotherapy. 

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 15 minute walk to promote blood flow through the deeper veins. Patients are instructed to go for and additional 45 minute walk later in the day. 

Medical stockings are usually worn for 1- 2 weeks after treatment and patients are advised to walk for 45 minutes a day. 

 

Side-effects of 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. 

 

Complications of sclerotherapy are rare and include

  • Injection ulcers are skin ulcers that can appear in the weeks after treatment. They are usually small and heal over several weeks leaving minimal if any scarring.  

  • Deep venous thrombosis(DVT) 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.

  • A number of cases of stroke have been reported world-wide after sclerotherapy. 

Leg veins before treatment

After standard sclerotherapy

Before

 

After