Sclerotherapy & It's Treatments

Varicose veins are permanently dilated veins through which blood circulates with difficulty, or not at all.

What causes varicose veins?  The major cause is heredity.  Pregnancy, heat and standing or sitting for lengthy periods of time are predisposing factors.

Varicose veins – an evolving disease:  Only by continuing and completing treatment can you control the evolution of venous disorders.  It is in your best interest to complete the full course of treatment prescribed and thereby safeguard the investment you have made in the health of your legs!

TREATMENT OF VARICOSE VEINS

Treatment Alternatives:

• Compression: Elastic stockings can be worn to compress the lower extremities and to stop swelling of the legs and formation of new varicose veins.


• Sclerotherapy: A sclerosing agent (Sotradecol, FDA approved drug for vein treatment) is injected into the non-working vein, backwashing the pooled blood.  The medication in the vein causes the incompetent vein to collapse, and wash through the system naturally.  Blood circulation is restored through normal veins.


• Ultrasound Guided Sclerotherapy (UGS): An extension of sclerotherapy using ultrasound technology to visualize an otherwise non-visible vein or vein junction.  Treatment consists of a series of injections using a duplex ultrasound to guide the placement of the sclerosing solution into the incompetent vein or abnormal vein junction.   This procedure is often an option to surgery.


• Ablation: Using ultrasound a tiny catheter is positioned into the diseased vein through a small opening in the skin.  The tiny catheter delivers heat to the vein wall.  As the thermal energy is delivered, the vein wall shrinks and the vein is sealed closed.  Once the diseased vein is closed, blood is re-routed to other healthy veins.  Incompetent veins that are not eliminated by this method can be followed by sclerotherapy.


• Phlebectomy: An effective procedure that provides much quicker symptom relief and cosmetic improvement.  The treated vein is removed surgically using local anesthetics in an outpatient setting.

BEFORE TREATMENT

• Varicose veins are treated from the thighs downward; large veins are injected before small varicosities.


• Your first treatment is administered primarily to test the medication and how you react.


• Pain tends to disappear and the cosmetic appearance of the legs usually improves after only three or fours sessions.


• Injections in the areas of the knees, ankles, and feet may cause edema (swelling).  Elevate legs to reduce swelling if this occurs.  Swelling usually rapidly disappears.


• Treatment can normally be performed during menstrual periods; however, slightly greater discomfort in the legs may occur.

DURING TREATMENT   ----- BRING A PAIR OF SHORTS AND STOCKINGS EACH VISIT!!!

Recommendations:

• Do Not apply oil or cream the day of your treatment, because the bandages will not stick properly.


• Do Not shave your legs within 24 hours of your treatment.


• Do Not take hot baths, whirlpools or massages during treatment.


• Do Not go into the sun for 48 hours after your treatment without sunscreen (SPF 15 or greater).


• Do continue your routine as usual with emphasis on exercise (walking, jogging, and cycling).


• Do wear elastic stockings when traveling by airplane during treatment and for prolonged periods of sitting or standing. (This is especially helpful if you have received treatment for varicose veins using ultrasound guided sclerotherapy).


• Bring compression stockings with you.  It is recommended that stockings be worn for 36 hours after treatment.  Compression stockings of 20-30 mmHg is recommended.  * ACE BANDAGES DO NOT PROVIDE EQUALLY DISPERSED COMPRESSION AND THEREFORE ARE NOT RECOMMENDED.

READ CAREFULLY

Side effects

• Bruises may be either small or very large.  They may occur frequently during treatment, and are not a cause for alarm and typically disappear within 3-4 weeks.  If you normally bruise easily, you will bruise with sclerotherapy.


• Tiny red spots may be caused by the injection of small varicosities; they typically disappear within 2-3 weeks.


• Tender red cords.  This is not phlebitis!  This occurs occasionally and is usually a temporary inflammation reduced through brisk walking and by applying warm, moist compresses.  Do not hesitate to call us if you are nevertheless concerned.


• Staining of the skin.  In rare instances, the skin remains a darker color in some areas and takes longer to regain its normal pigmentation; some spots may even be permanent.  It is always important, especially after the first treatment, to return for a check-up.  If an area has over-reacted, your prompt return can result in treatment and non-reoccurrence.


• If you develop a lumpy or bumpy feeling under the skin after you receive a treatment, or if the area becomes tender, apply a warm, moist compress to the site.  You must apply this compress every 2-3 hours for 10-15 minutes. TO MAKE A WARM MOIST COMPRESS:  Wet a washcloth or small towel with warm water.  Wring out and apply to site.


• Small telangiectasia (spider veins) may appear after injections of large veins.  The majority will disappear after 4-6 weeks and the remaining veins can always be treated.

RARE COMPLICATIONS

Allergic response to the sclerosing agent.  Despite the detailed questionnaire we ask you to complete, it is possible you are allergic to the sclerosing agent.  Rare complications range from a slight tingling sensation and/or red blotches on the skin, to anaphylactic reaction; this rare complication will bring a drop in blood pressure associated with other symptoms demanding further medical attention.

Rare cases of deep vein thrombosis and pulmonary embolus have been reported in medical literature.

There are also possible complications that may arise if the sclerosing agent is injected into the subcutaneous tissue, into a tiny arterial vessel, or a nerve, which can result in an ulcer, a scar or nerve damage.  Incidents are rare.

AFTER TREATMENT

• Walking, sports, and physical exercise after your treatment are encouraged.  Avoid using weight lifting machines for the legs using heavy weights.


• Wear elastic stockings that you put on before getting out of bed, particularly if you are on your feet for prolonged periods of time.  Wearing stockings is especially helpful if you have received treatment for varicose veins by ultrasound guided sclerotherapy (UGS).


• Watch your weight.


• If you are on your feet for prolonged periods of time, life your heels frequently and move your toes inside your shoes to activate circulation.


• When working in a standing position, wear shoes with 1” to 2” heels.  High heels impair venous pump action of the legs and feet.


• Avoid sunburns.  During and after your treatments, apply total protection sunscreen.


• Avoid wearing girdles or other tight fitting garments which impair circulation.


• Make an appointment every six (6) months to check for new varicose veins that can appear.


• Do not hesitate to call us for any problems you may wish to discuss.