Sclerotherapy is the treatment of unsightly surface vessels or veins, known as spider veins or thread veins, sunburst or starburst vessels, telangiectatic vessels or unwanted leg veins. The Sclerotherapy treatment involves the injection of special sclerosing agents into the vein, followed by compression with the application of compression bandages and stockings. Thread veins, spider veins, can be successfully treated by sclerotherapy.
How costly is sclerotherapy and will insurance pay ?
The cost of sclerotherapy treatment varies and is directly related to the amount of time the physician must spend at each session. Although, this procedure is covered by many insurance plans, patients should check with their insurance companies to determine if Sclerotherapy is included in their coverage.
When should I have sclerotherapy?
Sclerotherapy is used to shrink certain types of vascular malformations, especially venous malformations. It is also used to thrombose and shrink varicose veins and, in conjunction with other treatment techniques, arteriovenous malformations.
Is it safe? Will it hurt?
Sclerotherapy is very effective for treating large areas and people can return to work the same day. A few treatments may be required before all the surface veins disappear. The treated veins may look worse for a few weeks before fading away. So it is best to have the treatments done a few months before a long planned holiday or other special occasion.
What are the possible complications if I do not have sclerotherapy performed?
In cases of large varicose veins (greater than 3 to 4 mm in diameter), spontaneous phlebitis and / or thrombosis may occur with the associated risk of possible pulmonary emboli. Additionally, large skin ulcerations may develop in the ankle region of patients with long-standing varicose veins with underlying venous insufficiency. Rarely these ulcers may hemorrhage or become cancerous
Are the results permanent?
Veins eliminated by sclerotherapy do not return. Sclerotherapy does not, however, prevent the formation of new spider veins. Most patients will slowly develop new spider veins over time. This should not be mistaken as a return of the original spider vein.
Are there other types of procedures to treat varicose veins and telangiectasias?
New lasers are being developed to treat spider veins but the current research shows that the laser treatments are more expensive and less effective than sclerotherapy. Ambulatory phlebectomy is a procedure in which certain types of veins can be removed through small surgical incisions. The complications of this procedure are similar to those of sclerotherapy with the addition of small surgical scars that naturally occur with this procedure.
Vein stripping and or ligation, performed by a vascular surgeon, may also be used to treat large varicose veins. This procedure may require a hospital stay and usually is performed while the patient is under general anesthesia. Risks of vein stripping and / or ligation include permanent nerve paralysis in a small percentage of patients, possible pulmonary emboli, infection, and permanent scarring. General anesthesia has some associated serious risks, including the possibility of paralysis, brain damage, and death.
How does this technique work?
Drugs used for sclerotherapy include alcohol and sodium tetradecyl. These drugs act by producing blood clotting within the malformation and also by damaging the cells which line these blood vessels. The desired effect is that, as the blood clot is absorbed by the body, it will be replaced by scar tissue, hardening the malformation so that it no longer fills with blood or other fluid. The body has natural mechanisms for dissolving blood clots, so some recurrence of a malformation frequently occurs. Because of this, sclerotherapy is usually performed as a series of staged procedures.
How will I learn the results?
The process of healing after sclerotherapy usually takes several weeks to a few months. Initially, the treated area will be more swollen and discolored than prior to treatment. The swelling diminishes over the initial 24 to 48 hours, but the blood clots created by the injections are absorbed more gradually, taking several weeks to two months. Initially, the skin overlying the malformation may be discolored, often purple or red. This discoloration fades gradually.
History
In 1925, Jausion used glycerin to try to treat varicosities. Since then many different agents have been used, including hypertonic saline, dextroject, sodium tetradecylsulphate, hydroxypolyethoxydodecane
Effective
The number of sessions required will depend upon the extent of the thread veins existing prior to treatment
Scientifically proven
Clinically proven over many years and in many countries, Sclerotherapy, when carried out by a trained and medically qualified practitioner is indicated as a safe treatment for removal of thread veins.
Does sclerotherapy work for everyone?
The majority of persons who have sclerotherapy performed will be cleared or at least see good improvement.
Is the procedure painful?
Most patients tolerate sclerotherapy and are surprised that the injections are essentially painless. A small pinch or "mosquitoe bite" is felt, but that is usually it. Occasionally, a mild burning sensation is felt after the injection, but this is mild and subsides quickly.
How many treatments will I need?
The number of treatments needed to clear or improve the condition differs from patient to patient, depending on the extent of varicose and spider veins present. One to six or more treatments may be needed; the average is three to four. Individual veins usually require one to three treatments
Can spider veins be prevented ?
Scientists have not discovered any clear cut methods to prevent the onset of these telangiectasias. However, some authorities have discovered that use of support hose, weight control and exercise may be beneficial
What is the procedure like?
Sclerotherapy is performed as an outpatient procedure in our office. The skin is cleansed with alcohol and the injections are performed. Most treatments require about 15 minutes. A bandage and compression hose will be placed over your legs. The support hose are worn for 5-10 days. Walking and moderate exercise are encouraged for most patients. Discomfort during this period is minimal. Mild bruising may be seen around the treatment sites.
What are the most common side effects?
The most common side effects experienced with sclerotherapy treatment include the following:
Itching: Depending on the type of solution used, you may experience mild itching along the vein route. This itching normally lasts 1 to 2 hours but may persist for a day or so.
Transient Hyperpigmentation: Approximately 10% of patients who undergo sclerotherapy notice discoloration (light brown streaks) after treatment. In almost every patient the veins become darker immediately after procedure. This darkening usually resolves in 10 to 14 days. In rare instances this darkening of the vein persists for 4 to 12 months.
Sloughing: Sloughing occurs in less than 1% of the patients who receive sclerotherapy. Sloughing consists of a small ulceration at the injection site that heals slowly over 1 to 2 months. A blister may form, open, and become ulcerated. The scar that follows should return to a normal color. This occurrence usually represents injection into or near a small artery and is not preventable.
Allergic reactions: Very rarely a patient may have an allergic reaction to the sclerosing agent used. The risk of an allergic reaction is greater in patients who have a history of allergies.
Pain: A few patients experience moderated to severe pain and some bruising, usually at the site of the injection. The veins may be tender to the touch after treatment, and an uncomfortable sensation may run along the vein route. This pain is usually temporary, in most cases lasting 1 to at most 7 days.
Telangiectatic matting: This refers to the development of new tiny blood vessels in the foot or ankle. It usually resolves in a few days and is lessened by wearing the prescribed support stockings.
Ankle swelling: Ankle swelling may occur after treatment of blood vessels in the foot or ankle. It usually resolves in a few days and is lessened by wearing the prescribed support stockings.
Phlebitis: Phlebitis is a very rare complication, seen in approximately 1 out of every 1000 patients treated for varicose veins greater than 3 to 4 mm in diameter. The possible dangers of phlebitis include the possibility if a pulmonary embolus (a blood clot to the lungs) and postphlebitis syndrome, in which the blood clot is not carried out of the legs, resulting in permanent swelling
