Sclerotherapy also known as ‘injection therapy’, is the gold standard treatment for spider and varicose veins on the legs.The principals of sclerotherapy involves injection of a mild chemical solution “sclerosant or irritant” into an unwanted vein which in turn results in collapse and closure of the unwanted vein. In the following weeks after the sclerotherapy treatment, the body’s own immune system recognizes the treated vein as a damaged vein and breaks it down and removes it from the body permanently. After the removal of the unwanted vein the blood is re-routed to another healthy vein, by which the normal venous circulation is reestablished.
What are the different types of chemical agents used during a Sclerotherapy session?
Saline sclerotherapy has been in use since 1926 and has been a popular sclerosant because it is a naturally occurring body substance with no toxicity. However, with the advent of all the new sclerosant chemicals available for sclerotherapy, saline has fallen out of favor due to its high side effect profile. Saline sclerotherapy has a higher rate of skin necrosis (skin Death and ulceration), temporary hemosiderin staining (area treated with sclerotherapy appears brown and stained by leakage of blood contents into the skin). Additionally, saline does not work well in treatment of larger varicose veins since it gets diluted easily by blood and becomes ineffective in larger veins; saline sclerotherapy is also very painful.
Foam sclerotherapy is a new form of delivering the sclerosing agent into varicose and feeder veins. The foam sclerotherapy is made by mixing air or Co2 with Sotradecol® or Asclera® solutions. A foam solution then is created which has the consistency of shaving cream. The Foam is very effective because since air is lighter than liquid it displaces blood within the vein, placing the sclerosing agent in direct contact with the vein wall without any dilution effects for an extended period of time. Additionally since the foam is visible via ultrasound imaging it can be easily tracked and guided to the source of the varicose vein problem.
We prefer glycerin sclerotherapy solution for the treatment of very small spider veins and broken capillaries. Since glycerin is a mild agent that only irritates the inner lining of spider veins, patients rarely develop any redness or bruising or any staining of the treated area.
4) Ultrasound-Guided Sclerotherapy
Using duplex ultrasound, doctors can guide a needle to the exact location of the vein (valve) to be injected. A foam solution is often used with this treatment to allow full visualization of the solution in the treated vein. The major advantage of ultrasound is that it enables visualization and injection of larger and deeper veins that once required more invasive surgical treatments.