Sclerotherapy is a procedure used to treat varicose veins.
Sclerotherapy is one method, along with surgery, radiofrequency and laser ablation, for treatment of varicose veins and venous malformations. In ultrasound-guided sclerotherapy, ultrasound is used to visualize the underlying vein so the physician can deliver and monitor the injection. Sclerotherapy is often done under ultrasound guidance after venous abnormalities have been diagnosed with duplex ultrasound. Sclerotherapy, under ultrasound guidance and using microfoam sclerosants, has been shown to be effective in controlling reflux from the sapheno-femoral and sapheno-popliteal junctions.
Foam sclerotherapy is a technique that involves injecting “foamed sclerosant drugs” within a blood vessel using a syringe. The sclerosant drugs (Sodium Tetradecyl Sulfate or polidocanol) are mixed with air or a physiological gas (carbon dioxide) in a syringe. This increases the surface area of the drug. The foam sclerosant drug is more efficacious than the liquid one in causing sclerosis (thickening of the vessel wall and sealing off the blood flow), for it does not mix with the blood in the vessel and, in fact, displaces it, thus avoiding dilution of the drug and causing maximal sclerosant action. It is therefore useful for longer and larger veins.
Risks and Complications in Sclerotherapy
Complications, while rare, include:
- Venous thromboembolism
- Visual disturbances
- Allergic reaction
- Skin necrosis
- Hyperpigmentation or a red treatment area
Most complications occur due to an intense inflammatory reaction to the sclerotherapy agent in the area surrounding the injected vein. Sclerotherapy is fully FDA approved in the USA.