About the Procedure of Sclerotherapy
Depending on the number of varicose veins you have, you may need 2 or 3 sessions of treatment, and occasionally more than this. The main surface vein to be treated will be marked on your leg initially using ultrasound scanning. A local anesthetic will then be injected into a small area of skin, usually in the lower thigh or mid-calf and a needle will be placed into the vein, again using ultrasound scanning.
This will be flushed with a salt solution containing heparin, a blood thinning agent, just to keep the needle open. Two or 3 smaller needles (called butterfly needles) will then be inserted into the visible varicose veins in the leg and these will be similarly flushed. Your leg will then be elevated above the couch and the foam solution will be injected in small volumes at a time into each of the needles. Whilst this is being done you will be asked to bend your ankle up and down in order to increase the blood flow in your deep veins.
You may experience some slight stinging as the foam is injected but it is usually painless. The passage of the foam in the vein will be monitored by ultrasound scanning and the foam injections into each needle will be repeated 2 or 3 times.
Once enough foam has been injected, the needles will be removed and pieces of sponge, gauze or bubblewrap (compression pads) will be applied to your leg followed by a bandage to compress the treated veins. An elastic compression stocking will then be put on your leg, including the thigh with a waist attachment. This will feel tight but should not be so tight as to make your foot discolored or painful.
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Frequently Asked Questions
What is sclerotherapy?
Sclerotherapy or injection of varicose veins is a procedure designed to improve the appearance of your varicose veins. The veins are injected with a solution called a sclerosant which damages the internal lining of the vein and causes blood clotting within the vein.
In time, your own body will then destroy the vein and it will disappear. The solution normally used for this procedure is called sodium tetradecyl sulphate (STD) and is available in different concentrations depending on the size of the vein being treated.
What is foam sclerotherapy?
Normally STD is injected as a solution directly into the vein to be treated. Foam sclerotherapy involves making small volumes of the solution into foam by rapid mixing and agitation with a small volume of air. This can then be used to treat some of the larger underlying abnormal veins which would not normally be treated with conventional sclerotherapy.
This is performed under ultrasound control. The foam solution causes intense spasm of the vein and a greater volume can be injected without using too much of the STD solution.
Is foam better than conventional sclerotherapy?
The initial results with foam sclerotherapy are very promising and this method of treatment offers a possible alternative to surgery. However, it should be emphasized that this is a new treatment and at present, the long term results are not yet known and it’s not possible to say how this treatment compares in terms of results with conventional surgery or sclerotherapy.
What happens after treatment?
You should keep the compression pads, bandage, and stocking on continuously for 5 days. After this, you may remove the pads and bandage and then replace the stocking which should be worn for a further 7 days. During this 7 day period, you may remove the stocking to shower and you may remove it at night if you wish. If you find the stocking comfortable and wish to wear it for longer, this may be helpful. Please bring your stocking back with you to your next visit as it may be possible to reuse it if you have further injections.
You should do plenty of walking and may generally do most normal activities without any problem. If in doubt ask your doctor.
You can be active as usual after the treatment and do not need to avoid anything in particular. However, you should not drive on the day the procedure is performed, just in case you experience any visual disturbances
Will I need further treatment?
It is unlikely that all your varicose veins will improve after one set of injections and you may need several treatments. You will be seen again in a few weeks’ time and further injections can be performed at that stage. Some of the untreated veins may have shrunk at that stage.
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