Sclerotherapy has made a major evolution with the introduction of Microfoam. Traditional sclerotherapy causes damage to the lining of the vein, causing it to collapse and making the walls of the vein then stick together. The vein is then slowly reabsorbed and disappears. Foam Sclerotherapy works in the same way only it is much more efficient. Foam is made by adding air to a liquid sclerosant such as the detergent Polidocanol (Asclera). The liquid and the air are agitated to produce a foam mixture. The foam is then injected directly into the vein. Foam is not diluted like the conventional sclerosant, so much less is needed and it remains in the vein for a longer period of time. Foam also works better because it pushes the blood out of the vein and makes a better contact with the vein walls. This enables us to treat much larger veins with liquid Sclerotherapy.
Another advantage to using foam is that it is very echogenic, making it very easy to see on ultrasound. We can track the entire vein that has been treated. We also track the travel of the foam in a particular vein and stop the flow by applying pressure with the ultrasound probe, then flow can then be redirected if necessary. The selective treatment of veins with foam is more complete than with surgical removal or microphlebectomy.
Sclerotherapy, the gold standard of treatments, involves injecting veins with a safe solution that causes the body to absorb the vein without harming the rest of your body. The success of the treatments is dependent on many factors, including the solution used, the technique of the physician, the general health of the patient, and the anatomy of the particular vein. Tiny needles are used, and complications are extremely unusual. The treatment involves no significant limitations or downtime, and the patient may go immediately back to work following their appointment.
Cryotherapy delivers cold air onto the skin as Sclerotherapy injections are administered, making sclerotherapy an almost pain-free process. Our cryotherapy machine delivers short bursts of super-cooled air to numb the skin. The cold temperature is extremely effective as a topical numbing agent and also helps in reducing inflammation. This results in a more comfortable procedure, faster results and faster healing time.
Ultrasound Guided Sclerotherapy
Ultrasound guided sclerotherapy improves the safety, accuracy and efficacy when injecting large varicose veins. The ultrasound accurately maps the veins to be injected and helps guide the needle tip to the targeted vein. The sclerosing agent is then injected into the vein by continuous monitoring and also helps the phlebologist control the direction of the injection. Ultrasound guided sclerotherapy should only be performed by a phlebologist who has undergone specialized training, and is experienced in the procedure. We use micro foamed detergent type sclerosants for the procedure, such as polidocanol. UGS makes it possible to easily treat the large trunk veins that are left after an endovenous laser ablation. It is also very useful to treat the large complex varices that can develop after vein stripping. Varicose vein disease is ongoing and even after an endovenous ablation procedure, patients sooner or later will probably develop collateral veins UGS makes it possible to easily treat these reoccurrences, before they become more of a problem, like phlebitis, ulcers, or dermatitis. We like to see all of our patients yearly after they have been treated for chronic venous insufficiency. UGS makes it easy to treat a small varicose vein if any have developed.
Sclerotherapy vs. Laser when treating spider veins
Many laser centers offer laser treatment for spider veins, unfortunately laser treatment are not very effective for spider veins. With laser treatments it is impossible to get to the feeding veins that are actually causing the spider veins. There may also be a risk of burning the skin with laser treatment for spider veins.
If you are fortunate to have success with laser, they usually return because the underlying cause was not addressed. Laser are seldom as effective as injections for this reason. Sclerotherapy when performed properly is still the gold standard for treatment of spider veins. Successful treatment requires expertise in the art of sclerotherapy, the correct diagnosis and the correct treatment plan for the type and size of vein to be treated. Even small spider veins can sometimes be caused by underlying large veins that are incompetent. All sources of reflux should be ruled out by duplex ultrasound before proceeding with sclerotherapy even on small spider veins and webs. If not high failure rates can be expected and complications such as matting, hyperpigmentation and early recurrence can be expected.
If your doctor offers only laser therapy, be prepared for mediocre results.
Complications of Sclerotherapy
Sclerotherapy is an extremely safe and effective procedure when performed properly. As with any medical procedures complications can occur. I will review the most common and rare complications.
Allergic reactions are very rare complications of sclerotherapy, but can occur with the use of any sclerosant.