Sclerotherapy

Sclerotherapy involves an injection of a small amount of liquid or foam sclerosant directly into the vein, inducing chemical inflammation, and then applying pressure so that the vein walls stick together. The vein can then no longer fill with blood and so it is obliterated. Sclerotherapy is a proven procedure that has been used worldwide.

Liquid sclerotherapy

The liquid chemical solution (we use sodium tetradecyl sulphateat (STS) at our center) is injected through a very fine needle directly into the vein and causes almost no pain. The procedure itself a few minutes long. The number of veins injected in one session depends on the size and location of the veins, as well as the general medical condition of the patient.

Liquid Sclerotherapy is a simple and safe procedure, that results in a fast recovery. This procedure can treat successfully over 90 percent of varicose veins and significantly reduces symptoms of pain and discomfort while improving the aesthetic of the treated area. Liquid Sclerotherapy is especially useful for spider veins and Reticular veins. In some patients, more than one session may be required for treatment, usually after an interval of 4 to 6 weeks.

One of the drawbacks of sclerotherapy is that it can cause skin pigmentation. Therefore, it is advisable to use low concentrations of the chemical liquid during treatment, although this may mean more treatment procedures. Liquid Sclerotherapy is not advisable for large varicose veins (greater than 2 mm in diameter) as the chances of reopening of the vein is higher.

Foam Sclerotherapy

To treat larger sized Varicose veins, the liquid sclerosant chemical is converted into a viscous, thick foam, by mixing it with either air or nitrogen. This foam is then injected into the varicose veins under ultrasound guidance, either directly with a needle and syringe, or via a catheter.

Since the foam is viscous, it stays in contact with the vein wall for a longer time, allowing the chemical sclerosant more time to act, and increasing the chances of the vein staying permanently closed. If used by experienced operators, foam sclerotherapy has very good results. However, it should be noted that the long-term chances of the vein reopening after foam sclerotherapy are much higher than the results obtained with Laser or RFA treatment. Therefore, the procedure may have to be repeated again after a few months.

Overall, sclerotherapy has very minimal side effects. However, if a large amount of sclerosant goes into the deep veins, it can potentially cause Deep Vein Thrombosis. Occasionally some patients can feel light-headed or a feeling of chest constriction for a few minutes after injection of foam. This is usually short-lasting. Some sclerosants like STS if injected by mistake into the skin or small artery can also cause skin ulcerations. But these are uncommon complications.