Varicose Veins (cont.)
What is sclerotherapy?
"Sclerotherapy" uses a fine needle to inject a solution directly into the
vein. This solution irritates the lining of the vein, causing the vein to swell
and the blood to clot. The vein turns into scar tissue that may eventually fade
from view. Sclerotherapy is typically used for spider veins and varicose veins
that are less than 6 millimeters in length. This is generally offered to
patients who have tried compression stockings and leg elevation without much
success.
Today, the substances most commonly used in the United States for
sclerotherapy are hypertonic saline and sodium tetradecyl sulfate (Sotradecol).
Aethoxyskerol (Polidocanol) is undergoing FDA testing but has not yet been
approved in the U.S. for sclerotherapy. Sclerosing agent or solution is the
general term for the substances used for sclerotherapy.
In sclerotherapy, after the solution is injected, the vein's surrounding
tissue is generally wrapped in compression bandages for several days, causing
the vein walls to stick together. Patients whose legs have been treated are put
on walking regimens, which forces the blood to flow into other veins and
prevents the development of blood clots. This method and variations of it have
been used since the 1920's. In most cases, more than one treatment session will
be required.
Picture of Varicose Veins Being Treated with Sclerotherapy
Picture of Spider Veins Being Treated with Sclerotherapy
What are potential side effects and complications of sclerotherapy?
In about 10-%30% of patients treated with sclerotherapy, dark discoloration of
the injected area may occur (hyperpigmentation). This usually happens because of
disintegration of the red blood cells in the
treated blood vessel. In majority
of cases, this discoloration will completely go away within 6 months.
Another problem may be the formation of new spider veins near the area that
was treated with sclerotherapy. This can happen in about 20% of patients, but
these new vessels also typically disappear within 6 months.
More rare complications may include the formation of an ulcer around the
injection site and the formation of small blood clots in the small surface veins
(superficial thrombophlebitis).
Is sclerotherapy safe for everyone with varicose and spider veins?
Sclerotherapy is generally safe for most people for
treatment of varicose veins and spider veins. However, in certain groups of
people, sclerotherapy needs to be avoided, including non-ambulatory people
(those unable to walk). Other contraindications for sclerotherapy include
obesity, blood clots in the deeper veins, allergy to the sclerosing agent, pregnancy, and arterial
obstruction (blocked blood flow in the artery near the varicose vein).
Next: What surgical procedures are available to treat varicose veins? »
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