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An
irritant (sclerosant)
is injected into the vein aiming to seal that vein.
This treatment is only used after the main superficial veins
prove to function normally with no reflux as confirmed by
ultrasound, or if they have been treated already. The
concentration used will vary according to the size of the vein
treated. This type of treatment is used for
spider veins and
surface varicose veins.
Improvement of
symptoms is usually appreciated
before cosmetic improvement. Sclerotherapy
sessions could take up to
2 years in some
patients. It is likely that you might develop new veins with time.
Treatment sessions are initially carried out at
3-4 weeks
intervals to allow enough time to evaluate the results
Contraindications:
Complications:
-
Brownish
pigmentation occurs in up to
30% of patients.
Spontaneous clearing within
6-12 months
is typical. Pigmentation occasionally persists longer than a year.
Discontinuing oral iron supplements for one week prior to injections
may help reduce that complication
-
If
the sclerosant leaks outside the vein,
skin
ulceration may occur
-
Allergic
reaction to the sclerosant occurs in about
0.3%
of patients
-
“Matting” or
“blushing”: these are tiny red veins that appear
following treatment in approximately 15% of patients.
The cause is unknown. It is possibly associated with
obesity, longer duration of spider veins and exposure to excess
estrogens. Although matting may be permanent, it
usually resolves spontaneously over several months. Areas of
matting may be treated with sclerotherapy or laser
-
Superficial
thrombophlebitis is painful tender veins affecting mainly
large veins. Treatment consists of compression,
ambulation and
anti-inflammatory drugs.
Drainage of a tender clot is sometimes required
Post-sclerotherapy:
-
If a
blood
clot forms and persists in the injected vein,
evacuation might be indicated to relieve the pain
-
Leg
ache
is common for several hours to days and may be
relieved
by walking,
cold compresses and
compression stockings
-
Mild localized
redness and
swelling is common and resolves with time
-
Post-sclerotherapy:
Do:
-
Ambulate
immediately
-
Instantly
wear
compression stockings (duration
varies according to the size of the treated veins)
-
Exercise
for 30-60 minutes daily (walking, riding bicycles and low-impact
aerobics)
Don't:
-
Heavy
lifting, resistance training, vigorous sports, jogging, or extreme
heat of saunas and spas for the first few weeks
-
Air travel
for at least 48 hours
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