Sclerotherapy

Sclerotherapy and foam sclerotherapy (ultrasonography guided foam sclerotherapy) is a method in which a sclerosing solution of aethoxysclerol (lauromacrogol) is injected into varicose veins.

This solution will cause damage to the lining of the venous wall from the inside, gradually closing the translucency of the vein.  Vein damaged in this way becomes scar-like tissue, which causes the vein to disappear from the surface of the skin. Sclerotherapy is also used to remove minor spider or reticular varices.

Preparation

Before the procedure, you will undergo an interview and an USG examination with a vascular specialist who will evaluate whether you are a suitable candidate for therapy with this method. Important for the doctor is information about previous difficulties in similar procedures, about allergies, about past thromboses and embolic events, about pregnancy, about taking hormonal contraceptives or other medications.

Procedure 

Procedure takes place usually in a horizontal position, a sclerosing solution is injected into the veins through a fine needle. At this point, it is possible that you will feel a slight discomfort to a spasm of 1 to 2 minutes, especially if the substance is injected into a vein of a larger diameter. The duration of the procedure and the scope depend, of course, on the extent of the afected veins, the patient's condition, but also on the evaluation of the specialist, respectively, on the amount of substance administered.

Medication

It is necessary to inform the doctor about each drug taken before the procedure, as it is possible that some of them may negatively affect the result, possibly they could be a contraindication to performance, and then it is necessary to postpone the procedure. Do not rub the lower limbs before the procedure, and it is also necessary to shave the limb about 12-24 hours before the procedure, depends on the agreement with the surgeon.

Side effects

During the procedure, in rare cases, patients may experience transient visual disturbances in terms of minor clouds, headaches or metallic flavor in the mouth.

After the procedure, it is possible that you will feel itching, which lasts about 1 to 2 days. A reddened field may appear in the puncture area. These disappear within a few days. Bruises may also be present in the injection area and usually disappear within a few days or weeks.

Some veins of a larger diameter after the procedure can harden and shrivel for many weeks to months.

Brown streaks can appear during the course of veins, these tend to disappear within 3-6 months, but rarely they can persist for different lengths of time.

Neovascularization (the formation of new thin vessels) can take place at the site of sclerosing. It appears within days to weeks after the procedure, but should disappear after 3 to 12 months without the need for further intervention.

Should any of the following reactions occur, it is necessary to inform the doctor:

• extensive inflammation in or around the groin site
• sudden swelling of part or all of a limb
• extensive color changes along with a decrease in the temperature of the entire limb
• formation of minor ulcers at the injection site
• allergic reaction after administration of a sclerosing agent

Immediately after the procedure, walking with a compression stockings of the legs for about 30 minutes is necessary. Subsequently, you will also be able to go home in the car and perform normal daily activities. Walks are recommended during this time.

You will wear a compression bandage/stockings of higher compression class, according to the doctor's instructions usually for 2-4 weeks.

Within 48 hours of the performance, it is necessary to avoid:

• hot bath
  
• hot wrap
  
• whirlpools and saunas
  
• direct sunlight
  
• showers are allowed, but it is advisable to wash the injection sites only with soap and lukewarm water.
  

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