Ultrasound Guided Sclerotherapy

Varicose Veins are a common condition. Modern technology means that there are now minimally invasive treatments for varicose veins which do not require incisions or general anaesthetic. In some cases, the varicose veins can be treated with ultrasound guided injection of a chemical which causes the varices to thrombose and their walls to adhere. This chemical is called a sclerosant. Not all cases are suitable for ultrasound guided sclerotherapy.

Planning for endovenous treatment usually requires an ultrasound. This determines which parts of the system are incompetent (refluxing) and causing the varicose veins. This allows a complete treatment to be planned.

The Ultrasound Guided Sclerotherapy treatment has two parts, both equally important.

The first part of the treatment involves treating the varicose veins and their feeding veins. The sclerosant is injected under ultrasound guidance to ensure it enters all the varicose veins and their feeding veins. This is done through a small needle and although several injections may be required, it does not cause significant discomfort. The sclerosant causes the varices to thrombose, and over a period of weeks (or months in the case of large veins), the body removes this so they are no longer visible.

The second component of the treatment commences immediately and involves compression. This is initially in the form of a compressive bandage and a compression stocking. In 3 days the compressive bandage is removed, but the compression stocking is used for a further 2-3 weeks. The compression helps the veins thrombose and importantly the walls to adhere so they cannot fill again and therefore cannot be seen. Thirty minutes of brisk walking is undertaken immediately after the procedure.

Check ultrasound scans will be arranged in the following weeks, and it may be necessary for further ‘touch-up’ injections of sclerosant in the following weeks to ensure a complete treatment. This is part of the package.

Complications are uncommon but can include allergy, infection, recurrence. There is a small risk (1-2%) of Deep Venous Thrombosis from the procedure, which requires the use of blood thinner for 3-6 months in some cases. There is a very rare complication of stroke from the sclerosant use reported in the literature.

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