Sclerotherapy Vein Treatment
What Is Ultrasound-Assisted Sclerotherapy?
The designated procedure for treating purple surface veins (spider veins) and small varicose veins is sclerotherapy. A very small needle is used to inject liquid solutions into the unsightly veins. The solution creates inflammation along the inner lining of the vein wall resulting in closure of the injected vein. This works well for very small veins, but in larger veins the solution is diluted by the blood, so it is less effective. If the liquid is mixed with a gas, it can be converted to a foamy state. This new foamy solution has the consistency of shaving cream, and displaces the blood in larger veins, to allow better contact with the vein wall and more likely achievement of the intended effect. This technique is called “Foam Sclerotherapy.”
Larger veins or veins beneath the skin surface can often be more effectively treated by using an ultrasound machine to assist in directing placement of the needle into the vein designated for treatment. This is referred to as Ultrasound-Guided Sclerotherapy. This is usually done using foam, since the vein is larger.
Another advantage to foam solutions is that they are visible on ultrasound, thus ultrasound probe can be used to better distribute the solution and direct it into small veins beneath the surface that may be feeding the visible abnormal veins. The use of the ultrasound machine can be beneficial for threating veins, even when not using it to direct needle placement. I refer to the process of directing distribution of the foam into the veins as “Ultrasound Assisted Sclerotherapy. “ I developed this technique about 15 years ago, and find that it has been beneficial as a standalone procedure for treatment of spider veins.
Patients with spider veins often come to see us for a second opinion, after they have been told that they will require multiple saphenous ablation procedures before they can have their spider veins treated. Almost no one in Houston has performed saphenous ablations for longer than me, and that recommendation is not only false, it is contrary to the practice guidelines established by the American Venous Forum and the Society for Vascular Surgery, the two most authoritative organizations when it comes to treatment of venous disease.
If you have noticed that the veins in your legs are becoming more visible, and want to know what can be done give us a call today at 713-461-4945, if you have concerns about being out in public during the pandemic ask about our “virtual consultation.”
Author: Dr. Michael Bardwil is a board-certified vascular surgeon in Houston, Texas.
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