Ultrasound Guided Injection Sclerotherapy Dallas, TX
Sometimes the diseased veins are beneath the skin and not visible to the eye. In this case, ultrasound is used to guide a small needle tip into the vein and a sclerosing solution is injected to ablate or close the diseased vein. The solution injected chemically irritates the lining layer of the vein, causing the vein to collapse and scar, closing the vein. This procedure is especially helpful when the diseased vein is below the knee or tortuous (the course of the vein shows twists and turns), because these veins cannot be treated with laser or radiofrequency procedures. This minimally invasive treatment is very safe and can be done in our Texas office. It produces no disability other than the need to avoid strenuous physical activity for five to seven days.
Medical injection sclerotherapy is performed in our Texas office and generally takes only a few minutes for each vein treated. As with cosmetic sclerotherapy, the sclerosant solution is mixed with a small amount of air to create foam. The tiny microbubbles of the foam make the sclerosant more effective at lower concentrations. Two common sclerosants used are Polidocanol and Sotradecol. Both are weak detergents that attack the cells lining the vein producing spasm, inflammation, and scarring of the vein. This reaction “closes” or ablates the abnormal vein. The sclerosing solution is then quickly diluted and inactivated in the bloodstream. No anesthesia is needed, and most patients experience very little pain, similar to having venipuncture to remove blood for a laboratory test. Polidocanol and Sotradecol are both FDA approved for sclerotherapy and considered very safe when used for medical injection of diseased veins.
Recovery and Results
Following medical injection sclerotherapy, patients can return to work or other normal activities the same day. Exercise and strenuous activities should be avoided for 5-7 days following the injection. Compression stockings will need to be worn for several days after the procedure, though only during the day. Some patients may experience mild bruising and pigmentation after sclerotherapy. The pigmentation, often referred to as “staining,” occurs as a tan streak over the course of the treated vein due to the breakdown of blood trapped in the vein when it closes. This is more likely to occur if the vein treated is superficial, or close to the skin. Staining will usually resolve spontaneously, but sometimes will need to be treated with a small needle prick 2-4 weeks after the sclerotherapy session to remove the coagulum, or old trapped blood within the vein.
The inflammation associated with the treatment may be felt as tenderness and lumpiness for several weeks after the procedure. This is normal and expected and resolves within six to eight weeks. Occasionally, a “delayed reaction” will occur six to eight weeks after the sclerotherapy, probably related to the disintegration of the vein wall, which releases the old trapped blood into the surrounding tissue. This is very common and not dangerous. Ibuprofen or another anti-inflammatory drug is effective in this case. Usually the tenderness resolves in 7-10 days. Click here to see real Reeder Vein Institute patient's results.
Side Effects and Risks
Sclerotherapy is a safe procedure that has been used to treat diseased veins for many years. Mild discomfort may be associated with the inflammation of the veins treated with sclerotherapy. The occurrence of staining is also greater in superficial veins treated. The inflammation may also produce tenderness and small lumps beneath the skin surface. All of these reactions resolve with time and are effectively treated with anti-inflammatory analgesics such as ibuprofen. Although blood clots produced by sclerotherapy has been reported in some studies, the risk of this problem is very rare. At Reeder Vein Institute we have not seen a deep vein blood clot produced by a sclerotherapy treatment. However, it is important to walk briskly several times a day for the first day or two after a sclerotherapy injection. In addition, caution should be exercised in patients who have had a blood clot in the past. The staff at Reeder Vein will discuss these considerations in detail before treatment if ultrasound guided injection sclerotherapy is recommended for your vein disease.