Treatments – Sclerotherapy for Bulging Varicose Veins
Some vein treatment centers recommend visual or ultrasound guided sclerotherapy as an alternative to phlebectomy for bulging varicose veins. A more concentrated sclerosing solution than used for spider veins is injected into the bulging varicose veins scarring them closed. However, Dr. Harper prefers phlebectomy over visual or ultrasound guided sclerotherapy for primary bulging varicose veins. In our experience patients heal quicker with phlebectomy and achieve a better cosmetic result over the short and long term.
Dr. Harper does recommend ultrasound guide sclerotherapy for recurrent varicose veins often referred to as neo-vascularized veins since these recurrent varicose veins are not amenable to phlebectomy. Repeat treatments for these veins may be needed to achieve the desired results.
Some centers that recommend sclerotherapy for bulging varicose veins may not be trained or experienced in phlebectomy. Physicians with less experience may find it easier to inject the bulging varicose veins.
Patients who have received sclerotherapy elsewhere for bulging veins tell us they were unhappy with painful trapped blood in the bulging veins. Repeat visits for removal of the trapped blood may be necessary. Trapped blood and acute inflammation of the sclerosed vein can leave a discoloration that takes a number of months to resolve.
Your Sclerotherapy Treatment for Varicose Veins
Sclerotherapy for bulging varicose veins can be performed under visual guidance or ultrasound guidance. FDA approved sclerosing agents are used in a higher concentration than for spider veins. After placing a needle into the varicose veins the solution is injected. If the solution is agitated prior to injection a foam is created. The foam can be guided under ultrasound into the affected veins.
Pressure is applied to the treated vein segments followed by compression wrap or hose. The patient is encouraged to ambulate prior to discharge. A follow up visit is schedule in 5 to 7 days for an exam and duplex ultrasound if an endovenous procedure was performed in conjunction with the sclerotherapy.
What to Expect After Your Sclerotherapy for Varicose Veins
Use of graduated compression hose and ambulation are encouraged. If the patient sits they are asked to elevate their legs. Compression hose are worn until tenderness and any swelling has resolved. This may be several weeks. The use of compression speeds healing and improves response rates.
If trapped blood or tender nodules develop along the treated varicose veins this may be evacuated with a needle puncture along the vein segment. A local anesthetic may be used at these sites. Evacuation of the trapped blood relieves the local pain and lowers the risks of hyper-pigmentation of the overlying skin.
Additional treatments may be necessary to achieve the desired results.
Possible Side Effects
The side effects of sclerotherapy for bulging veins are similar to those for cosmetic spider vein sclerotherapy. These include: allergic reaction, swelling, bruising, trapped blood, hyper-pigmentation, superficial and deep vein thrombosis, pulmonary embolus, and transient neurologic findings. You should notify your provider immediately if you experience any of these symptoms including shortness or breath or chest pain.
Schedule a Consultation
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