Varicose veins - sclerotherapy
Sclerotherapy of varicose veins
Sclerotization, or hardening, is a procedure that is used in the treatment of varicose veins. Varicose veins are a very common disorder where the superficial veins especially in the legs swell. Consequently, the blood accumulates in the veins and flows less toward the heart. Varicose veins have the form of swellings on the skin that can be felt by palpation. Patients initially do not have significant symptoms, but later a feeling of heavy legs and pain mainly in the evening occurs. Most often, about 90%, the disease is inherited. Their formation is also promoted by prolonged standing, female sex hormones and pregnancy.
Methods of sclerotherapy of varicose veins
Methods of sclerotherapy are most commonly used to remove small varicose veins of the lower extremities, or in addition to other surgical procedures for varicose veins.
- The basis is to inject a special substance into the swelled veins. This substance causes minor inflammation in the vein, after which the venous wall is scared and sealed. This causes the blockage of the affected vein and its exclusion from the venous circulation. Its function is taken over by the surrounding veins. The procedure itself is virtually painless. Injection is performed using very thin needles for a single use.
- The procedure itself takes only a few minutes. After its completion the affected limb must be bandaged with a compression bandage for 48 hours and over the next three weeks compression stockings must be worn. This causes that the venous walls stay sealed and the blood flow is not restored.
- The advantage of sclerotherapy is that it burdens the patients minimally. It is performed outpatient, i.e. without hospitalization.
- Rare complications of surgery include bruising, changes in skin pigmentation or the formation of new veins in their vicinity. Although the procedure itself can look simple, it is always necessary to be performed by an experienced physician. Faulty injection of the sclerosing agents can cause severe damage to the skin and the subcutaneous tissue. When an insufficient quantity of the substance is injected the veins do not disappear and the treatment is ineffective.
- The correct choice of the sclerosing agents is also very important. The substance must be sufficiently aggressive so it irritates the inner wall of a vein, but must affect only in the desired location, and not influence other body functions. It is also necessary that the patient is not sensitive to the substance and that it does not cause an inappropriate reaction of the organism. The most commonly used substances are based on hydrocarbons, such as polidocanol.
Substances used for sclerotherapy of varicose veins
For sclerotherapy of varicose veins, the physician may use the substance in two forms, as a foam or as a liquid. Previously, the use of a liquid was common. It is now established that a foamy substance has several advantages. One of them is that the foam remains in the place of the operation much better than a fluid. This reduces the length of the procedure itself and also the amount of the sclerosing agents. When using a liquid it dilutes faster and is washed away from the site of surgery. In general, both types of drugs have their uses. The fluid is used more often for removing smaller blood vessels, while for larger varicose veins foam is preferable. Foam sclerotherapy is also friendlier to the surrounding blood vessels.
Contraindications of sclerotherapy of varicose veins
Contraindications are a set of circumstances which preclude the procedure. It is not appropriate to carry out the procedure during pregnancy, breast-feeding, if the patient has blood circulation disorders of the lower extremities or movement limitations and the patient is unable to put on compression stockings. Furthermore, this procedure is not performed if the patient has an allergy to the administered substance, when severe liver and renal malfunction, in bronchial asthma, cardiac insufficiency, venous inflammation or disorders in coagulation. Before sclerotization of the varicose veins it is necessary to stop taking certain medications, especially hormonal contraception in women.
Results of sclerotherapy of varicose veins
After sclerotherapy of varicose veins mainly a cosmetic improvement of the appearance of the lower extremities occurs. The veins disappear or fade out, but it is usually necessary for the desired outcome to perform this procedure several times. For the successful treatment, it is necessary to wear compression stockings to keep the venous walls stuck together and prevent re-flow of blood. But unfortunately, sclerotherapy can not prevent the formation of other varicose veins in the future. This depends mainly on the genetic weakening of the venous walls.