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Sclerotherapy injection

What are varicose veins? 

Leg veins that become enlarged and twisted. This condition affects 3 in 10 people. They are often passed down through families but can be caused by pregnancy and spending a lot of time on your feet. Women tend to seek treatment for this condition more than men. Foam sclerotherapy is one treatment for varicose veins. It involves injecting a chemical into the veins. The following page will detail both the benefits and the risks of this treatment option.

How are varicose veins formed?

They are formed when blood flowing from the leg back up to the body begins to travel in the wrong direction as a result of weak vein walls. There are two types of leg vein – deep and superficial. Deep veins are found inside the muscles and superficial veins near the skin, at the surface of the leg. The superficial veins are the ones that create varicose veins. The calf muscles act as a pump to force blood up the leg and back into the body. The veins carrying the blood have one-way valves to stop the blood travelling backwards; however, if a superficial vein has a weak wall it can become enlarged and stop the valve from working. This causes the vein to build in pressure (see figure 1).

What does foam sclerotherapy do to help?

It helps to treat the affected veins and reduce the pressure. It cannot be used to remove the affected veins however and is therefore not a cosmetic procedure – ask your surgeon for details on the final outcome of a foam sclerotherapy procedure.

 

Figure 1
The cause of varicose veins. When the veins enlarge, the valves fail and blood flows backward.
Copyright © 2015 EIDO Healthcare Limited

 

What are the alternatives to foam sclerotherapy?

There are a few different choices for varicose vein treatment other than foam sclerotherapy:

  1. Varicose vein surgery, which removes the affected superficial vein from the deep vein. This is done from a cut made in the groin or behind the knee.
  2. Endovenous ablation, which treats the affected veins with the use of laser- or radio-frequency energy.
  3. Support stockings, which help to reduce the symptoms of varicose veins but does not treat them.

Talk to your surgeon for information on all treatment options.

Foam sclerotherapy – what happens without it?

Varicose veins do not often heal themselves so often require direct treatment. Foam sclerotherapy helps to directly treat the affected veins. If left untreated, the following may occur:

  • Infection in the skin (cellulitis)
  • Skin inflammation (phlebitis)
  • Visible varicose veins on the legs
  • Dark skin discolouration (pigmentation) on the ankle
  • Pain or aching
  • Varicose vein bleeding
  • Itching
  • Ulcers (these are not a side effect of all varicose veins)


The procedure

Local anaesthetic will be used as the procedure is only a few minutes long. You might be requested to lie back and lift the legs – this relieves blood pressure. The areas marked for injection will be wiped with anti-septic and once the area has been cleaned, catheters or needles will be inserted; an ultrasound scan will be used for guidance as they go in. The chemical used for treatment will be inserted via the catheter or needle and an ultrasound probe will be used to monitor the injections as they go in (see figure 2).

 

Figure 2
Foam sclerotherapy
Copyright © 2015 EIDO Healthcare Limited

The chemical used causes the vein walls stick together and then shrink. The catheters or needles will be removed and the injection sites will be dressed if it is needed. You may also have to wear a compression bandage or support stocking.

What is recovery like?

Patients can walk around and leave the hospital shortly after the procedure but are advised to avoid driving for 24hours and to check their insurance policy if they wish to drive after the procedure. You will probably be asked to return to the clinic for a check-up. Always follow the instructions of the healthcare team. Resume normal activities and exercise as soon as possible. When resting keep the leg elevated on a chair or stool. It is normal for legs to feel achy or swollen after the procedure. These symptoms will improve in time. Skin pigmentation may stay but will not get worse. Varicose veins can come back – sometimes in the same place, sometimes elsewhere (risk one in three in five years).

What lifestyle changes should I make?

To help reduce the risk of developing varicose veins do the following:

  • Stay a healthy weight
  • Exercise regularly
  • Stop smoking

Summary

Both men and women suffer from varicose veins – it is a common condition. It can cause complications if left untreated – there are different treatment options available; support stockings are the least invasive but they will not remove the varicose veins. Foam sclerotherapy is safe and effective and directly treats varicose veins.

 

References: EIDO Healthcare Limited - The operation and treatment information on this website is produced using information from EIDO Healthcare Ltd and is licensed by Aspen Healthcare.

The information should not replace advice that your relevant health professional would give you.

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