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ULTRASOUND GUIDED FOAM INJECTION SCLEROTHERAPY

Injection sclerotherapy is a well known treatment for the management of varicose veins. The term sclerotherapy arises from a chemical called sclerosant which is injected into the affected vein, and over a period of time causes the vein to collapse. This is the result of inflammation in the vein wall, which in turn destroys the vein making it less noticeable or even invisible.

Another way of injecting the sclerosant into the vein is by transforming the chemical from its liquid form to foam by mixing it up with air. Foam has various advantages such as requiring less chemical agent, thus making treatment safer. Also, the properties of the created foam enable much better contact with the vein wall. The result is that larger segments of affected veins can be treated with less amount of chemical solution.

The foam has the additional property of being detectable by ultrasound. It spreads evenly along the course of the affected vein under direct vision with an ultrasound machine. The use of the ultrasound enables the treating doctor to identify and minimise any adverse leaking of the foam to the deep veins, thus protecting the deep veins from this undesirable effect.

The treatment usually takes between 20-30 minutes. No anaesthesia is required and pain in 99% of the cases is completely absent. Return to daily activity is resumed after a 15min walk. The number of sessions needed depend upon the extent and the size of the varicose veins.

Following foam sclerotherapy there may be some itching and discolouration to the treated site. This should gradually fade. Following treatment you will be required to wear a compression dressing for around one to two weeks.

Foam sclerotherapy could cause in a small percentage of patients complications. Such complications can be allergy to the injected solution or a reaction that kills the skin locally. Either of these can cause a small inflamed area, leading to an ulcer that may rarely then lead to a permanent scar. Such permanent scars affect less that 1% of patients. Another uncommon complication is the development of deep vein thrombosis.

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© George Geroulakos 2002
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