Sclerotherapy

Injection sclerotherapy is an office procedure performed by our physician assistants
specially trained in sclerotherapy, under the supervision of the vascular surgeon. The
technique is effective in treating varicose veins of all sizes and has been in use for 50
years.

Patients choosing to have sclerotherapy are asked not to use any lotions or oils on the
area to be treated 48 hours prior to the scheduled procedure and to bring shorts to be
worn during the procedure. If the patient is on aspirin or Plavix, they are asked to stop
these medications one week prior to their procedure after getting approval to stop the
medications from their primary care physician.
The procedure is performed by injection of a polidocanol solution into the vein while
compressing the vein to empty it of blood. This solution is very irritating to the vein and
basically glues the two walls of the vein together, preventing it from filling back up with
blood. To work well, the pressure on the vein should be maintained continuously for at
least 48 hours and this is done by utilizing compression hose continuously during those
48 hours. The hose cannot be removed for 48 hours (even for bathing). After 48 hours,
the hose can be removed for bathing, and then re-applied after bathing, for another 10-14
days. Compression stockings may be substituted for the elastic bandages after the first 48
hours.

Discomfort at the injection site is considered minimal by most patients. The needles used
in sclerotherapy are very tiny, thinner than a strand of your hair. Tylenol 500-650mg or
is usually effective for pain relief.

Walking is encouraged after sclerotherapy, including the day of the procedure. If
swelling or increased discomfort occurs in the leg, elevation of the leg for one to two
hours several times a day may help. Remember to lie flat and elevate the ankle above the
level of your heart. If swelling or pains persist, despite leg elevation, call our office.
Upon removal of the stocking after 48 hours to shower, expect to see some bruising or
discoloration, and possibly some tender lumps. These are normal findings. Occasionally
some blistering of the skin is seen. Remember to reapply stockings after showering.

Risks of sclerotherapy include:
    Allergic reaction to solution-0.1 %
    Development of other varicose veins in the future-20%
    Brownish discoloration in area of injections-mild 10%, prominent 1-2%
    Skin sores which heal within several weeks-2%
    Phlebitis requiring hospitalization-0.1 %
    Persistence of certain varicose veins after injection-10-20%
    Poor cosmetic result-1-3%

The cost of cosmetic sclerotherapy is $500.00 per session with most patients needing one
to three sessions depending on the number of veins to be treated.