Colchester Veins

21st century treatment for varicose veins
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Treatment
Surgery
Laser Treatment
Radiofrequency
Sclerotherapy
Sclerotherapy

Liquid sclerotherapy


Liquid Sclerotherapy is the injection of a chemical called a sclerosant into a vein which damages the lining of the vein wall causing it to block off.  The concentration of sclerosant used depends upon the size of the vein. Commonly used sclerosants are Sodium Tetradecyl Sulphate (STS) and polidocanol. Injecting the sclerosant on its own is effective in treating smaller varicosities or thread veins (microsclerotherapy), but is not usually as effective in treating vein trunks or bigger varicosities.


Foam Sclerotherapy


Foam sclerotherapy is injection of the sclerosant which has been pre-mixed with air or another gas allowing it to spread more easily within the vein filling it more effectively. The vein trunks commonly giving rise to varicosities, amenable to treatment by foam sclerotherapy, are the long and short saphenous veins. This is a flexible technique since almost any vein can be injected, particularly recurrent varicose veins which are often too tortuous and twisted to be treated by laser or radiofrequency treatment. Often this technique is used to treat remaining varicosities after the vein trunk has been successfully treated by laser or radiofrequency techniques.


The advantage of foam sclerotherapy is that it can be done as an outpatient often allowing patients to go back to work the same day. The disadvantages are that often more than one treatment session is often needed to treat all the veins. This treatment often causes some skin staining and firm lumpiness of the veins. Although a safe treatment, the surgeon will counsel you about the possible side effects.

The procedure




The surgeon will mark the veins to be treated using an ultrasound scanner as above.



Local anaesthetic is given to freeze the skin and a “cannula” (a needle) put into the vein to be treated. Two or three cannulas are sometimes inserted to ensure that as many varicosities as possible are treated.  The leg is then elevated and the foam injected which can be seen travelling up the vein using the ultrasound

scanner.







During this time the patient is asked to exercise their ankle. After completing treatment the canulas are removed and a bandage wrapped around the leg over which a compression stocking is applied. You will be given specific instructions for removal of bandages etc. This procedure is not painful although some discomfort may be felt during insertion of cannulae. 




After the procedure


Normally after foam sclerotherapy bandages and stockings are worn for approximately 10 days, after which time bandages can be removed and stockings worn on their own for about a further 4 days. During this time walking is encouraged but avoiding vigorous exercise and gym workouts in the first couple of weeks is sensible.


Success of treatment


The vast majority of patients undergoing foam treatment have an improvement in both their symptoms and appearance of their varicose veins. In some patients treatment may not be successful particularly in very large veins. In these patients surgery or the other techniques may be more effective.

Side effects

As with any treatment side effects are possible. The surgeon will counsel you about these before treatment commences. Brown skin staining overlying the vein treated occurs in 10-20% of patients and will usually resolve over a few months.  The veins treated may turn lumpy and hard due to thrombo-phlebitis , this will usually resolve on its own although applying topical anti-inflammatory gel over the vein and/or tablets can help.


Rarer side effects are leakage of foam into the tissue which can damage the skin rarely resulting in an ulcer, deep vein thrombosis (DVT), a brief episode  of visual disturbance or weakness on one side of the body lasting a few seconds, a migraine attack or a cough.  Very rarely some patients may have an allergic reaction to the sclerosant.