Sclerotherapy from professionalradiology.com.

Sclerotherapy

For questions or to schedule an appointment call, Cincinnati Cosmetic and Vein Specialists, 513-527-9999

What is sclerotherapy?
Sclerotherapy is a safe, proven and effective non-surgical procedure used to treat various sizes of veins. Sclerotherapy is a simple technique performed in the interventional radiologist’s office.In addition to offering obvious cosmetic results without scarring, sclerotherapy eliminates the burning, aching and discomfort often caused by varicose veins. With the availability of sclerotherapy, it is no longer necessary to strip varicose veins extensively, a technique resulting in multiple scars and a significant recurrence rate.

Who are the best candidates for sclerotherapy?
Women of any age may be good candidates for sclerotherapy, but most fall between 30 – 60 years old. In some women, spider veins may become noticeable in the teen years. For others, the veins may not become obvious until later in life or after child bearing. These long-term visible varicosities may actually be a sign that there are greater venous insufficiency issues that, if left untreated, could lead to swelling, pain, pigment change, or ultimately ulceration. Spider veins in men aren’t nearly as common as they are in women.

Men who do have spider veins often don’t consider them to be a cosmetic problem because the veins are usually concealed by hair growth on the leg. However, sclerotherapy is just as effective for men.

What is the sclerotherapy procedure like?
Prior to the procedure, you will have an initial consultation to determine if you are eligible for sclerotherapy. This includes an ultrasound of the veins to evaluate the full extent of the problem causing the spider veins. The doctor’s goal is to find the largest vein, which is likely at the root of the problem. This larger vein must be treated before sclerotherapy is performed. If the vein causing the problems is not treated first, other spider veins will appear after the sclerotherapy is complete.

During sclerotherapy, the patient will lie on a table. No sedation is required because there is not a significant amount of discomfort during this procedure. The doctor will make small injection of irritating solution into the vein, which causes the vein to close. The vein then disappears as it is absorbed by the body through the body’s natural healing mechanism.

After each sclerotherapy session, the veins will appear lighter. Two or more sessions are usually required to achieve optimal results. Patients also should be aware that the procedure treats only those veins that are currently visible; it does nothing to permanently alter the venous system or prevent new veins from surfacing in the future.

How long does the sclerotherapy procedure take?
This depends on the number of veins being treated. On average, the total procedure takes about 30 minutes to 1 hour. Each injection is extremely quick, lasting approximately 5 to 10 seconds.

How safe is sclerotherapy?
Complications from sclerotherapy are extremely rare when the procedure is performed by a qualified interventional radiologist. However, it is possible for complications to occur. Risks include the formation of blood clots in the veins, severe inflammation, adverse allergic reactions to the sclerosing solution and skin injury that could leave a small but permanent scar.

Are there any side effects of the sclerotherapy treatment?
A common cosmetic complication is an irregular coloring on the skin – brownish splotches on the affected skin that may take months to fade, sometimes up to a year. Another problem that can occur is fine, reddish blood vessels appearing around the treated area, which would require further injections.
You can reduce the risks associated with treatment by choosing a doctor who has adequate training in sclerotherapy and is well versed in the different types of sclerosing agents available.

How long do the effects of the sclerotherapy treatment last?
The effects of the treatment usually last six weeks for an average case of small vein disease and 8-9 weeks for larger varicose veins. Studies have shown that as many as 50-80% of injected veins may be eliminated with each session of sclerotherapy.

Less than 10% of the people who have sclerotherapy do not respond to the injections at all. In these instances, you should ask your doctor about other options. Although this procedure works for most patients, there are no guarantees for success.

Will I need repeat the sclerotherapy procedure to maintain or improve my look?
The affect of sclerotherapy lasts for approximately two years if the whole spectrum of venous insufficiency is thoroughly reviewed and treated appropriately. After two years, there may be some recurrence, but it usually is never as bad as the initial presentation. The veins that may return also can be treated with sclerotherapy.

Are there any other procedures for the treatment of spider veins?
If sclerotherapy is not successful for your situation, a procedure called stab phlebectomy may be another option. This is involves the use of a special local anesthetic that is injected into the area surrounding your vein. The doctor then removes the entire problem vein through a small incision.

Does my insurance provider cover this procedure?
A number of insurance companies are paying for vein procedures. For more information about this procedure or if you have insurance questions, please contact our nursing division at513-527-9999.

What are varicose veins?
Normally, veins in the leg return blood to the heart by the pumping action of the muscles when a person walks. One-way valves prevent reflux of blood back into the legs. Veins become less elastic and the valves can begin to malfunction. When this happens, the veins become distended and take on a ropy appearance that can be unsightly and cause pain, swelling, or itching. Standing and walking may become uncomfortable. Some of the causes of varicose veins are: age, heredity, pregnancy, and weight gain. Endovenous laser ablation may provide a solution to the problem.

What is endovenous laser ablation of varicose veins?
Endovenous laser ablation is a less invasive alternative to standard vein stripping for patients suffering from varicose veins. The procedure treats the vein(s) from the inside using heat energy from a laser source to seal the afflicted vein(s). Local anesthesia is all that is required.
Interventional radiologists perform this procedure on an outpatient basis and when compared with traditional surgical techniques, endovenous laser ablation is as effective, has fewer negative outcomes, and is associated with less pain during recovery. There are virtually no scars because catheter placement requires skin openings of only a few millimeters, not large incisions.

What happens during the procedure?
Unlike older, more invasive procedures that strip veins from the leg through the use of small incisions, endovenous laser ablation uses a catheter, or small tube, which is inserted through a small nick in the skin. Only local anesthesia is required.
The leg being treated will be sterilized and covered with a surgical drape. A local anesthetic will be administered to the site where the incision will be made, generally immediately above or below the knee. Let your doctor know if you have an allergy to anesthetics.
The procedure starts by advancing the catheter inside the vein up to the top of the leg. Anesthetic is injected along the vein(s) being treated. Energy is applied as the catheter is slowly withdrawn. This heats and seals the vein closed. By the time the heat energy is delivered, the vein will be numb and there should be no pain. Throughout the procedure, the radiologist guides the catheter using the external ultrasound wand positioned directly outside on the surface of the leg.

How long does the procedure take?
The procedure takes about 45 minutes to one hour right in your physician’s office.

What happens after the procedure?
A compression stocking must be worn after the procedure to help reduce bruising, tenderness, and the slim possibility of forming blood clots. Normal activity can be resumed, with the exception of lifting heavy objects or prolonged sitting (for instance a long plane or bus trip).
Four weeks after endovenous laser ablation, the radiologist will follow up using ultrasound to ensure that the procedure was successful at treating the vein(s) in the leg. Minor additional procedures to treat associated veins may be necessary.

How long do the effects of treatment last?
In clinical trials, laser treatment has proved to be 97% effective. Therefore, you should experience no recurrence in the veins that have been treated. However, you may want to have follow-up procedures to obtain the best cosmetic results.

How safe is endovenous laser ablation treatment?
Medical lasers work by delivering light energy to the targeted tissue with extreme precision so as not to harm the surrounding tissue. Lasers are proven to be safe and effective for treating many health issues. In the hands of a skilled physician, lasers offer far less risk and complications than conventional surgery.
Endovenous laser ablation is generally a complication-free and safe procedure. Most patients report their symptoms are greatly reduced after the varicose veins are treated.Many patients experience bruising and tenderness after the procedure. Wearing compression stockings and taking anti-inflammatory medication may take away some of the tenderness. In addition, there have been some reports of heat damage to nerves, although this is rare and often goes away over time. Lastly, it is possible for blood clots to form in the leg veins. If this occurs, the clot can travel to the lungs causing a pulmonary embolism. However, this reaction is extremely rare.

Will I need repeat procedures to maintain or improve my results?
Endovenous laser ablation is successful at closing the treated vein(s) nearly 100 percent of the time. Small dilated branches that persist often require additional treatment with phlebectomy (a minor surgical procedure to extract them) or injection of a liquid agent to seal them off, called sclerotherapy. Subsequent treatments can be scheduled two to four weeks after ablation.

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Computed Tomography | Diagnostic Radiology/Fluoroscopy | Interventional Radiology | MRI | Nuclear Medicine | PET Scanning | Ultrasound | Women's Imaging | Angioplasty | Carotid Artery Stenting | Endovenous Laser Ablation of Varicose Veins | Epidural Steroid Injection | Peripheral Arterial Disease/Peripheral Vascular Disease | TIPS - Transjugular Intrahepatic Portosystemic Shunt | Sclerotherapy | Treatment of Deep Vein Thrombosis (DVT) | Uterine Fibroid Embolization | Kyphoplasty | Vertebroplasty | Venous Access