Sclerotherapy (hardening) is a chemical procedure used to obliterate dilated veins, also known as varicose veins. Sclerotherapy is mainly used in the treatment of varicose veins . The aim is to inject liquid or foamy sclerosing agents into the vein to harden it from the inside and subsequently transform it into a strand of connective tissue.
Below you will find further information on this treatment method and specialists for vein sclerotherapy.
Vein problems are a widespread phenomenon, with almost every second woman suffering from varicose veins at an advanced age. In the medical field, varicose veins are also known as varicose veins. These are dilated veins that can spread like a network over time. In the early stages, varicose veins are commonly known as spider veins, which tend to appear in the back of the knees or on the lower legs.
Strictly speaking, however,spider veins are not varicose veins. Rather, they are just small vein branches that are visible under the skin as blue or purple nets. However, they can be the first sign of enlargement of the superficial leg veins (also known as truncal veins ). The truncal veins(saphenous veins) lie somewhat deeper in the tissue than the smaller spider veins and are therefore only visible when the enlargement has increased significantly.
The superficial leg veins, also known as the truncal veins, are located on the inner thigh(saphenous vein) and the back of the lower leg( saphenousvein ) directly under the skin or in the subcutaneous fatty tissue. These veins are under particular strain due to the upright gait and the effect of gravity. The blood can pool here, so to speak, causing the venous valves in the vein to leak. In the normal state, the venous valves, which are located a few centimetres apart in the entire truncal vein, prevent the blood from flowing back downwards in accordance with the force of gravity. They only allow blood to flow from bottom to top, so to speak, and not in the opposite direction.
As women experience a loosening of the connective tissue during pregnancy, they suffer from varicose veins much more frequently than men. However, standing or sedentary activities also put a strain on the superficial veins and increase the risk of developing varicose veins.
Varicose vein patients should move frequently @ Solarisys /AdobeStock
As mentioned above, spider veins can sometimes be the first sign of varicose veins. Other typical symptoms, which occur particularly in the evening, are
Other, albeit much rarer symptoms can be open wounds in the inner ankle area, which do not heal or only heal very slowly. The reason for this is the poorer removal of blood and, in particular, tissue breakdown products, which in turn leads to an enlargement of the wound or a delay in healing.
Varicose veins that do not cause any problems do not necessarily need to be treated. However, varicose veins will never disappear on their own and, in the worst case, can increase in size and ultimately cause serious problems such as non-healing wounds on the lower leg(leg ulcers). It is therefore advisable for every patient with varicose veins to wear compression stockings. The latter is particularly recommended in stressful situations such as prolonged standing or sitting.
The sclerosing agent dissolves the cells of the inner vascular wall and an inflammatory reaction causes the varicose veinsto stick together @ Pepermpron /AdobeStockSclerotherapy involves injecting the so-called sclerosing agent, usually polidocanol(Aethoxyskerol®, 0.25 - 3%), into the diseased veins and then compressing them from the outside. Ideally, the inflammatory reaction to polidocanol causes the vein walls to contract. This procedure (known as liquid sclerotherapy) can usually be used very successfully for spider veins and smaller veins.
In addition to the usual injection of liquid polidocanol, there is another way of successfully sclerosing veins in phlebology. This therapy is known as foam sclerotherapy. In foam sclerotherapy, the sclerosing agent is mixed with air before it is also injected under the skin. This is particularly recommended for thicker veins in order to ensure that the sclerosing agent is used sparingly and still achieve effective vein wall adhesion.
Ultimately, it is always up to the patient and the treating doctor to decide which of the above-mentioned treatment methods to choose. Sclerotherapy can be used successfully for smaller vessels(spider veins) in particular. In the case of larger vessels, there is a considerable risk that the vein will not completely adhere and the treatment will therefore not be successful. In these cases, varicose vein stripping or laser or radiofrequency treatment should be preferred.
The treatment is usually carried out with the patient lying down. The dose of the sclerosing agent depends on the patient's body weight. First of all, the puncture site is carefully disinfected before the treating doctor injects a tiny amount of air under the skin to displace the blood. The liquid medication is then injected into the vein. However, the doctor must be careful not to inject the medication into the surrounding tissue.
Foam sclerotherapy works in a similar way. However, the doctor mixes the medication with air before injecting the sclerosing agent into the vein. The blood is also displaced by the foamy consistency of the agent so that the medication can take effect. After sclerotherapy, the injection site is covered with a cotton pad and the patient must then wear compression stockings that exert even pressure on the tissue.
During vein sclerotherapy, the doctor treats the patient by injecting foam or a liquid sclerosing agent such as polidocanol @ rh2010 /AdobeStock
Although sclerotherapy is one of the standard therapies for pathologically altered vessels, the treatment is accompanied by a number of risks.
The most common complications include
Minor swelling, reddening of the skin or skin discoloration (bruising) are completely normal after vein sclerotherapy. However, patients should consult a doctor if they suffer from
a blue discoloration of the toes.
To avoid the risk of infection, patients should refrain from sunbathing, going to the sauna or solarium while the wound is healing. Short showers are permitted as long as the puncture site is covered with a plaster.
Exercise is extremely important after sclerotherapy to prevent spider veins and varicose veins. Patients must avoid standing and sitting for long periods. The legs should be elevated as often as possible, and walking, Nordic walking and jogging also help to improve circulation.
The Leading Medicine Guide's quality assurance is ensured by the following acceptance prerequisites.
