Sclerotherapy is a method of treatment of which involves injection of a medicine (sclerosing solution) into the blood vessels in order to shrink the vessel. It is used to treat vascular and lymphatic malformations. In adults it has been used most popularly to treat haemorrhoids and varicose veins. The veins are injected with a sclerosing solution, this causes sclerosis and shrinkage of the vein. Over a period of weeks or months the vein dissolves and is naturally absorbed by the body. It is usually preferred over laser treatment to eliminate telangiectasiae and small varicose veins in the lower extremities. Telangiectasis is a condition where there is dilatation of the small vessels near the surface of the skin or mucous membrane. It consists of tiny blood vessels, all joining together and forming a conglomeration of blood vessels resembling the shape of a spider. With the help of sclerotherapy, there is destruction of the telangiectasiae and there are less chances of recurrence with this therapy.
In the case of varicose veins of the lower legs, multiple injections of the sclerosant solution is injected into the surface veins. Following this the patient is advised to compress the legs with crepe bandage or elastic stockings for a period of around two weeks. This applies a firm pressure over the sclerosed veins and in a period of weeks the veins shrink and disappear.
It can be performed as an Outpatient procedure and does not require anaesthesia. Once the treatment area is cleansed, the surgeon injects the solution directly into the blood vessels with the help of fine needles. This procedure may be done with or without ultrasound guidance. Depending on the size and location of the veins, the number of sessions of sclerosant injections would differ.
Sclerotherapy has been seen to highly successful in most patients. Almost 50 to 80 percent of the injected veins may be sclerosed in each session. Only a few of the patients about 10 percent do not respond to the procedure. In such cases different methods may be tried out including laser therapy. Bigger veins may take longer to respond, period varying from 3 to 6 months, whereas the smaller ones respond in about 3 to 4 weeks. The procedure takes about 30 to 45 minutes.
Complications: The side effects following the procedure may include:
The larger veins which are injected may not shrink and dissolve for a period of many months. Until then the veins may appear as hard and lumpy swellings under the skin.
Following injection the surrounding skin may appear red and inflamed and may take a few days to return back to their normal colour and texture.
Some patients may develop an allergic reaction to the sclerosant solution. They may develop itching, redness and swelling.
The skin over the treated area with sclerotherapy may get discoloured in most cases. Brown lines or spots may form over the area. In some cases this discolouration may be permanent, in others it may disappear in a period of 3 to 6 months. The discolouration is believed to be due to the iron deposition in the skin. The iron being derived from the blood that oozes during the injecting procedure.
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