In most people, varicose veins (varicose veins) develop in the course of life due to changes in the veins. Those who suffer from them and want to get rid of them have several treatment techniques to choose from. For smaller varicose veins, sclerotherapy is an option.
What is varicose vein sclerotherapy?
Variceal sclerotherapy is the sclerotherapy of varicose veins. In this procedure, a sclerosing agent is injected into the vein and artificially triggers inflammation inside the vein. Varicose veins are not only a cosmetic problem, they can, especially if they are larger varicose veins, also have health consequences up to thromboses and open legs. Therefore, it makes sense to treat them in time. Various non-surgical and surgical procedures are available for treatment. One of these procedures is sclerotherapy of varicose veins (varicose sclerotherapy), it is also called sclerotherapy. During sclerotherapy, a sclerosing agent is injected into the vein and artificially triggers an inflammation inside the vein. This causes the inner walls of the vein to stick together and scar. It is mainly used to treat spider veins and smaller varicose veins. For spider veins a liquid agent is injected, for smaller varicose veins a foam. Several sessions are usually required for successful treatment.
Function, effect and goals
Smaller spider veins, superficial dilations of the veins, and varicose veins that are not that large can be treated well with sclerotherapy. Sclerotherapy of varicose veins does not require hospitalization and can be performed on an outpatient basis. However, it only makes sense if the blood return to the heart in the leg veins is not obstructed. A compression stocking must be worn for about 2 days before the first session to ensure that the fit is right before sclerotherapy. During the treatment, the veins are punctured and then a sclerosing agent in liquid form (foam in the case of larger varicose veins) is injected into the veins, causing an artificially induced inflammation that causes the inner walls of the vein to stick together and scar over. After the injection, patients are given a compression bandage and told to walk around for at least half an hour. They do not have to limit themselves physically and can also go straight back to work; it is in the spirit of the therapy to move around a lot. Standing and sitting is less favorable. As a rule, the bandage can be removed the same evening and replaced by the compression stocking. It must be worn consistently every day for the next few days. The patient must bring the bandage back to the follow-up sessions. 2 to 5 days after the sclerotherapy a control examination takes place. When the treatment is completed, the stocking must be worn regularly for another 4 to 6 weeks. 3 to 6 months after the sclerotherapy, the function of the veins is checked again. Varicose vein sclerotherapy is a relatively painless procedure and has the advantage that it can be repeated if necessary. A repetition is necessary in most cases because the predisposition to varicose veins remains despite the treatment. Therefore, before sclerotherapy is performed, careful consideration should be given to whether it is the most appropriate treatment method. Whether a liquid sclerosing agent or a foam is injected depends on the size of the varicose veins. For spider veins, a liquid agent is usually sufficient. For larger ones, foam has proven more effective. Varicose vein sclerotherapy is one of the oldest and best methods for smaller varicose veins such as spider veins. As the technology advances, it will certainly be possible to expand the treatment spectrum of varicose vein sclerotherapy in the future. Compared to other treatment methods for varicose veins, sclerotherapy offers the advantage that it is largely painless and can be performed on an outpatient basis. Patients usually have no restrictions other than the need to wear compression stockings and can go about their daily lives as normal. At most, they may have to accept that if they have a predisposition to varicose veins, the treatment may need to be repeated a few years.
Risks, side effects and dangers
Even though varicose vein sclerotherapy is a relatively low-risk treatment method, there are certain contraindications that limit its use:
- Water retention
- Inflammation in the sclerotherapy area
- Circulatory disorders in the arteries
- Restrictions in the ability to move or bedriddenness
- Hole in the cardiac septum (foramen ovale)
- Venous inflammation / thrombosis
- Pregnancy
- Diseases with fever
- Allergy to the sclerosing agent
Apart from the contraindications, side effects of sclerosing varicose veins are rare. The injection of the sclerosing agent may cause a slight burning pain for a few seconds, and sometimes the sclerotherapy causes small bruises or a mild but harmless vein inflammation. The sclerosed area reacts like a bruise. It first turns blue, then green and yellow, until it is no longer visible. Sometimes the skin at the puncture site turns brownish, but the discoloration recedes over the next few months. In very rare cases, the injection site may become infected and leave a small scar. Even more rarely, leg vein thrombosis of the internal leg veins occurs or an artery is accidentally hit during injection with the risk of tissue death. Allergic reactions to sclerosants or dressings also occur only rarely. It is very important to move a lot directly after the sclerotherapy, sitting or standing is unfavorable. Those who love visits to the sauna or solarium should skip at least one week to 10 days.
