SCLEROTHERAPY

What is Sclerotherapy?
Sclerotherapy is a medical procedure used to treat varicose veins and "spider veins." Sclerotherapy involves injection of a solution (Dr. Malik uses sodium chloride) directly into the varicose vein. The solution irritates the lining of the vessel, causing it to swell and stick together, and the blood to clot. Over time, the vessel turns into scar tissue that fades from view. Sclerotherapy is a well-proven procedure has been in use since the 1930s to treat varicose veins.

How is Sclerotherapy done?
Sclerotherapy is performed in our office. In most cases, a 23 percent sodium chloride sterile solution with or without addition of Lidocaine is injected directly into the blood vessel, using a very fine needle. The number of varicose veins injected in one session is variable, depending on the size and location of the veins, and the patient’s overall medical condition. Mild disconfort may occur with leg cramping for 2 to 3 days. Usually Tyelenol is sufficient for discomfort and no prescription pain medication is needed.

How successful is Sclerotherapy in treating varicose and spider veins?
Sclerotherapy works well for most patients with varicose veins. It is estimated that as many as 50 percent to 80 percent of injected varicose veins may be eliminated with each injection session. A few (less than 10 percent) of the people who have Sclerotherapy on their varicose veins do not respond to the injections at all. In these instances, a different method, such as laser therapy or surgical vein stripping, may be tried. In general, spider veins respond to Sclerotherapy in 3 to 6 weeks, and larger veins respond in 3 to 4 months. If the veins respond to the treatment, they will not reappear. However, new veins may appear over time. If needed, you may return for injections.

What do I need to do before the procedure?
Prior to Sclerotherapy, certain medications should be avoided. Tetracycline or Minocin, both antibiotics, may possibly cause a staining of the skin if taken 7 to 10 days before or after Sclerotherapy. Ask the doctor about other antibiotic medications you may take, or ask for safe guidelines for discontinuing these medications. If you are required to take an antibiotic before any invasive procedure, such as dental procedures, colonoscopy or surgery, please inform Dr. Malik .

Do not take aspirin, ibuprofen or other NSAIDS. (i.e. Advil and Nuprin) or other anti-inflammatory medications for 48 hours before and after Sclerotherapy, because these medications may interfere with the action of the sclerosing agent. Tylenol is permitted. Ask your doctor for specific guidelines before discontinuing any medication prior to Sclerotherapy.

Prednisone also decreases the effectiveness of the sclerosing agent. Ask the doctor who prescribed your prednisone if it can be safely discontinued for 48 hours before the Sclerotherapy procedure.

No lotion is applied to the legs before or after Sclerotherapy. It is recommended that you bring a pair of shorts to wear during the varicose vein treatment procedure.

If you have compression hosiery from previous treatments, please bring them with you so we can make sure they will provide adequate support after the Sclerotherapy procedure.

What are the common side effects of Sclerotherapy?
Larger injected varicose veins may become lumpy and hard for several months before resolving. Raised red areas may appear at the injection sites and should disappear within a few days. Brown lines or spots on the skin may be noted at the site of the injection, possibly caused by a form of iron that escapes from the injected veins. In most cases, they disappear within 3 to 6 months, but can be permanent about 5 percent of the time. Bruising may occur around the injection site and can last several days or weeks. There is a common risk of developing a network of fine red blood vessels following injection which may resolve on its own within a few months or can be treated with further injections.

Rare Risks after Sclerotherapy. There is a small possibility of Deep Venous thrombosis. This risk is higher in those predisposed to blood clotting through inherited Thrombophilia, lack of exercise, air travel, following major operations, and women taking birth control pills or HRT. There is risk of ulceration at injection site, which will eventually heal but may leave a scar.

How will I know if I am a candidate for Sclerotherapy?
Prior to the procedure, you will have an initial consultation with Dr. Malik to determine if you are eligible for Sclerotherapy. You are not eligible for Sclerotherapy if you are pregnant, breastfeeding, or are bedridden. You must wait at least three months after birth before you can be considered for this procedure. You are considered high risk for formation of blood clots after Sclerotherapy if you take birth control pills or If you have had a blood clot in the past. Dr. Malik does not offer Sclerotherapy to patients currently on birth control pills, or on HRT and to patients with history of blood clots. veins that are potentially usable for future surgical bypass procedures (such as the saphenous vein for coronary artery bypass graft surgery) will generally not be considered for injection, unless they are already deemed unusable for bypass procedures.

If you have Varicose veins and would like to consider Sclerotherapy as a treatment option, call our office for a complimentary consultation with Dr. Malik to see if you are a candidate.