Ultrasound guided foam sclerotherapy offers a new alternative to surgery in treating varicose veins. The procedure is carried out in less than one hour under local anaesthetic in the out-patient department. It is the prefered method for non-truncal varicose veins. The impaired blood flow in these veins causes aching, itching, heaviness and also skin damage such as eczema and even ulceration. Varicose veins do not heal spontaneously and invariably deteriorate over time.
Advantages of foam sclerotherapy
Avoids the need for hospital admission, surgery and general anaesthesia. Results in minor discomfort during treatment and only minimal bruising compared with surgery. All treatment is performed as an outpatient and little or no time is required off work. Much less expensive than varicose vein surgery.
Disadvantages of foam sclerotherapy
More clinic attendances are required than for surgical treatment (usually 3-4 appointments if both legs are treated). Up to 6 months may required for final outcome to be obtained with resolution of all bruising and uncomfortable lumpiness. Brown skin staining can take a long time to fade, occasionally still being present after a year (surgery can also cause this, although less often than sclerotherapy). Thread veins may develop in the region of treatment in susceptible people, these may also appear following surgical treatment for varicose veins . These may be treated by microsclerotherapy and KTP laser , if necessary. Your colour duplex ultrasound scan will also help guide your Surgeon in the choice of treatment – some veins are more suited to this treatment then others.
Preparing for treatment
Please bathe as normal prior to treatment but avoid any lotions or perfumes. Wear loose clothing and soft shoes (your leg will be bandaged). You may want a friend to drive you home. You will have the opportunity to ask further questions at the hospital before giving your written consent to treatment.
How is this treatment given?
Foam sclerotherapy is performed lying on a treatment couch in the outpatient consulting room with the help of an injection of local anaesthetic. The aim is to inject and destroy the main surface vein, which is causing the varicose veins. The long saphenous vein is injected just above the knee in the thigh and the short saphenous on the back of the calf. A needle is placed within the vein with the help of ultrasound imaging. The leg being treated is elevated to empty all the surface veins. The foam is prepared and injected into the vein. The foam rapidly spreads along the vein and is guided by ultrasound. Injection of foam continues as the foam spreads into the varicose veins. Several injections of foam may be needed. Additional injections can be given during follow-up visits to treat any veins that the foam has not reached initially.
What does the injection feel like?
You may feel some mild burning sensation or sometimes minor discomfort.
Following foam injections we apply a firm bandage and compression stocking to the leg. The bandage can be removed after 48 hours; after showering were the stockings continuously until your next appointment (usually about a fortnight).
After treatment carry on with your usual activities. Avoid vigorous exercise, gentle walking is best. When resting, raise your leg above hip height (avoid standing still or sitting with legs down if possible). A modest ache in the leg should respond to simple pain-killers. You may drive, provided you are confident of performing an emergency stop.
Side effects and complications
A very few people experience chest tightness, a cough or visual disturbance (like a migraine) during treatment. These effects are transient, lasting less than 30 minutes or so. Very rare allergy to the foam has been reported. Bruising and lumpiness is usual after treatment, Arnica and anti-inflammatory drugs (like diclofenac, ibuprofen etc) can help (either tablets or topical gel). Occasionally trapped blood is tender and may need removal by needle suction. The lumpiness sometimes takes months to gradually settle down.
Brown skin staining is often seen where the veins have been treated – this usually fades in a few months but can sometimes still be seen after a year.
Deep vein thrombosis occurs very rarely but can be serious. Compression stockings help prevent DVT but if your leg becomes painful or swollen please contact the doctor who treated you immediately.
Thread veins (spider veins) sometimes develop after treatment (especially if you already have some). They may also occur after surgery and are treatable.
An ulcer may occur at the site of injection – this is rare. It will heal but may leave some brown staining.
You may develop further varicose veins in the future – this also applies to surgery. If you develop more varicose veins – please return for further assessment.
Side effects and complications of foam sclerotherapy
Please review the following procedure guidelines before your treatment day:
• You will need to bring your compression stockings to wear after the sclerotherapy session. Compression stockings are an essential part of the treatment. If you do nothave compression stockings, please contact the clinic prior to your sclerotherapy appointment;
• Do not take aspirin, Ibuprofen, or arthritis medication for at least 48 hours before treatment;
• Avoid alcoholic beverages for 48 hours before treatment; do not smoke 1 day prior and 1 week following treatment.
• Do not shave your legs, or use creams or oils on them. Shower using antibacterial soap on the day of treatment.
Please remember to bring your compression stockings with you to each session.
Please call +43 1 328 8777 , 24 hours in advance to cancel a session to avoid unnecessary costs.