Sclerotherapy of the lower extremities veins Today it is one of the most effective treatments for varicose veins and other diseases of the lymphatic system and blood vessels. This method is used in many clinics, such a procedure is atraumatic and painless.
The essence of sclerotherapy
This procedure is non-surgical and consists in the removal of altered veins. This method involves introducing a special drug substance into a vein using a very thin needle. As a result, the walls of the vessel stick together, after which the drug dissolves in the body, without causing side effects. After some time, the lumen of the vein gradually overgrows, and the vessel becomes just a fibrous cord. This method is no less effective than the methods of surgical disposal of varicose veins (laser surgery).
Historical reference
Sclerotherapy of the veins of the lower extremities is a relatively young method. However, the first attempts at treatment in this way were made back in the 17th century, when doctors tried to inject acid into the vessel for thrombosis (blockage). Then, in the 19th century, Perchlor was tested to get rid of varicose veins. But such experiments led to serious negative consequences in patients, so they refused this technique for a long time. In 1946, a drug such as Tetradecyl Sulfate (or Fibrovein) was discovered, and sclerotherapy received a rebirth. This tool is used today. However, now this procedure is carried out using modern equipment and the latest diagnostic methods, in particular, ultrasound examination of blood vessels (ultrasound).
Types of sclerotherapy
Today, doctors use three main methods of the procedure:
Microsclerotherapy. This is the simplest technique. A sclerosing agent is injected into a vein with a thin needle. This method is used if pathological formations do not exceed 2 mm in size.
Echosclerotherapy. When the drug is administered, an ultrasound duplex scan is performed, with which the doctor monitors the position of the needle and pathologically altered veins. In this case, sclerosing agents will fall exactly into the vein. This method is used for sclerosis of deep and large veins.
Foam sclerotherapy - this technique is also called the “foam form”. In this case, the drugs used are detergents, that is, when mixed with air, they can turn into foam. Compared with other treatment methods, this method has certain advantages: due to the foamy state, the dose of sclerosing agents can be reduced without loss of effectiveness; the contact of the drug and the inner surface of the vein wall improves; it is possible to treat the superficial trunk veins of the lower extremities (small and large saphenous veins) in the area where they flow into the main deep veins.
How is the procedure performed?
First of all, the doctor carefully examines the areas requiring correction, if necessary, prescribes additional studies, after which puncture of the affected vein or vessel is performed. As a rule, this procedure is carried out under the control of ultrasound. This is necessary for the most accurate hit of the needle in the affected area and control over the administration of the drug. To prevent possible bleeding, the puncture is carried out with the thinnest needle (similar to the needle of an insulin syringe). After the puncture, a special sclerosing agent is introduced into the affected area. The dose of the drug is determined by the phlebologist individually. The amount of funds administered depends on the location of the affected area and its size. If the foam sclerotherapy method is chosen (“foam form”), then the agent is administered in the form of foam, in the usual way, the liquid form of the drug is used.
Actions after the procedure
After sclerotherapy, the patient is recommended:
walking for an hour;
within three days after the procedure, abandon aerobics and gymnastics;
avoid prolonged sitting or lying position for two weeks;
for two months do not visit saunas, baths, do not take hot baths;
Wear elastic stockings or bandages for three to four months.
Indications for the procedure
Sclerotherapy of the lower extremities veins carried out under conditions such as:
Vascular nets. This is the first sign of a beginning varicose vein disease. At this stage, treatment is most effective.
Spider veins. These are vascular formations in the form of a star whose rays diverge from the center outward.
Varicose veins of the lower extremities. Sclerotherapy is not used at all stages of this ailment. Indications for the procedure are determined by the doctor.
Subcutaneous vascular neoplasms - hemangiomas, lymphangiomas. With these ailments, sclerotherapy is usually carried out in a specialized surgical hospital.
Sclerotherapy of the veins of the lower extremities: contraindications
This procedure is contraindicated in:
obstruction of deep and connecting veins;
diabetes mellitus;
chronic diseases of the kidneys and liver;
tendency to allergies;
severe heart disease;
pregnancy and lactation;
serious vascular disease;
infections and inflammatory processes on the skin at the site of the alleged injection.
The presence of any of these conditions must be reported to the doctor.
Possible events after the procedure
After many medical procedures, various side effects occur. After a procedure like sclerotherapy, the consequences may be as follows:
Bruises always remain at the injection site, which disappear over time.
On the area of the skin that has undergone manipulation, the appearance of pigmentation is possible. As a rule, this phenomenon is not common, but when removing large veins, it is impossible to avoid the appearance of this defect.
Around a distant spider vein or vein, a small network of capillary vessels may appear - recurrent telangiectasias. This phenomenon may be a consequence of skin hyperreaction to the administered drug. As a rule, almost all (up to 90%) capillaries disappear on their own 6 months after the procedure.
In rare cases, more serious complications are possible:
A severe burn that can occur if a large amount of sclerosing substance gets into the tissue around the vein.
Thrombophlebitis is an inflammation of the vein wall that occurs with sclerotherapy of large veins and with non-compliance with the doctor's recommendations after the procedure.
Vein thrombosis - after the introduction of a sclerosing substance, blood clots may form. However, this phenomenon is extremely rare.
Sclerotherapy of veins of the lower extremities: prices for the procedure
The cost of this treatment method is an important issue that arises in potential patients. Not everyone can afford an expensive treatment. For such a procedure as sclerotherapy of the veins of the lower extremities, the prices are, although not at a low, but at an affordable level. The cost of the procedure depends on the severity of the disease. In Russia, the average price is 14,000 rubles. The most expensive is a comprehensive technique where microsclerotherapy and sclerotherapy of veins are required. Prices for this procedure are in the range of 11000-40000 rubles. The cost of the foam form method is about 20,000-30000 rubles.
Sclerotherapy: before and after the procedure
The advantages of this technique
Sclerotherapy of the veins of the lower extremities in comparison with other methods of treating varicose veins has a number of undeniable advantages:
The procedure is painless. During the manipulation, the patient can only feel a slight burning sensation, which is the norm. Since the sclerosing drug is administered using the thinnest needle, even a patient with increased sensitivity to pain will not feel any discomfort.
The clinics use modern equipment that does not have any negative effect on the body. Therefore, the procedure is absolutely safe.
The procedure is performed on an outpatient basis and does not require inpatient therapy.
A positive effect can be seen after the first injection of sclerosing agent.
The course of treatment does not take much time.
After sclerotherapy, there is never a scar on the skin.
Reviews about the procedure
Most of those who turned to such a method as sclerotherapy of veins reviews the procedure is left positive. However, first of all, they are satisfied with the obtained cosmetic effect, because in most varicose veins it manifests itself only visually - a network of vessels and asterisks. Those who were afraid of surgery and decided to get rid of more serious problems with the help of a procedure such as sclerotherapy of lower extremity veins leave negative reviews. And there is an explanation for this. The fact is that this technique is effective for the treatment of small veins and small vessels. When the stage of varicose veins is already quite serious, sclerotherapy will be ineffective.
There is no absolutely perfect treatment methodology, each procedure has its own disadvantages and advantages.