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CLaCS (Cryo-Laser and Cryo-Sclerotherapy) is a treatment for leg vein lesions by combining transdermal laser effect and injection sclerotherapy, all under skin cooling (Cryo - cold air blown onto the skin at -20C). [1] [2] [3] The laser causes a selective photothermolysis damaging the vein wall. The vein's lumen gets smaller.
Sclerotherapy has been used in the treatment of spider veins and occasionally varicose veins for over 150 years. Like varicose vein surgery, sclerotherapy techniques have evolved during that time. Modern techniques including ultrasonographic guidance and foam sclerotherapy are the latest developments in this evolution.
Polidocanol is also used as a sclerosant, an irritant injected to treat varicose veins, under the trade names Asclera, Aethoxysklerol [5] and Varithena. [6] Polidocanol causes fibrosis inside varicose veins, occluding the lumen of the vessel, and reducing the appearance of the varicosity.
Sclerotherapy is often used for telangiectasias (spider veins) and varicose veins that persist or recur after vein stripping. [43] [44] Sclerotherapy can also be performed using foamed sclerosants under ultrasound guidance to treat larger varicose veins, including the great saphenous and small saphenous veins. [45] [46]
A 2013 Cochrane systematic review aimed to determine the effectiveness of foam dressings for helping to heal venous leg ulcers. The authors concluded that is uncertain whether or not foam dressings are more effective than other dressing types and that more randomized controlled trials are needed to help answer this research question. [ 53 ]
Venous cutdown is an emergency procedure in which the vein is exposed surgically and then a cannula is inserted into the vein under direct vision. It is used for venous access in cases of trauma, and hypovolemic shock when the use of a peripheral venous catheter is either difficult or impossible. The great saphenous vein is most