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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.
It is commonly used in the treatment of varicose and spider veins of the leg, during the procedure of sclerotherapy. [2] Being a detergent, its action is on the lipid molecules in the cells of the vein wall, causing inflammatory destruction of the internal lining of the vein and thrombus formation eventually leading to sclerosis of the vein. It ...
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.
Local anaesthetic endovenous surgery using the thermoablation (endovenous laser ablation or radiofrequency), perforator closure (TRLOP) and foam sclerotherapy showed an 85% success rate of healing, with no recurrence of healed ulcers at an average of 3.1 years, and a clinical improvement in 98% in a selected group of venous leg ulcers. [48]
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]
Polidocanol causes fibrosis inside varicose veins, occluding the lumen of the vessel, and reducing the appearance of the varicosity. The FDA has approved polidocanol injections for the treatment of small varicose (less than 1 mm in diameter) and reticular veins (1 to 3 mm in diameter).
'Foam sclerotherapy for reticular veins of the dorsal hands: a retrospective review." Dermatol Surg. 2014 Aug;40(8):892-8. doi: 10.1097/DSS.0000000000000076. Massaki AB, Kiripolsky MG, Detwiler SP, Goldman MP (2013). Endoluminal laser delivery mode and wavelength effects on varicose veins in an ex vivo model. Lasers Surg Med. 2013 Feb;45(2):123-9.
Varicose veins and reticular veins are often treated before treating telangiectasia, although treatment of these larger veins in advance of sclerotherapy for telangiectasia may not guarantee better results. [18] [19] [20] Varicose veins can be treated with foam sclerotherapy, endovenous laser treatment, radiofrequency ablation, or open