Introduction
TVC offers Foam Sclerotherapy and other ultrasound-guided minimally invasive procedures such as Radiofrequency Ablation and Endovenous Laser Ablation for varicose veins. These new treatments have the common advantage of eliminating the need for a groin incision and stripping to treat the cause of varicose veins. Uniquely, Foam Sclerotherapy can also treat the varicosities themselves and offers outpatient treatment for varicose vein disease. Foam sclerotherapy therefore has potential advantages over all other treatments.
Your Foam Sclerotherapy treatment
Foam sclerosant causes the veins to go into spasm and the lining of the veins to become inflamed and sticky. Compression bandages and stockings then ensure that he veins stick together and shrivel up.
Under local anaesthetic, duplex ultrasound scanning is used to guide the insertion of small plastic needles (cannulas) into the main varicose veins. Smaller needles (butterflies) are used for the varicose veins that lie nearer to the skin. These needles are held in place by sticky tape. Only one to three needles are usually required.
The leg is then raised to empty the veins of blood. The foam is then slowly injected into the veins. The spread of the foam through the varicose veins is monitored with the ultrasound scanner. This ensures that foam fills all the varicosities that are being treated and that the veins go into spasm.
After all the injections have been completed your leg will be compressed with bandages and a compression stocking will be rolled over the top. These dressings are usually worn for 5 days. After this time you should remove the bandages and wear the stocking for a period of 2 – 3 weeks.
You will be reviewed again after 2 - 4 weeks and a further duplex ultrasound scan will be performed. Any veins that have not closed at that time may be treated with further injections of foam.
This regimen effectively treats the majority of patients with suitable varicose veins. The treated veins may occasionally re-open over the first 3 - 6 months, therefore a further duplex ultrasound scan is performed at 6 months and any re-opened veins are treated again.
After each course of injections you will be advised to go for a short walk, then return to your normal activities. There are no restrictions other than that prolonged standing should be avoided and that the legs should be elevated when at rest.
Effective treatment via ultrasound guided foam sclerotherapy reduces the discomfort of open surgery and speeds recovery from varicose veins treatment.
Potential problems of Foam Sclerotherapy
This technique may not be as reliable as the other procedures at completely obliterating the long saphenous vein all the way up to the groin, but it is usually the simplest and best technique we have to treat varicose veins that are due to short saphenous vein valvular incompetence, relatively small varicose veins and varicosities that have recurred following previous surgery. All varicose veins MAY be treated by this method.
Trapped blood within the treated vein may produce lumpiness and occasionally discomfort but this can easily be removed at your follow-up outpatient appointment. There may also be some brown discolouration but this and lumpiness / scarring fade with time. current varicose veins can be retreated with further injections.
Other complications: A temporary dry cough may occur immediately after the injection has been given. Very few patients also report minor and temporary visual disturbances. These symptoms are transient and self limiting.
Effective treatment of varicose veins
Effective treatment of varicose veins usually involves 2 components. Incompetent valves in the main veins which cause the varicose veins lie in the thigh (long saphenous vein) or behind the knee (short saphenous vein). These veins may not be visible in you but it is essential that they undergo effective treatment as well as dealing with the visible varicosities. The newer treatments such as radiofrequency ablation and laser ablation aim to achieve this effect by passing catheters from the knee into the vein in the thigh. Heat treatment is then applied to the vein. This gradually shrivels up the vein before the body absorbs it. This may also be achieved by foam sclerotherapy via cannula injections under local anaesthesia.
The second component of varicose veins is the removal of the visible varicosities themselves. After the catheter-based techniques have been used to treat the truncal veins, the varicose veins themselves are usually removed surgically through small stab incisions, or by sclerotherapy injections.
Only foam sclerotherapy and conventional surgery have the potential to obliterate not only the truncal causative veins but also the visible varicose veins, although radiofrequency or laser ablation of the causal veins may be combined with avulsions or foam sclerotherapy to the visible varicosities
