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What is sclerotherapy?
Sclerotherapy is a non surgical office procedure that can treat
most diseased surface veins. Medication is injected into a vein
using an extremely tiny needle. The medication closes down the vein
walls so that they stick together and are gradually reabsorbed by
the body. Getting rid of these diseased veins actually improves
the circulation and makes the legs healthier.
What will happen in the first consultation?
You will be asked questions regarding your past health, medication
history and symptoms. An ultrasound exam may be performed and Dr.
Martin will examine your legs. You will have an opportunity to discuss
the treatment and ask any questions. Often, injections are started
on the first day.
What causes vein problems?
Veins carry used blood to the heart through one-way valve systems.
When there is a weakness in the vein wall or a faulty valve, the
valve stretches and no longer closes properly. The veins become
filled with blood that can’t flow normally, causing pain, swelling,
discoloration, sores that won’t heal, blood clots and other
problems.
What types of vein problems does Martin's Vein Clinic treat?
Spider veins and varicose veins are the most common. Other vein
problems include chronically swollen legs, recurrent infections,
thrombophlebitis, and pregnancy-related problems.
How many treatments are required?
Depending on the type and severity of the varicose veins, the
average number of treatments is anywhere between 2 and 5, however
as many as 10 treatments may be required. The larger vessels only
require a few (3 or 4) well placed needles with a stronger solution.
They must be treated first. The smaller spider veins may require
many points of injection with a weaker solution. The injections
will be stopped at any time if the patient so requests. The number
of injections is less important that the type of sclerosing agent
used, its dosage, the site of the injections and the skill of Dr.
Martin and her staff. Most patients experience moderate discomfort
similar to an allergy of tetanus shot with each injection..
Why Martin's Vein Clinic?
We have many years of experience in the field, and have helped thousands
of patients to say goodbye to their varicose vein and spider vein
problems.
Diagnosis & Treatment
Diagnosis starts with a careful history and physical exam. Diagnostic
tests are often needed to evaluate the extent of disease. If treatment
is indicated, each treatment takes about 20 minutes. The number
of treatments depends on the severity of the problem.
Discomfort after treatment is rare. Most patients leave our office
and go directly back to work. We recommend that patients walk as
much as possible after each treatment.
Insurance Coverage
The diagnosis and treatment of significant problems due to diseased
veins are often covered by O.H.I.P. Spider veins are considered
"cosmetic" and usually are not covered. Our evaluation
can usually tell whether diseased veins are causing medically significant
problems or whether the problem is strictly cosmetic.
What are the most common side effects?
All medical treatments entail a certain degree of risk. This
will be discussed during you first visit and consent to treatment
must be signed before the injections are started. Fortunately, when
injections are undertaken by well trained professionals, complications
rarely arise.
Spider Veins:
In the first few days itching, bruising, aching, redness and
swelling are common. Most of these symptoms resolve spontaneously.
You may take Tylenol (acetaminophen), but do not take ASA or related
compounds (aspirin, naproxen, and ibuprofen) since they may increase
bleeding. It may help to elevate the legs and rotate the ankles.
Some patients (particularly those with fair skin) notice small red
circles or brown lines after treatments. These are due to the pigment
of blood or inflammation and usually resolve within 1 month. 90%
of the discoloration's resolve with 1 year. A superficial blood
clot may develop at the injection site which causes a lump. This
will disappear in 2-8 weeks. A small superficial ulceration of the
skin overlying the injected vessel may occur. It will usually leave
a small scar. "Matting" refers to the development of new
tiny blood vessels in the treated vessel. This temporary phenomenon
occurs 2 to 4 weeks after treatment and usually resolves within
4 to 6 months. It occurs in up to 18% of women receiving estrogen
therapy (for menopause) and 2 to 4 % of all patients. You will be
monitored at the clinic for an allergic reaction (very rare) which
can include hives, shortness of breath and swelling around the airway.
If this occurs at home, seek medical attention immediately.
Varicose Veins:
In addition to the side effects listed above there are several
complications which are unique to varicose vein treatment. Phlebitis
may develop at the site of injection as a firm nodule. This resolves
with elevation of the legs, application of a cool pack, rotation
of the ankles, tensor bandage and aspirin for 48 hours after treatment.
Deep Venous Thrombosis (DVT) is a very rare complication, seen in
approximately 1 out of every 30,000 patients treated for varicose
veins greater that 3 to 4 mm in diameter. DVT will be recognized
by pain and swelling of the entire foot. The possible dangers of
DVT include the possibility of a pulmonary (lung) clot and post
phlebitis syndrome, in which the blood clot is not carried out of
the legs, resulting in a permanent swelling of the legs. If the
sclerotherapy solution becomes lodged in an artery instead of a
vein, its occlusion may cause an interruption of the blood supply
to an area outside of the limb.
What should I do before a treatment?
Do not take aspirin, ibuprofen or other arthritis medicine for
2 days before and after you treatment because these medications
can increase bruising. Do not drink alcoholic beverages or smoke
for 2 days before and after your treatment. They may impair healing.
Shower and wash your legs thoroughly with an antibacterial soap.
Do not shave your legs the day of your appointment. Do not apply
any cream or lotion to your legs, including tanning cream. Bring
loose fitting shorts to wear during the treatment. Eat a light meal
or snack 1 - 1½ hours before your appointment. If you sometimes
get lightheaded during medical procedures, consider bringing someone
to drive you home.
What should I do after a treatment?
Spider Veins - Your legs will be covered in cotton balls attached
with tape, so you are advised to wear dark colored loose fitting
clothing to the session. Remove the cotton balls after one hour.
Resume normal activities. Avoid alcohol, ASA, and hot baths for
48 hours.
Varicose Veins - If the veins are large, you may be asked
to wear your compression stocking for 48 hours. Walk or keep active
for a half hour after the session to maximize results. Bring comfortable
walking shoes. If traveling more that 30 minutes to the office,
have someone drive you so that you can move your feet and legs as
the passenger. Avoid tanning until the end of treatment and all
the bruises have disappeared, otherwise you tan colour may be irregular.
Do not use self tanning lotions for at least one month (it can cause
unsightly streaking). Maintain normal activities but avoid strenuous
physical activities such as high-impact aerobics or weight lifting
for the first 48 hours. Avoid prolonged standing and hot baths for
1 week. Cool your legs with cold water after each shower. Most people
can return to work immediately after a treatment.
What can I do to prevent varicose veins from coming back after
a treatment?
Varicose veins are a chronic illness and are subject to recurrence,
but there are some steps that you can take:
1. Compression stockings are highly recommended and come in a variety
of colours and styles. Use them when you legs ache, for long trips
or for prolonged walking or standing. Dr. Martin will prescribe
the correct strength and size for you.
2. Wear comfortable shoes with a 1 - 2 inch heel (running shoes
are best).
3. Avoid wearing girdles and ordinary knee high stockings.
4. Exercise regularly. Avoid standing for long periods and if you
do, flex your muscles or sit/lie down with your legs up.
How to get more information
Just pick up the telephone and call our office. We have brochures,
patient education literature, articles and many other resources
we’d be glad to share with you. (705) 735-0639 or 1-800-627-3309.
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