Can sclerotherapy treat varicose veins that have been scarred due to old clots?

I have seen two vascular surgeons. Both said that my varicose veins have been scarred due to old clots and that EVLT or VNUS closure may not be possible. One suggested ligation, while the other recommended compression hose and possible sclerotherapy. These options would be on the table if my condition has not changed by the next appointment. What is best?

Answers from doctors (12)


Americas Vein Centers - Southborough

Published on Mar 14, 2013

If you have deeper varicose vein disease, sclerotherapy may not be recommended. Using compression stockings may relieve your symptom temporally.

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Answered by Americas Vein Centers - Southborough

If you have deeper varicose vein disease, sclerotherapy may not be recommended. Using compression stockings may relieve your symptom temporally.

Published on Jul 11, 2012


Intermountain Vein Center

Published on Mar 11, 2013

First, find an interventional radiologist (IR) in your area to consult with. I would start there for another opinion. IRs are the best doctors for these types of procedures. There is usually always a way to help relieve the pain.

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Answered by Intermountain Vein Center

First, find an interventional radiologist (IR) in your area to consult with. I would start there for another opinion. IRs are the best doctors for these types of procedures. There is usually always a way to help relieve the pain.

Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on Mar 09, 2013

Foam sclerotherapy may be an option since ligation is not usually a good option in most circumstances.

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Answered by Bella MD Laser Vein and Aesthetic Center

Foam sclerotherapy may be an option since ligation is not usually a good option in most circumstances.

Published on Jul 11, 2012


Vein 911

Published on Mar 08, 2013

It sounds like ultrasound-guided foam sclerotherapy would be your best option. Some practitioners are not comfortable or skilled with this procedure but in the right hands, ultrasound-guided foam sclerotherapy can adequately treat (eliminate) any problem vein. There is no cause for vein stripping or ligation on any patient in my opinion. All problem veins can be dealt with without traditional surgery.

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Answered by Vein 911

It sounds like ultrasound-guided foam sclerotherapy would be your best option. Some practitioners are not comfortable or skilled with this procedure but in the right hands, ultrasound-guided foam sclerotherapy can adequately treat (eliminate) any problem vein. There is no cause for vein stripping or ligation on any patient in my opinion. All problem veins can be dealt with without traditional surgery.

Published on Jul 11, 2012


Arizona Vein Specialists

Published on Mar 07, 2013

EVLT can be attempted, as it is more effective than sclerotherapy. Obviously, being able to "navigate" up the vein is essential. Occasionally, additional access sites are needed to skip over scarred areas. A ligation may not be as effective if the rest of the vein remains in place. Compression hose are intended to be only temporary, unless the deep veins have been damaged. Tributary veins should be treated with sclerofoam or phlebectomy if pathologic reflux is present.

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Answered by Arizona Vein Specialists

EVLT can be attempted, as it is more effective than sclerotherapy. Obviously, being able to "navigate" up the vein is essential. Occasionally, additional access sites are needed to skip over scarred areas. A ligation may not be as effective if the rest of the vein remains in place. Compression hose are intended to be only temporary, unless the deep veins have been damaged. Tributary veins should be treated with sclerofoam or phlebectomy if pathologic reflux is present.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Mar 07, 2013

If your varicose veins are due to underlying saphenous insufficiency, the appropriate treatment is laser ablation of that vein. If the clots were in the varicose veins (which are more superficial) and these have resolved, I would recommend microphlebectomy under local anesthetic (the veins are remove through tiny punctures). Injection of these involves multiple visits, whereas phlebectomy is a one treatment visit. If your saphenous vein is scarred due to an old clot, I would not ligate. Instead, I would go to the highest straight area in the thigh and do an ablation.

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Answered by Vein Specialties of St. Louis

If your varicose veins are due to underlying saphenous insufficiency, the appropriate treatment is laser ablation of that vein. If the clots were in the varicose veins (which are more superficial) and these have resolved, I would recommend microphlebectomy under local anesthetic (the veins are remove through tiny punctures). Injection of these involves multiple visits, whereas phlebectomy is a one treatment visit. If your saphenous vein is scarred due to an old clot, I would not ligate. Instead, I would go to the highest straight area in the thigh and do an ablation.

Published on Jul 11, 2012


Advanced Vein Center

Published on Mar 07, 2013

Sclerotherapy would be my recommendation.

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Answered by Advanced Vein Center

Sclerotherapy would be my recommendation.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Mar 07, 2013

Closure procedures don't treat the varicose veins directly, but rather the leaking valves in the saphenous veins that are feeding the varicose veins. If your valves are the problem, then they need to be closed either by laser closure (preferred) or sclerotherapy. Next, the varicose veins can be treated by either microphlebectomies or sclerotherapy. If the saphenous vein is severely scarred, then ligation and stripping may be an option. However, the latter procedures are done very infrequently. Due to advancements, I have not had to do ligation and stripping in over 13 years.

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Answered by Vanish Vein and Laser Center

Closure procedures don't treat the varicose veins directly, but rather the leaking valves in the saphenous veins that are feeding the varicose veins. If your valves are the problem, then they need to be closed either by laser closure (preferred) or sclerotherapy. Next, the varicose veins can be treated by either microphlebectomies or sclerotherapy. If the saphenous vein is severely scarred, then ligation and stripping may be an option. However, the latter procedures are done very infrequently. Due to advancements, I have not had to do ligation and stripping in over 13 years.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Mar 07, 2013

Try sclerotherapy first.

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Answered by Cosmetic Vein Centers of Texas

Try sclerotherapy first.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Mar 07, 2013

It is hard to make a recommendation without more information, but it is fair to say that sclerotherapy could be your best option. The procedure can provide a good deal of relief as far as symptoms are concerned.

Answered by Laser Vein Center (View Profile)

It is hard to make a recommendation without more information, but it is fair to say that sclerotherapy could be your best option. The procedure can provide a good deal of relief as far as symptoms are concerned.

Published on Jul 11, 2012


Miller Vein

Published on Mar 07, 2013

I have yet to see a patient who is not a candidate for a minimally invasive procedure. Sometimes, patients are not suited for an ablation procedure; however, microphlebectomy is always an option if there are varicose veins present. Sclerotherapy is an acceptable alternative to microphlebectomy. Ligation is no longer considered a helpful procedure.

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Answered by Miller Vein

I have yet to see a patient who is not a candidate for a minimally invasive procedure. Sometimes, patients are not suited for an ablation procedure; however, microphlebectomy is always an option if there are varicose veins present. Sclerotherapy is an acceptable alternative to microphlebectomy. Ligation is no longer considered a helpful procedure.

Published on Jul 11, 2012


General Vascular Surgery Group

Published on Mar 07, 2013

Either option may be possible. It depends on if you can thread an ablation catheter in the vein. Otherwise, foam sclerotherapy may be the best alternative.

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Answered by General Vascular Surgery Group

Either option may be possible. It depends on if you can thread an ablation catheter in the vein. Otherwise, foam sclerotherapy may be the best alternative.

Published on Jul 11, 2012


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