Which veins get injected with sclerotherapy for varicose veins treatment? Is it the bulging ones or the ones inside the leg that we don't see that are varicose? Thank you!
If the Great Saphenous Vein (GSV) or the Small Saphenous Vein (SSV) is insufficient (not able to prevent blood from flowing down with gravity), treatment, i.e., 'vein closure', is almost always done by EVA (Endovenous Ablation). EVA involves heating the vein by the placement of a catheter within the vein's lumen. THe heat is delivered to the vein through radiofrequency or laser energy. Sclerotherapy treats most other insufficient Varicose Veins. Although visible Varicose Veins are sometimes treated by Phlebectomy (through multiple small incisions in which segments of the vein are 'teased' out), this invariably results in small scars (that always remain) and the segments of the Varicose Veins that have not been removed usually bulge on the skin months or years after treatment.
Published on Jul 11, 2012
Depends on the patient. If we're talking about spider veins generally we inject those directly.
Larger veins may also need injections of the deeper feeding branch some times with ultrasound guidance.
Michael D. Ingegno
Published on Jul 11, 2012
Typically we reserve sclerotherapy for spider and reticular veins (these are usually below the surface or appear as very small varicose veins. If they are larger, I would remove them using microphlebectomy which are tiny punctures and using a fine hook. It is cosmetically pleasing and a one time procedure. If the deeper vein you mention is the saphenous vein, we would use endovenous ablation under local anesthesia where a laser fiber is inserted into the veins and sealed from within. The varicose veins, if larger, can be removed at the same setting.
Injecting larger varicose veins usually requires several treatments, may have episodes of trapped blood which need to be released and involves more trips to the office.
Norman N. Bein MD FACS RVT
Published on Jul 11, 2012
Sclerotherapy is only used for spider veins.
Published on Jul 11, 2012
Almost any vein can be treated by sclerotherapy as long as the vein is big enough to accommodate the needle. However, spider and the blue reticular veins do better with sclerotherapy than the larger varicose veins.
Published on Jul 11, 2012