No, not necessarily.

Published on Jul 11, 2012

Sclerotherapy may, in many patients, be helpful in preventing the rupture of small veins that have almost eroded through the skin. This is very common near the ankle. A vein specialist should review your history and ultrasound. If there is a problem with the valves in your superficial or perforator vein system, that should be addressed as well.

Published on Jul 11, 2012

Thank you for your question. Chronic venous insufficiency causes proliferation of different types of veins, classified as spider veins, reticular veins and varicose veins, especially in the most dependent areas that are farthest away from the heart where gravitational influences are most likely to be highest in insufficient veins. The underlying problem with venous insufficiency is increased pressure in the veins. Typical pressures can be increased 10-fold and reach 40-50 mm Hg. As a result, the reticular veins and varicose veins erode into the skin and ultimately are at risk for spontaneous bleeding. The skin will continue to thin over the said veins and are most likely to bleed when patients are showering where increased skin temperature causes further vasodilation of the veins. When this happens, you should use a single finger and place digital pressure directly over the bleeding site and hold it for more than 15 minutes without looking at it by removing digital pressure. You can decide at that point whether you need to go to the emergency room for evaluation and treatment.

Sclerotherapy with foam is an excellent technique to treat this problem, but it is necessary to get evaluated for venous insufficiency and to get the underlying problem solved in order to reduce and/or normalize venous hypertension, i.e. high pressure in the veins that place you at risk for recurrent bleeding.

Options for treatment for venous insufficiency are endovenous laser ablation or VNUS RF ablation or some of the newer procedures such as varithena. EVLT/EVLA/ELVeS and VNUS closure are time tested and published series have shown them to be quite efficacious at 5, 7 and 10 years follow-up.

Always seek treatment from ABVLM certified vein specialists.

Published on Jul 11, 2012

If you have reflux (faulty valve) in the saphenous vein, there is pressure in the lower legs causing varicose veins (pressure relief valves) and when the skin and vein walls become thin, they can rupture. Best to apply local pressure and elevate immediately above heart level to stop. Treating the local area will not solve the problem long-term. You are a good candidate for laser ablation (EVLA) of the saphenous vein with microphlebectomy (removal of varicose veins through tiny punctures) at the same time. These procedures are in-office and only require a local anesthetic. You can walk in and walk out with very little time off work. See a board-certified vascular surgeon who specializes in these procedures, and I think your long-term problems will be greatly decreased.

Published on Jul 11, 2012

Sclerotherapy will occlude the vein, but there is no guarantee that bleeding will not occur again. It would be wise to treat the cause of the varicose veins with a closure procedure and remove the veins through either microphlebectomies or sclerotherapy. If you bled, I would prefer microphlebectomies.

Published on Jul 11, 2012