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If the chemical is injected directly into the vein and stops it up, couldn't the blood clot and cause problems? Is sclerotherapy safe if someone has a blood clotting disorder?
First we should separate clotting in superficial veins versus clotting in deep veins. Clot formation in sclerotherapy targeted superficial varicose veins and even spider veins is expected and is part of the treatment, not a complication. In fact the name of same type of medication that we use here in US, is ThromboVar (meaning cLot in Varice) in France. VeinClots in superficial veins of legs is not dangerous and cannot lead to pulmonary embolization per se. Normally, clots (trapped blood) in superficial veins that are treated with sclerotherapy are removed by simple procedures about 1-3 weeks after sclerotherapy. Clotting in the deep vein system is referred to DVT (deep Vein thrombosis) and is a risk and complication of any leg surgery or other treatments, which can lead to life threatening pulmonary embolization specially in the case of deep vein clots at thigh and groin levels. With proper sclerotherapy, risk of DVT is very slim and estimated at less than 1/10,000 (when done by experienced phlebologists).
By definition sclerotherapy causes clotting of the targeted veins injected. This is the desired effect to close off the dysfunctional veins. Generally these clotted veins cause no problems, but it does aleviate symptoms and unsightly veins. There may be contraindications to injection sclerotherapy in patients with clotting disorders i.e hypercoaguable states.
Sclerotherapy does cause thrombosis and scarring of the small target veins. This promotes abliteration and subsequent elimination of these veins. However the clotting is not dangerous and should not involve any larger or deeper veins.
Sclerotherapy can cause pockets of trapped blood (which can be drained),
but this is very superficial and doesn't typically cause further
problems. It is very rare for a patient to get a DVT (deep vein clot)
from sclerotherapy. We do have our patients walk around for about 10
minutes directly following a treatment. The reason for this is to get
the blood circulating and flush out any of the solution from the deep
veins if it were to accidentally end up in the deep veins.
The intention of sclerotherapy is to create inflammation within the lining of the vein, causing it to collapse and seal closed. This process frequently involves trapping and subsequent clotting of small amounts of blood within the involved vessel, which the body slowly reabsorbs over time. This process is perfectly normal, and is not dangerous. The dangerous types of blood clots are called "deep vein clots", these vessels are all superficial, and very small. I have not experienced difficulties with patients who have clotting disorders, again because the treated areas are very superficial, and involve small vessels. However, common sense would dictate that we would simply exercise more caution, and be more conservative with someone who has a known clotting disorder, depending on what type it is.
What you are saying is true and a known complication of sclerotherapy.
However, in experienced hands, it is safe even in patient's with a
The short answer is sclerotherapy is very safe. Blood clots in the superficial veins (the ones being treated) are usually not problematic unless extensive.
Sclerotherapy works usually in one of two ways-displacing the blood in the vein to cause it to seal and later dissolve or clotting the blood in the vein first which will lead to resorption of the vein. So sclerotherapy can cause clotting but this is in only superficial veins. It would be unusual for sclerotherapy to cause clots in deeper veins. Sclerotherapy can be done in someone with a blood clotting disorder but it would carry increased risks. I have done sclero in several such patients without any major problems but it has been more difficult to clear all of the spiders. I would recommend you confer with a hematologist before commencing treatment.
Not really. Sclerotherapy is usually reserved for tiny spider veins. Injecting them does not carry a risk of clotting deep veins. If the veins are larger than spider veins, injecting them with some sort of imaging guidance would be best.