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If sclerotherapy and cool touch laser didn't work what should I try next?
Depends on the vein size. If they are very small veinwave may be an option. if they are larger re injection with a different or stronger solution of polidocanol of sotradecol may be efficatious.
Michael D. Ingegno, MD
Perhaps a second opinion with a fresh look with a different ultrasound
technologist might identify other leaking veins. If plan A and B have not
worked it is time to consider Plan C. I do have patients who have problems
with persistent and stubborn spider vein clusters after a successful
endovenous laser closure and what I would consider a complete series of
injection sclerotherapy. If it has been more than a few months I will then
repeat the ultrasound to make sure no new veins have become leaky and if
there is nothing which needs laser closure(ablation) then I will use
ultrasound guidance to perform the next session of sclerotherapy and inject
the unnamed veins which usually lie beneath the clusters of veins. This
will usually fix the problem.
You should first have a venous ultrasound to see if you have underlying reflux, which could be contributing to your vein problem. If this is the case, then the reflux should be treated first. If no reflux, then see an experienced sclerotherapist. A higher concentration of solution or a different solution can be used.