Endovenous laser treatment has been pushed on my by most doctors, but the procedure is expensive and out of my budget. Are veins ever too large for ultrasound-guided sclerotherapy? I'm afraid I can't get a honest answer.
Treating varicose veins alone is not the answer. The veins are a result of the refluxing valves usually in the saphenous system. If you treat the varicose veins without treating their source, then they will return. Ultrasonic sclerotherapy can be done on large varicose veins, but the larger the vein, the longer it will take to absorb and resolve.
Published on Jul 11, 2012
Sclerotherapy is most commonly used for smaller, spider veins (those less than 5 mm in diameter) and involves injecting a liquid or foam solution directly into the vein to help coagulate and shut down the vein. The solution is designed to damage the lining of the vein, causing the vein walls to swell, stick together, and seal shut. Blood flow will then cease in that vein, and it will become scar tissue. No anesthesia is required for this treatment; however, it is less effective on larger veins and has a higher recurrence rate compared to other minimally invasive techniques.
Published on Jul 11, 2012
Generally, big veins are best treated with ablation of the source veins and phlebectomies, not sclerotherapy.
Published on Jul 11, 2012
Having published several research papers in medical journals during the 1990's on this very topic, I would say ultrasound-guided sclerotherapy (UGS) can always be used to treat even the largest of varicose veins, often successfully. Still, some larger veins do fail to respond. I would be more concerned about the underlying saphenous vein size. If larger than 10 mm on ultrasound, thermal ablation is a better bet. If smaller than 10 mm, UGS is reasonable. Just keep in mind that unsuccessful UGS results usually preclude thermal ablation for many years afterward and can increase the overall cost of treatment. Ask for a comparison of both treatments. If your physician will not discuss both options, consider going elsewhere.
Published on Jul 11, 2012