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Ultrasound guided sclerotherapy is the technique of injecting varicose veins at their source which may be some distance from the visible veins on the skin surface. The adequate treatment of varicose vein disease depends on diagnosing the highest leaking point (reflux) in the venous system of the leg. To enable us to do this, we use doppler ultrasound as a visual guide. This therefore increases the efficiency of this form of treatment for varicose veins.
The patient should allow approximately one hour for the duration of this procedure. No sedation is necessary, therefore the patients are able to leave the Center by themselves. On arrival in the Center, a confirmatory duplex ultrasound is performed with the patient standing. The patient then lies down, the area of the skin to be injected is then sterilized with alcohol. By way of a butterfly needle or angiocath, the medication is directed under visual guidance into the pathological vein. This is essentially a painless procedure. Several injections may be performed in the same session. The area treated is then dressed with bandages and in indicated cases, compression hosiery is applied on top.
Bandages and compression hosiery should be worn for a period of five days. Further instructions will be given to the patient at the time of the procedure. Once the procedure is finished, the patient is up and about and may return to normal activities immediately.
This is a very well tolerated procedure and effectively replaces stripping operations in certain patients. From one to five visits may be needed depending upon the size of the vessel, the extent of the reflux and number of vessels involved. A small percentage of patients may be resistant to sclerotherapy and therefore need surgery comprised of ligation with or without division of the main venous junction in the groin, but this can be done without stripping.
Follow-up visits are on a monthly basis until treatment of the initial diseased system is complete and then yearly maintenance.
Normal post-ultrasound guided sclerotherapy sequels are bruising, pigmentation and spider veins.