Ultrasound Guided Sclerotherapy
Ultrasound Guided Sclerotherapy is the term used for a minimally invasive technique for treating various vascular diseases. It is most frequently used for small to medium sized varicose veins it is an extremely well tolerated local anaesthetic procedure that can be performed with minimal discomfort and with no need to stay in hospital. Patients can usually walk in and walk out again within an hour or so having been treated.
With the patient lying down and using an ultrasound scanner, the Vein Specialist identifies the vein or veins to be treated and use the live pictures to guide the tip of a needle into the right place within the vein. Once the needle is secured in the correct place and checked for safety, a chemical, called a sclerosant, is injected into the vein. This damages the lining of the vein, causing it to clot and get absorbed over time. For bigger veins, the sclerosant can be mixed into a foam, using air, and injected. The foamed sclerosant can treat a larger area of vein by using the air to push the blood within the vein away allowing the chemical to be in close contact with the vein wall so as to have its effect. The foam can be seen as it travels along the vein so the extent of treatment can be accurately assessed. It also enables the Vein Specialist to ensure that the vein does not pass out of the vein to be treated and into normal veins. The foam disperses within a few seconds of treatment.
UGS and UGFS (with foam) can be used to treat a wide variety of varicose veins and is often used in combination with Endovenous Ablation techniques to "mop-up" any remnant veins. It frequently needs several visits to treat all the veins, particularly if there are very many. A limited amount of the sclerosant can be injected at any one visit, a couple of weeks between visits is recommended.
After treatment, the patient is given a compression stocking to wear to help keep the vein closed preventing too much blood from filling and clotting within the vein as this can cause swelling and inflammation. Some inflammation is expected but too much can cause excessive pain and bruising. The compression stocking should be worn for at least the first 48 hours and then it is advisable to wear it for the rest of the week during the day only and during activity.
The immediate post procedure period may have noticeable bruising and inflammation. This settles quickly and within a few days the bruising will begin to disperse. Depending on the amount of bruising, some brown tanning can effect the skin for a longer period, but that usually becomes unnoticeable within a couple of months.
The main risks of the procedure are excessive inflammation, deep vein thrombosis, skin burns from the chemical inadvertently being injected into the skin, and recurrence of the vein. Overall, UGS is a very well tolerated, and very safe procedure for small to medium sized varicose veins.
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