The Clinic is Closed

Sclerotherapy and How It Works

One of the commonest questions I get asked both by doctors and nurse colleagues is what is sclerotherapy and how exactly does it work? Sclerotherapy is the injection of a prescription medicine directly into to a vein and this results in the permanent closure.

So it achieves the same as a surgical removal and the chemical injected into the vein is called a sclerosant. Sclerotherapy is really very versatile. It is the only single modality treatment that can be used for nearly any vein in the superficial venous system of the leg. Sclerotherapy is the treatment of choice for thread veins spider veins and their feeder veins called reticular veins. And in addition sclerotherapy can be used to treat varicose veins reflux in the great saphenous vein and the small saphenous vein. It can treat residual veins – that’s leftover veins after other treatments such as laser and VNUS closure. It can be used to treat recurrent veins – that’s veins that comeback after treatment. And it can be used to treat incompetent perforating veins that connect varicose veins to the deep veins.

Sclerosing agents can be classified into one of 3 different types. Detergents, osmotic agents and chemical irritants. Now very few people in the United Kingdom use osmotic agents such as hypertonic saline because they are painful on injection and if the sclerosant leaks out of the vein it can damage the skin quite severely. Very few people in the United Kingdom use chemical irritants such as chromated glycerine because they can cause serious allergic reactions and serious complications such as kidney failure. Most specialists in United Kingdom use detergents such as sodium tetradecyl sulphate – fibrovein – or polidocanol – aethoxysclerol.

This is how sclerosants work. They all cause endothelial destruction and the aim is to cause endothelial destruction over a sufficient length and circumferentially so that when an inflammatory reaction is initiated it leads to healing by fibrosis and complete obliteration of the vessel wall. Sclerosing agents work by disrupting the delicate cell membrane of endothelial lining. And they are used in their liquid form to treat thread veins and reticular veins. One of the special characteristics of of detergent sclerosis and is is they can be mixed with air and as a foam sclerosant and they can be used to treat large varicose veins or reflux in the great saphenous vein and the small saphenous vein. Now as you can see from the right-hand side of this slide in some cases there can be quite a lot of clot forming in the vein lumen and occasionally this clot can organise and the vein can recannalise leading to failure of the treatment. So it is very important after sclerotherapy to follow the patient up and if necessary perform more sclerotherapy to areas that are recovering. Well that is what a sclerosis is and that’s how sclerotherapy works.

Contact me today for a confidential chat

If you’re worried about your veins and would like a confidential chat please do get in touch. I am happy to offer simple advice by telephone or email for free and without obligation.

The VeinCare Centre also offers a screening assessment with our vascular technologist. For £25 you can have a scan with Wendy Parsons. She is not a doctor and so she could not give you medical advice but she can check your deep veins and your varicose veins and give you an idea of how bad they are and what treatment options might be available. If you would like to have an appointment with Wendy please call 0800 698 3467.