The method of sclerotherapy as a way of treating certain diseases, has been known since ancient times. The essence of this method is that the abnormal blood vessel (in this case, the varicose vein) injected a substance that causes the walls of his so-called aseptic inflammation (ie, without the infection). This leads to adhesion of the walls and their fusion with the further formation of fibrosis - scar tissue. Thus, the vessel "disappeared", but instead remains cicatricial cord.
What is sclerosant and what complications are possible when using them
For the procedure of sclerotherapy used drugs, called sclerosants. This is a specially designed material (based on alcohol), which are designed to penetrate into the vein.
When injected into the vessel sclerosant leads to the destruction of the inner - endothelial layer of the vein wall, thereby causing its chemical burn. There is inflammation. With sclerotherapy after administration into a vein, it is compressed by bandages or special jersey. Approximate each other inflamed vein wall faster and easier to stick together and scarring. Thus, the lumen of the vessel simply disappears.
Sclerosant made known pharmaceutical companies in the world. Our country is being recorded and used for the following sclerotherapy sclerosant: etoksisklerol (company Kreisler, Germany) Fibro-Vein (firm STD, England).
It should be noted that these drugs are being used as a treatment for varicose veins in the legs, and for treatment similar to the pathogenesis of venous diseases in other areas, such as varicoceles (varicose veins of the spermatic cord, one of the most common causes of male infertility), and hemorrhoids.
Type of sclerosant, as well as the concentration and volume matched only by your doctor. If the sclerosant is entered correctly into the superficial vein, he has only a local effect, with toxic effects on the body is possible. Contact with a small amount of sclerosant into the deep veins lead to its rapid dissolution (as the flow velocity in the deep veins is higher than in subcutaneous), with no local or general damaging effect.
How is the procedure of sclerotherapy
Sclerotherapy procedure is carried out in a horizontal position of the patient. Before the introduction of the drug the patient should raise the leg to allow the blood to flow down in Vienna. The purpose of such a method - to reduce the amount of blood in a vessel that sclerosants do not dissolve in it, and acted directly on the vein wall. Sclerotherapy procedure takes from 5 to 30 minutes, depending on the number of varicose veins that need to be addressed.
During one session of sclerotherapy doctor can make from 5 to 10 injections. Number of drug administration is determined by the severity of varicose veins and a dose of sclerosant. On average, the treatment can take anywhere from 3 to 5 sessions.
The very introduction of sclerosant into the vein may be accompanied by a burning sensation and some pain for a few minutes.
There is also a new technique for sclerotherapy, which consists of introducing a sclerosant than using needles, but with a catheter. At the same time the introduction of sclerosant is led by duplex Doppler sonography. This method allows sclerotherapy treatment for varicose veins of those who previously could only be treated surgically (ligation or stripping). The use of ultrasonic technology in this case provides greater accuracy and safety of sclerotherapy.
Studies also show that the use of duplex Doppler so-called Foam sclerotherapy-forms (when injected sclerosant in the form of whipped foams) has advantages over the introduction of a liquid sclerosant.
At the present time and such modification is used sclerotherapy as mikroskleroterapiya, which is conducted for the treatment of small varicosities in the form of a "spider veins".
Before the sclerotherapy should consult with your doctor if you are taking any medications (eg, hormones, nonsteroidal anti-inflammatory drugs, etc.). Such drugs will cancel the doctor a few days before sclerotherapy, because they affect blood clotting and can lead to formation of skin bruising and hemorrhaging.
It is also recommended prior to sclerotherapy for 2 days to limit smoking and alcohol intake.
It is also not recommended any cosmetic procedures involving the use of various creams, waxes to remove hair that is all that can lead to skin irritation or infection.
After the sclerotherapy and the imposition of an elastic bandage (jersey) on foot, we recommend a half hour walk a little. In addition, should avoid prolonged standing or sitting, often saunter. Within a week after the procedure, sclerotherapy should limit physical activity, and for 2 months - the sauna or bath (because they lead to the expansion of blood vessels).
Indications for sclerotherapy
Sclerotherapy is indicated for the treatment of:
Small varicosities and the so-called "spider veins"
Smaller varicose veins that appear again after stripping
Large varicose veins using duplex Doppler sonography.
Varicose veins in the early stages when there are no pathological venous relief from superficial veins into the deep.
Sclerotherapy can be used as a method of treating varicose veins separate, and as a complement to surgical methods.
Contraindications to sclerotherapy
Conducting sclerotherapy is contraindicated:
Pregnant and lactating women with breast milk,
Persons with an allergy to sclerosants,
Individuals with thrombosis or thrombophlebitis of deep leg veins,
The combination of varicose veins with severe valve insufficiency main trunks of subcutaneous or communicating veins,
Purulent-inflammatory diseases of the skin of legs.
The effectiveness of sclerotherapy
The advantages of sclerotherapy is a much lower cost compared with the operation, no need to be in the hospital (ie, the patient can go home at once), and a faster recovery period. Sclerotherapy effectiveness in eliminating manifestations of varicose veins is 85%.
Possible complications of sclerotherapy
Among the complications of sclerotherapy include:
Discoloration of the skin along the vein, which was introduced sclerosant. This is the most frequent side effect of sclerotherapy. These changes take place within 6-12 months, and some people can stay permanently.
Recurrence of varicose veins.
Itching, bruising, pain and blistering of the vein.
Scarring and ulcers, if not sclerosant was introduced into the vein, and the skin.
Allergic reactions to the sclerosant.
The formation of blood clots.
Severe pain and burning with the introduction of sclerosing medication is rare, but if it happens it runs fast. Usually after the injection the patient may feel a slight burning for 1-2 hours.
In case of incorrect application of elastic bandage on his leg after the administration of sclerosant may be a strong swelling of the feet, so it is important to properly bandage the leg. This complication occurs in almost no use of compression hosiery.
Allergic reactions to the sclerosant is very rare, mainly in those patients who previously had an allergic reaction to any medications. So if you are allergic to any medication, you should definitely skaschat your doctor.
After contact with a significant amount of skin may be necrosis of the skin. Such a complication, of course, very rare, and may be due to abnormal redistribution of blood flow (arteriovenous shunting) at the site of sclerosant.
Deep vein thrombosis leg with the introduction of sclerosant - an extremely rare phenomenon and is seen in 1 in 10,000 patients (according to the literature). This complication usually occurs in people who already had previous deep vein thrombosis