INJECTION TREATMENTS - Ultrasound guided Sclerotherapy

	DOING NOTHING
	STOCKINGS
	INJECTION TREATMENTS
		SCLEROTHERAPY
		ULTRASOUND GUIDED SCLEROTHERAPY (UGS)
	ENDOVENOUS LASER TREATMENT (EVLT)
	SURGERY
		TRANSILLUMINATED POWERED PHLEBECTOMY
		VNUS CLOSURE
		SURGITRON

Sclerotherapy  ::  Ultrasound Guided Sclerotherapy

Ultrasound guided Sclerotherapy (UGS)

The origin of the Varicose Vein is very often not visible, and may in fact be some distance from the visible vein. This can be demonstrated with a duplex ultrasound. If suitable, the origin of the Varicose Vein can be injected by using the picture of the ultrasound, much like a radar, to guide the injection into precisely the correct spot. This technique has many advantages over surgery in that it is quick, very safe, and an immediate return to work, and of course no anaesthetic.

However there are some down sides

A tight stocking needs to be worn day and night for 2 weeks

A small percentage of people do not react (Approximately 4 – 7%)

There is an unknown long term success rate. (The procedure is relatively new)

There is a recurrence rate, which is not known yet (for the same reason.) but is probably around 25%. (We review our results every 2 years, and find that there is a definite recurrence rate which increases as time goes on)

It may take several visits, as we will not use more than the recommended dosage per session. Thus extensive varicose veins always require multiple visits if done safely.

Caution!

Creating a foam in the sclerosant before injecting is used in some clinics. The idea is that there is greater contact with the vein wall, and thus a better result and less sclerosant used. However, injecting bubbles into a vein could create a similar risk to that suffered by divers who develop “the bends”. (which is also due to bubbles). There are reports of loss of vision with this technique, but the concern is that the brain damage that may be caused by injecting bubbles may not become apparent for many years.

We have been waiting for reports in the literature that demonstrate the safety of this technique. As these have not been forthcoming, we are in the process of attempting a prospective trial in conjunction with Auckland University, so that these concerns can be defined safely.

Until the safety of this procedure has been demonstrated by properly constructed and reported trials, we will not use this technique.