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Last updated: 11/24/2009
Cosmetically, the chief risk of sclerotherapy is that new spider veins may develop after the procedure. New spider veins are dilated blood vessels that can form when some of the venous blood forms new pathways back to the larger veins; they are not...
the original blood vessels that were sclerosed. Some patients may develop telangiectatic matting, which is a network of new spider veins that surface around the treated area. Telangiectatic matting usually clears up by itself within three to 12 months after sclerotherapy, but it can also be treated with further sclerosing injections.
Other risks of sclerotherapy include:
- Venous thrombosis. A potentially serious complication, thrombosis refers to the formation of blood clots in the veins.
- Severe inflammation.
- Pain after the procedure lasting several hours or days. This discomfort can be eased by wearing medical compression stockings and by walking briskly.
- Allergic reactions to the sclerosing solution or foam.
- Permanent scarring.
- Loss of feeling resulting from damage to the nerves in the treated area.
- Edema (swelling) of the foot or ankle. This problem is most likely to occur when the foot or ankle is treated for spider veins. The edema usually resolves within a few days or weeks.
- Brownish spots or discoloration in the skin around the treated area. These changes in skin color are caused by deposits of hemosiderin, which is a form of iron that is stored within tissue cells. The spots usually fade after several months.
- Ulceration of the skin. This complication may result from reactive spasms of the blood vessels, the use of overly strong sclerosing solutions, or poor technique in administering sclerotherapy. It can be treated by diluting the sclerosing chemical with normal saline solution.
- Hirsutism. Hirsutism is the abnormal growth of hair on the area treated by sclerotherapy. It usually develops several months after treatment and goes away on its own. It is also known as hypertrichosis.
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Varicose veins are the tortuous veins that are visible just under the surface of the skin. While the condition is not generally medically important, varicose veins are not desirable cosmetically. The narrated animation describes how varicose veins are thought to form.
During sclerotherapy for the treatment of varicose veins, the doctor injects a chemical solution directly into the vein (A and B). The needle travels up the vein, and as it is pulled back, the chemical is released, causing the vein to form fibrous tissue that collapses the inside of it (C). (Illustration by GGS Inc.)
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A commonly performed non-surgical treatment for varicose and "spider" leg veins is sclerotherapy. It has been used in the treatment of varicose veins for over 150 years. Sclerotherapy is often used for telangiectasias (spider veins) and varicose veins that persist or recur after vein stripping. Sclerotherapy can also be performed using microfoam sclerosants under ultrasound guidance to treat larger varicose veins, including the greater and short saphenous veins. A study by Kanter and Thibault in 1996 reported a 76% success rate at 24 months in treating saphenofemoral junction and great saphenous vein incompetence with STS 3% solution. A Cochrane Collaboration review concluded sclerotherapy was better than surgery in the short term (1 year) for its treatment success, complication rate and cost, but surgery was better after 5 years, although the research is weak. A Health Technology Assessment found that sclerotherapy provided less benefit than surgery, but is likely to provide a small benefit in varicose veins without reflux. Complications of sclerotherapy are rare but can include blood clots and ulceration. Anaphylactic reactions are "extraordinarily rare but can be life-threatening," and doctors should have resuscitation equipment ready. There has been one reported case of stroke after ultrasound guided sclerotherapy when an unusually large dose of sclerosant foam was injected.
From http://en.wikipedia.org/wiki/Varicose_veins#Sclerotherapy
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