is an FDA-approved system used to permanently treat varicose veins close to the surface of the skin. A catheter is inserted through the skin, and a small amount of medical glue is injected into the affected vein. Once the vein is sealed, blood that was once backed up gets re-routed to other healthy veins in the leg. The treatment is indicated for varicose veins that produce mild to moderate symptoms such as pain, blood clots, or skin ulcers.
Clinical studies have demonstrated that the procedure is safe and effective. The procedure is administered without the use of tumescent anesthesia, avoiding patient discomfort associated with multiple needle sticks.
The VenaSeal™ closure system uses a proprietary medical adhesive to close the superficial vein. Thermal energy procedures use heat to close the vein. The intense heat requires a large volume of numbing medicine, which is injected through many needle sticks. The injections may cause pain and bruising after the procedure.
is a commonly used method to reduce and close varicose, reticular and spider veins. Veins are injected with a sclerosing agent that irritates and closes the vein. Best results of sclerotherapy treatments are visible 4 to 6 months after injections.
What to Expect
Most patients require several treatments of sclerotherapy to obtain optimal results. Treatments are typically scheduled in 4 week intervals. There is no recovery period and bed rest is not required. Exposure to the sun should be avoided for 2 weeks after treatment to prevent skin discoloration.
Travelling by air must be avoided for at least 2 weeks following sclerotherapy due to an increased risk of blood clot formation.
Following a sclerotherapy treatment patients are required to wear compression stockings for 3 consecutive days and nights. Bathing, showering, swimming, heavy lifting and extreme physical exercise or activities should be avoided during this 3 day period.
Risks Associated with Sclerotherapy
- Skin discoloration can take 6 to 12 months to disappear; can also be permanent.
- Failure of treatment; it is successful for 80% of patients.
- Itching, bruising, pain, and blistering where the veins were treated.
- Scarring resulting from ulcers or deterioration of the tissue around the treated vein. This is rare.
- Blood clots or damage in the deep vein system (DVT).
- Allergic reaction to sclerosing agent is possible but uncommon.
Common Effects of Sclerotherapy
Following sclerotherapy it is normal to experience bruising, tenderness and redness at the injection sites. In larger veins, as the healing progresses and the veins begins to close, it is common for small lumps to develop along the length of the vein. This is normal and is an indication that the treatment is working. These common effects of sclerotherapy will dissipate on their own. An anti-inflammatory drug such as Advil or Aleeve, along with a cold compress or ice packs can be used to alleviate any discomfort if necessary.
EndoVenous Laser Therapy (EVLT)
is a minimally invasive procedure performed with local anesthetic. A sheath (tube) is inserted into the vein being treated using ultrasound guidance. The laser energy (heat) is then applied heating the vein and sealing it closed as it is drawn out.
What to Expect
EVLT takes approximately 1 hour to perform. It involves minimal discomfort and has a quick recovery period. Compression therapy is used immediately following the procedure and patients are required to wear the compression stockings for 2 consecutive days and nights and then for an additional 2 weeks during daytime hours only. Patients are unable to drive themselves home following this procedure and a driver must be arranged.
Common Effects of EVLT
Following EVLT it is normal to experience bruising along the treatment site as well as tightness that may feel like a “pulled muscle”. Stiffness, swelling and discoloration can also occur over the treated area and will continue to progressively improve. Patients are encouraged to walk and drink plenty of fluids. An anti-inflammatory drug such as Advil or Aleeve, along with a cold compress or ice packs can be used to elevate any discomfort if necessary.
- You may eat and drink normally however please avoid products containing alcohol and limit the number of caffeinated beverages to one (i.e. coffee, cola, tea) this is to prevent constriction of blood vessels.
- Ensure to bring your thigh-high compression stockings with you to your appointment. These must be 20-30mmHg compression strength unless otherwise indicated by the vascular surgeon.
- Wear or bring comfortable, loose fitting clothing that can easily be worn over the compression stocking and bandages
- Ensure you have arranged transportation home as you will not be able to drive for 24 hours following the procedure.
During the Procedure
- Upon arrival you will be asked to change into a gown (if your undergarments are high-cut they may be left on)
- The vein to be treated will be viewed on an ultrasound and a pre-treatment photograph will be taken
- You will then lie on the procedure table and a cleaning solution will be used along the leg to be treated and sterile sheets will be placed around the area.
- Local anesthetic (freezing) is administered at the access site and a needle is placed through the skin into the centre of the vein to be treated. Rarely a small incision is made.
- A guide-wire is placed through the needle into the vein. It is possible to feel the wire but it will not be painful.
- A sheath (tube) is placed over the guidewire and the correct position of the vein is established using ultrasound imaging. A laser fibre is then placed into the sheath.
- Additional anesthetic will be administered along the length of the vein to be treated.
- The laser is then turned on and pulled back along the length of the vein using heat energy to close the vein channel. The laser is usually on for approximately 5-6 minutes.
- The laser is then removed and a small bandage is placed over the access site.
Immediately After Procedure
- A bandage wrap will be applied around the leg and your support stocking put into place to apply pressure to the treated area.
- We will encourage you to stand and walk for a few minutes to ensure bandages are comfortable and to promote circulation.
The First 48 Hours
- The compression stocking and bandage must be kept on and kept dry.
- You are encouraged to walk at a casual pace for limited durations.
- Avoid prolonged periods of standing in place or sitting with legs downward. When sitting, elevate your legs.
- You may apply ice packs on top of the bandage and stocking and/or take an anti-inflammatory (Advil or Aleeve) should you have any discomfort.
- Drink plenty of non-alcoholic and caffeine free beverages to avoid dehydration
remain fundamental and vital for the prevention and treatment of varicose veins and lymphatic disorders in ambulatory patients. The stockings will slow the process of developing more and worse varicose veins but will not eradicate them. In addition, regular wearing of elastic support stockings will relieve swelling, pain, soreness, cramps, improve calf muscle pump function and reduce progression of venous disease.
Compression stockings work by reducing the amount of blood and pressure inside superficial and deep venous systems of the legs. To be effective patients should wear stockings at the start of the day and remove them prior to going to sleep.
Compression stockings are used post sclerotherapy of small and medium size varicose veins. After the solution is injected the stockings are put on to keep the veins collapsed sticking together eventually turning into scar tissue which will fade away. Medical compression stockings are 20 – 30 mmHg or higher and are used for chronic venous insufficiency, edema, venous stasis ulcer, dermatitis and post treatment of varicose veins including EVLT and surgical procedures.