Sclerotherapy is the injection of a medication (sclerosing solution, sclerosant) into an abnormal vein in order to bring about its disappearance. The sclerosant agitates the lining of the vessel, causing it to swell and stick together, which makes the vein collapse and disappear. If the injected vein is feeding a spider vein web, the entire cluster of spiders may also disappear. Depending on the size, length, location of the vein to be treated and other factors, your vascular surgeon or phlebologist will choose different concentrations of sclerosant for each vein.

At Dr. A. R. Shamma Medical Center we perform sclerotherapy using four different techniques: straight (simply diluted solution), transillumination-guided sclerotherapy, foam sclerotherapy, and ultrasound-guided sclerotherapy.

Transillumination-Guided Sclerotherapy (TGS)

Spider veins are often fed by blood leaking from an underlying feeder reticular or varicose vein. Like the root of a weed, this feeder vein is not visible to the naked eye but is the lifeline of the spider veins (weed).

In TGS, a fibre optic light is placed on the skin, allowing us to see the feeder vein with the feeder illuminated, the sclerosing solution (straight or foam) is injected directly and accurately. The spider veins frequently disappear as a result of this treatment alone, and their direct injection is avoided.

Foam Sclerotherapy

Normally the sclerosing solution is injected directly into the vein. Foam sclerotherapy involves making small volumes of the solution into foam by rapid mixing and agitation with air. This can then be used to treat some of the larger underlying abnormal veins which would not normally be treated with conventional sclerotherapy.
The foam solution causes intense spasm of the vein, which amplifies the sclerosing effect. Furthermore, the foam solution stays in contact with the inner lining of the vein for longer, again increasing the effect.

Ultrasound-Guided Sclerotherapy

Using ultrasound scanning, the vein to be treated will be marked on your leg. With the ultrasound image as a guide, your vascular surgeon or phlebologist will introduce a fine needle to the vein, usually in the mid-calf or lower thigh. The needle will then be flushed with a blood-thinning agent containing heparin. Your leg will be raised and the foam solution will be injected in small volumes into each of the needles.  During this procedure you will be asked to bend your ankle up and down in order to increase the blood flow in your deep veins. As the foam is injected you may experience some slight stinging, but it is usually painless. The passage of the foam in the vein is monitored by the ultrasound scan, and the foam injections will be repeated 2 or 3 times. Once enough foam has been injected, the needle will be removed, and pieces of sponge will be applied to your leg, followed by a bandage in order to compress the treated veins. An elastic compression stocking will then be put onto your leg, up to the thigh with a waist attachment.


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