SCLEROTHERAPY

Sclerotherapy Treatment in Jumeirah, Dubai

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 treatment 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 Treatment

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.

ultrasound-guided-sclerotherapy

Before The Procedure

Patients with spider veins, reticular veins and varicose veins who do not have reflux in their saphenous veins, or who have had reflux successfully treated before, are the best candidates for sclerotherapy. Age is not an issue for the treatment. Pregnant and breastfeeding women are, however, advised to postpone the procedure. Sedentary, morbidly obese patients and those with chronic illnesses are not good candidates for sclerotherapy.

Your treating doctor will obtain a detailed medical history from you and will advise you against sclerotherapy if you have certain medical conditions.

The initial consultation will involve examining the legs, and the doctor may draw a simple sketch to map-out the affected areas and the zones that require work. A venous duplex ultrasound examination is performed to check for reflux in an underlying saphenous or major vein.

  • Before coming for the procedure, shower and wash your legs. Dry them well
  • Do not shave your legs on the day of treatment
  • Do not apply any cream or lotion to your legs after you shower
  • Come to your doctor’s office in loose, comfortable clothes and shoes

During The Procedure

Sclerotherapy for spider veins and varicose veins is a relatively simple procedure that requires no anesthesia, so it will be performed in your doctor’s office. The procedure is relatively painless, so local anesthesia is not used. Some oversensitive patients who are apprehensive about needles may require an oral sedative prior to the procedure.

What To Expect Afterwards

First 2 weeks

  • Patients can resume normal activities immediately after sclerotherapy. Walking is encouraged, although strenuous exercises are to be avoided for the first 2 weeks
  • You are advised to wear compression stockings for three days after sclerotherapy treatment
  • Tanning and excessive sun exposure are not advised for few weeks as they may cause staining of the treated area
  • Travelling by air is to be avoided for the first 48 hours following treatment
  • There will be bruising, which is normal. It may be helpful to apply Hirudoid or a similar cream to the bruised areas at night after removing the stockings
  • A hard knot that is tender to touch may develop. This is due to trapped blood inside the treated vein. This will resolve with time. Usually your treating doctor will perform an evacuation of it
  • Occasionally there is a brownish discolouration after injections. This is transient but can take several months to fade
  • Should you experience some tenderness in the area treated, Panadol, Tylenol or Iboprufen will help with this discomfort

After 2 weeks
Sclerotherapy treatment will make the treated veins disappear, and the spider veins fade away. More than one session may be needed to obtain optimal results. It should also be known that the procedure treats only those veins that are currently visible; it does nothing to permanently alter the venous system or prevent new veins from surfacing in the future.

The Future

The majority of people who have sclerotherapy will see an excellent improvement.  Unfortunately, it is not guaranteed to be effective in every case. Around 10% of veins treated do not disappear.

The number of treatments necessary to clear or improve the condition differs with each patient and depends on the extent of the varicose and spider veins.  One to three treatments may be needed.

Complications of sclerotherapy are mostly minor and reversible

  • Itching: you may experience mild itching in the treated areas that lasts up to an hour after the treatment
  • Transient hyperpigmentation: less than 10% of patients who undergo sclerotherapy notice a discolouration after treatment. This usually appears as minor dark streaks. This will fade away with time and disappear. In rare instances this darkening may persist for 4 to 12 months
  • Skin irritation: in less than 1% of patients who undergo sclerotherapy a small ulceration can develop at or near the injection site. That heals slowly over 1 to 2 months. This usually is due to inadvertent injection into or near a small artery. Sometimes this is not preventable.
  • Allergic reactions: very rarely a patient may have an allergic reaction to the sclerosant used. The risk of an allergic reaction is greater in patients with a history of allergies
  • Telangiectatic matting: appearing as a reddish hue, matting is the development of tiny new blood vessels in the treated area. This temporary phenomenon occurs 2 to 4 weeks after treatment and usually resolves itself within 4 to 6 months.
  • Ankle Swelling: this may occur after treatment of veins in the foot or ankle. It resolves in a few days and is lessened by wearing the prescribed support stockings
  • Scotoma: transient visual disturbance occurs infrequently after foam sclerotherapy and is reversible.
  • Phlebitis: this is a rare complication seen in approximately 1 out of every- 1,000 patients undergoing sclerotherapy. It can be treated
  • In large varicose veins (greater than 3mm to 4mm in diameter), spontaneous phlebitis or thrombosis (or both) may occur with the associated risk of pulmonary embolism. Additionally, large skin ulcerations may develop in the ankle region in patients with longstanding varicose veins and underlying chronic venous insufficiency (CVI).

Looking for the best sclerotherapy treatment for spider veins in Dubai? Get in touch with our experts at SHAMMA Clinic in Jumeirah today!

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