Varicose veins may be treated by either surgery, ultrasound guided sclerotherapy (UGS) or Endovenous Ablation (EVLT).
What is UGS
UGS involves the injection of a sclerosant substance into the vein under ultrasound guidance. The two sclerosants or solutions that are normally used are Sodiumtetradecylsulphate and Aethoxysclerol. These solutions came in a concentration of 3% and can be reduced in concentration by the doctor as required.
How is the treatment
Normally, the treatment protocol is to treat any 1 leg at a session (a session may take between 1/2 hour and one hour) with reviews done at 1 week, 2 weeks, 6 weeks and 12 weeks post treatment. If two limbs need to be treated, the 2nd limb can be treated after 2 weeks. A compression stocking following treatment is mandatory and worn for a minimum of 2 weeks.
Is the treatment painful?
The treatment is relatively pain free and no anaesthetic is used. Return to normal duties immediately after treatment is encouraged. As with all treatments, there is a healing period and this time depends largely on the state of the veins to start with – the bigger the varicose vein, the longer the healing period.
Treating varicose veins is not a cure – reoccurrence is possible no matter what method is used to treat them. Left untreated, varicose veins may lead to itching and eczema, discolouration of the skin, swelling of the legs, deep venous thrombosis, bleeding and ulceration.
Treatment of spider veins and reticular veins.
These may be treated by micro sclerotherapy or laser ablation.
Micro sclerotherapy is done by direct vision and the same sclerosants, Sodiumtetradecylsulphate and Aethoxysclerol in reduced concentration is used.
Multiple injections are done into the offending veins and most patients require 2 to 3 treatment sessions per leg to obtain a good cosmetic outcome. Again 1 leg is treated at any 1 session with each session being of 30 minutes duration. A compression stocking is again generally required and worn for one week.
The 2nd leg is treated one week after the first and repeat treatments to the same leg are spaced 1 month apart. No anaesthetic agent is used in the treatment and most patients cope with the pain quite well for the duration of the treatment.
With the introduction of foam sclerotherapy for UGS and micro sclerotherapy the outcomes are far better and achieved with fewer injections and treatment sessions.