Sclerotherapy

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Sclerotherapy is a procedure used to treat blood vessels or blood vessel malformations (vascular malformations). A medicine is injected into the vessels, which makes them shrink. This is one method, along with surgery, radiofrequency and laser ablation, for treatment of varicose veins and venous malformations. In ultrasound-guided sclerotherapy, ultrasound is used to visualize the underlying vein so the physician can deliver and monitor the injection. Sclerotherapy is often done under ultrasound guidance after venous abnormalities have been diagnosed with duplex ultrasound.

Need to Know

Nice to Know
  • You will be asked to sign a consent form before the procedure is performed
  • Tell your radiologist about any allergies, especially to local or general anesthetics and contrast materials (“x-ray dye”)
  • If you are taking a blood thinner or aspirin product, the physician will instruct you when to stop taking these medications
  • Inform your radiologist if you are pregnant
  • Following the injections, avoid aspirin, ibuprofen, or other anti-inflammatory drugs for at least 48 hours. Tylenol may be used if needed
  • You should avoid the following for 48 hours after treatment:
    - Hot baths
    - Hot compresses
    - Whirlpools or saunas
    - Direct exposure to sunlight
    - Showers are permitted, but the water should be cooler than usual
    - The injection sites may be washed with a mild soap and tepid water

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How Does It Work?

This procedure may be done in your doctor's office or at the hospital. Sclerotherapy is a medical procedure used to eliminate varicose veins and spider veins. Sclerotherapy involves an injection of a solution directly into the vein. The solution irritates the lining of the blood vessel, causing it to swell and stick together. Over time, the vessel turns into scar tissue that fades from view.

What Happens — Before, During, and After?

A nurse will bring you into the pre-procedure area and ask you to change into a gown. Your doctor will greet you, review the procedure, and answer any questions you may have. You will be brought into the procedure room, and you will be positioned on the procedure table. The solution is injected through a very fine needle directly into the vein. At this point, you may experience mild discomfort and cramping for one to two minutes, especially when larger veins are injected. The number of veins injected in one session varies, and depends on the size and location of the veins, as well as the general medical condition of the patient.

The procedure takes approximately 30 minutes.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. You might like to keep a list of questions or – as you’re doing now- educate yourself about the procedure.

Another important part of your preparation will be guided by your doctor:

  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin, Warfarin, Plavix, Fragmin) for a time before the procedure.

Some of your preparation will need to be timed to the procedure:

  • The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a clinical staff member from the Interventional Radiology Department will call you. The clinical staff member will give you any additional instructions, and will ask if you have any questions.
  • Take your medications as instructed
  • When you arrive, make sure the clinical staff member and radiologist know about any allergies you may have, especially allergies to local anesthetics (such as lidocaine), general anesthetics, or x-ray dye (contrast media). If there’s any chance you might be pregnant, tell your radiologist.
 
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What Should I Bring?

  • Wear comfortable, loose-fitting clothes
  • Wear comfortable shoes
  • Avoid bringing jewelry or valuables
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What Are the Benefits and Risks?

The benefits of Sclerotherapy could be:

  • Targeted veins can be eliminated with each session of sclerotherapy
  • In general, spider veins respond in three to six weeks, and larger veins respond in three to four months. If the veins respond to the treatment, they will not reappear.

Risks you should be aware of include:

  • Itching, this can last for one or two days after the procedure
  • You may experience raised, red areas at the injection site. These should disappear within a few days
  • Bruising may also occur around the injection side and can last several days or weeks
  • As with any procedure there is a slight risk of bleeding and or infection
  • Allergic reactions to the fluid that's injected may occur at the time of the injection and are rarely serious

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.

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