Ultrasound-Guided Sclerotherapy

What is Ultrasound Guided Sclerotherapy?

When a vein cannot be seen because it is hidden beneath the skin, it may be necessary to use ultrasound guided sclerotherapy. For these procedures, the sclerosant solution is injected into the abnormal vein after it is targeted using ultrasound imaging. Prior to entering to inject the sclerosant solution, in these procedures a detailed ultrasound examination is usually done first to provide a roadmap of sorts for the upcoming sclerotherapy.

Ultrasound-Guided Sclerotherapy
Ultrasound-Guided Sclerotherapy

What Sclerotherapy Targets

The procedure basically substitutes ultrasound imaging for the naked eye of one of our providers. With spider or varicose veins that are visible, it’s not difficult to see the targeted vein and deliver the sclerosant into the vein. When the vein is hidden beneath thicker skin, however, this isn’t possible. Ultrasound imaging is used to visualize the vein first, and then to guide the delivery of the sclerosant solution.

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Are There Any Risks Involved with Ultrasound-Guided Sclerotherapy?

Ultrasound doesn’t add any additional risk to these already very low-risk treatments. Ultrasound uses sound waves to generate the images of the veins being targeted. You’ve probably heard of ultrasound being used to provide images of the fetus during pregnancy. This is a safe, harmless energy source that has been used for decades and presents no negative impacts on the human body.

Sclerotherapy has been used for over 90 years, and it has proven safe and effective. There is a very low risk of any reaction to the sclerosant solution. Tens of millions of sclerosant injections have been given and continue to be the method of choice for treating spider veins and smaller varicose veins.

Minor issues may be some redness at the injection sites and slight irritation, but that’s about it.

Ultrasound-Guided Sclerotherapy
Ultrasound-Guided Sclerotherapy

What to Expect During an Ultrasound Guided Sclerotherapy Procedure

Prior to targeting the vein or veins in your session, your provider will usually perform an ultrasound examination of the area. This gives them a good idea of the precise locations of the abnormal veins, as well as adjacent structures such as deep veins and arteries. It also gives them a better idea of what is creating the varicose veins.

The ultrasound energy is delivered through a hand-held wand over the treatment area. It broadcasts images to a video screen that your provider can view to guide them, providing precise accuracy for delivery of the sclerotherapy needle. Once they arrive at the correct vein, the sclerosant solution is injected. The sclerosant irritates the vein wall and the vein collapses. For larger veins, this process is repeated down the vein until it is completely closed and dramatically lessened in appearance. Any blood that was running through the vein is instantly re-routed to an adjacent, healthy vein. The body then scavenges the closed off vein over the new few weeks.

Ultrasound-Guided Sclerotherapy
Ultrasound-Guided Sclerotherapy

What to Expect After an Ultrasound Guided Sclerotherapy Procedure

After the procedure, the patients are fitted with stockings and encouraged to walk. Recovery for Ultrasound Guided Sclerotherapy is no different than the recovery process for normal sclerotherapy. Most patients are able to return to normal activities the same days as their procedure. We advise our patients to use compression bandages around the area of treatment for several days. It is expected to experience some mild swelling and bruising for a few days following treatment. Patients are seen two weeks after the procedure and a repeat ultrasound is done to ensure the success of the treatment.

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Ultrasound-Guided Sclerotherapy
Ultrasound-Guided Sclerotherapy

How Can I Maintain My Results?

The veins that close off and disappear due to the injection of the sclerosant agent are gone for good. They close off in reaction to the sclerosant, and the body then scavenges and removes them over the next few weeks. Any blood that was in the veins instantly is shifted to a nearby, healthy vein.

Of course, the circumstances that allowed the formation of your varicose and spider veins in the first place remain. That means you could form new spider and varicose veins down the road.

Maintaining your results means not developing any more spider and varicose veins. That’s pretty hard to do, especially if you have a job where you’re on your feet all day, such as a flight attendant or retail worker. Genetics also play a role, and you can’t do much about your genes.

Still, there are some things you can do to try and prevent future new unhealthy veins from developing:

  • Exercise regularly 
  • Lose weight 
  • Avoid standing or sitting for long periods
  • Put your feet up
  • Wear support pantyhose 
  • Get some compression hose
Ultrasound-Guided Sclerotherapy

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