Ultrasound Guided Sclerotherapy (UGS)

Sclerotherapy can be performed in one of two ways. 

  1. Veins that can be seen on the surface can be injected without the use of ultrasound. 
  2. If the vein lies under the surface of the skin, the doctor will need to use ultrasound technology to be able to “see” the vein so that it can be injected. These injections are therefore described as “Ultrasound Guided”, meaning the ultrasound helps the doctor find the veins under the skin surface so they can be injected safely.

An initial duplex ultrasound scan is often performed before your first visit to the Centre to determine whether there are any veins hidden under the surface of the skin. If present, treatment of these “hidden” veins is usually necessary to give a better result with the veins that are seen on the surface. 

UGS is a safe and effective method for the treatment of varicose veins. Unlike surgery there is no need for hospitalisation or an anaesthetic. There is no surgical scarring and virtually no downtime. Most patients with varicose veins are suitable for UGS.

The UGS procedure is performed using ultrasound technology to locate the hidden abnormal veins and allow the doctor to accurately and safely inject sclerosant detergent solution or more recently with sclerosant detergent foam. Once injected the veins collapse and the body’s process of absorption begins. Numerous injections may be required and can be associated with a slight burning sensation that usually only lasts for a few minutes. The sclerosant becomes diluted and neutralised within a short distance from the injection site and therefore is unlikely to damage normal veins. 

The appearance of the treated veins rapidly improves over a few weeks with continued improvement still occurring for about three to nine months. 

Review at I Month

All patients are reviewed at approximately 1 month, or longer if there has been treatment to the other leg in the meantime.

Again, an ultrasound is performed and compared to the original mapping scan to determine whether there are any significant veins remaining under the skin surface. 

The doctor will then discuss the results with the patient, and a decision can be made as to whether any more injection treatments are required. 

This follow-up treatment also includes injections to the remaining visible veins on the surface, including “spider veins”.

 

Recent Advances in Sclerotherapy (i.e. the use of “sclerosant foam”)

Detergent sclerosant LIQUID can be converted into FOAM with the addition of a small amount of Carbon Dioxide (CO2). The use of foam has proved to be advantageous in patients with varicose veins. A meeting of European specialists (2003) concluded “Foam sclerotherapy… is a powerful tool in experienced hands and in general more powerful than conventional sclerosant solution”. It was stated at the 2003 UIP World Congress meeting that the use of foam “marked a new era in treatment of primary venous disease with the advent and universal acceptance of foam sclerotherapy”. Published studies from Australia and New Zealand support the safety and efficacy of foamed sclerosants. The Australasian College of Phlebology has developed guidelines (2004) for the use of both sclerosant solution and foam. The Therapeutics Goods Administration (TGA) approved sclerosant solution for clinical use several years ago. However, this approval was granted before foam sclerotherapy was introduced and properly evaluated. Applications have been made to the TGA for the use of foam but this process takes time. Until then, the use of foam does not have formal TGA approval. However, foam can be used as an “off label” product provided consent has been obtained and if there is a benefit to the patient. 

Should you have varicose veins then using foam is now considered a more effective option. 

 

Compression Stockings

All treatments performed at the Vein & Laser Centre require the wearing of a Class 2  compression stocking after the procedure for a variable amount of time. The length of time the stocking needs to be worn varies from 5 days to 2 weeks depending on the size of the veins injected and the treatment method provided. The stockings may be claimable from your health fund if you have ancillary cover.