Ultrasound Guided Sclerotherapy
Ultrasound Guided Sclerotherapy (UGS) uses special ultrasound equipment to guide injections of sclerosant which close the abnormal varicose vein.
Since 1998 Palm Clinic have treated over 10,000 legs with varicose veins.
Sclerotherapy has been a routine medical vein procedure since the 1960's, particularly in Europe. It has been used for visible varicose veins and for spider veins or thread veins.
The major advancement of Ultrasound Guided Sclerotherapy is that special ultrasound equipment (similar to that used to look at babies in pregnancy) is now used to find and inject the part of the varicose vein that is not visible on the surface.
This area between the groin and the knee is extremely important to treat, as the flow of blood is running backwards down the leg from the junction of the varicose vein and the deep vein.
Before Ultrasound Guided Sclerotherapy (UGS) this part of the vein could not be treated leading to temporary improvement only. With UGS the veins can now be closed permanently.
The Benefits of Ultrasound Guided Sclerotherapy
The vein specialists (phlebologists) at Palm Clinic remain excited about the ultrasound guided sclerotherapy technique which they say is so simple and straightforward for patients who are appreciative of relieving themselves of the pain associated with their leg veins.The added bonus of the ultrasound guided sclerotherapy treatment is that it provides cosmetic improvement without having to take time off work. Patients are often amazed at the fact they can have 'gross' varicose veins treated by ultrasound guided sclerotherapy, and be back at work an hour later.
Advantages of the treatment include:
- No time off work
- No anaesthesia (the procedure is virtually painless)
- No surgery
- No scars or stitches
- Patients can continue normal daily activities
- Lower cost than surgery. The cost varies but is typically $2500-2800 for one leg and $4-4800 for two legs.
- UGS is covered by most medical insurers. There is full cover from Sovereign, Tower, Unimed, SDA and others. Southern Cross pays the full amount provided specific medical necessity criteria are met. Palm Clinic is an affiliated provider to Southern Cross.
A Patient's Story
In June 1998 Tony of Howick had big, ugly, throbbing varicose veins which bulged down both of his legs to the ankles as seen below. He was the first patient at Palm Clinic to have the new treatment. He was delighted at the time with the simplicity of the procedure and over ten years later remains relieved at the absence of his huge veins. Since that time Palm Clinic has treated over 10,000 legs and now often combines endovenous laser ablation (EVLA) with ultrasound guided sclerotherapy as a further improvement in the modern management of varicose veins.
What to Expect During the Procedure
Ultrasound Guided Sclerotherapy is a simple process that usually involves four to six injections into the saphenous vein - most commonly from the groin to the knee. There may be more than one treatment session required.
Vein Mapping
Jenny Weeks or Tania Harrison (vein sonographers) "map" the leg veins using an ultrasound technique before endovenous laser treatment and sclerotherapy treatment to obtain a precise picture of which veins need treatment, and which are best left alone.
Patients who have had their veins return after surgical treatment often have a very complicated pattern of veins in the groin. The advantage of using ultrasound mapping is that we can pinpoint the exact cause of the recurrent veins. The ultrasound is then used to guide injections to eliminate the source of the problem.
Sclerosant Injection into the Vein
A solution (called a sclerosant) is injected directly into the veins using a very fine needle. This procedure has been used for decades on larger veins, and more recently refined for injecting tiny superficial spider veins (microsclerotherapy). The solution irritates the inside of the vein wall causing it to become inflamed. This triggers the bodies natural healing which results in the vein being closed off thus preventing any blood flow. Over a period of weeks the vessels fade, being barely or not visible.
Depending on its size, a single varicose vein may have to be injected more than once, a week or more apart. In any one treatment session many veins may be injected.
How long does the treatment take?
- Patients with very complicated veins (particularly the post surgical recurrences) may need three or four treatments. Other patients may only need one or two treatments.
- Each treatment takes less than half an hour. Patients then go for a walk for half an hour before returning to work.
A compression stocking is worn for one week continuously after treatment and a further two weeks during the day only.
Patients are reviewed one week and three months after the initial treatment.
Smaller veins including spider veins are treated once the ultrasound guided sclerotherapy is completed.
Possible Side Effects
Like all medical procedures there may be side effects but generally Ultrasound Guided Sclerotherapy is a very safe technique. Because patients are mobile there is a markedly reduced risk of Deep Vein Thrombosis which is relatively common after surgical stripping of veins.
A full discussion about side effects and other types of procedures will be undertaken at the initial consultation.
Sclerosants
The sclerosants used at Palm Clinic for Ultrasound Guided Sclerotherapy are:
- Sodium Tetradecyl Sulphate - this has been used on millions of people worldwide for sclerotherapy of varicose veins since 1945.
- Polidocanol - used extensively since 1960 as the sclerosant of choice for spider veins but is also used at times for varicose veins.
At Palm Clinic, these solutions are converted to a foam of microbubbles. This reduces the number of injections required making it safer and less uncomfortable. Foaming of the sclerosant has been a major advance in the last three years and Palm Clinic has contributed to the world literature on the safety and high patient satisfaction with the technique. Their articles appeared in the January 2004 issue of "Dermatologic Surgery" - a copy can be requested from Palm Clinic.
