Sclerotherapy is a method for elimination of varicose veins and superficial telangiectasias (spider veins). Using this method, a solution is injected into the veins, which causes the veins to collapse and disappear. There are a variety of solutions that can be used depending on the type of vessels being treated.
The majority of people who have sclerotherapy performed will be cleared, or at least see improvement, of the leg veins treated. However, there is no guarantee that sclerotherapy will be effective in every case. Approximately 20 percent of patients who undergo sclerotherapy have poor to fair results, ("poor results" mean that the veins have not totally disappeared after six treatments).
The number of treatments needed to clear or improve the condition differs from patient to patient and depends on the extent of varicose and spider veins present. One to six or more treatments may be needed (the average is three to four). Individual veins usually require one to three treatments.
In cases of large varicose veins (greater than 3 to 4 mm in diameter), spontaneous phlebitis and/or thrombosis may occur with the associated risk of possible pulmonary emboli. Additionally, large skin ulcerations may develop in the ankle region of patients with long-standing varicose veins with underlying venous insufficiency.
Because varicose and telangiectatic leg veins are not life-threatening conditions, treatment is not mandatory in every patient. Some patients may get adequate relief of symptoms from wearing graduated support stockings. Ambulatory phlebectomy is a procedure where certain types of veins can be removed through small surgical incisions. The complications of this procedure are similar to sclerotherapy with the addition of small surgical scars, which naturally occur with this procedure.
Vein stripping and /or ligation may also be utilized to treat large varicose veins. This may require a hospital stay and is performed while the patient is under general anesthesia. Risks of vein stripping and/or ligation include permanent nerve paralysis in up to 30 percent of patients, possible pulmonary emboli, infection, and permanent scarring. General anesthesia has some associated serious risks.