TREATMENT
OF UNSIGHTLY OR UNCOMFORTABLE VEINS (Continued)
In
the majority of cases, a procedure called sclerotherapy is used to treat
these blood vessels, in which a solution called a sclerosing solution is
injected with a very fine needle directly into the blood vessel. This procedure
has been used in various forms for veins since the 1920s but has only been
associated with an acceptably low side effect rate in the more recent past.
Hypertonic saline was used from the 1920s, but by the 1940s a solution called
sodium tetradecylsulfate (STD) was developed, which was associated with
a lower rate of side effects. In 1961, polidocanol was developed for the
purposes of sclerotherapy (it was used as a local anaesthetic prior to this
time), and by the 1980s duplex ultrasound was being used to guide injections
into vessels not visible from the surface.
The
solution irritates the lining of the vessel, causing it to swell and stick
together. Some vessels will fade from view, eventually becoming barely
or not at all visible. Some vessels will have vanished by the time the
bandages are removed.
A
few vessels will need a second treatment, and a few will not be accessible
for injection at any given treatment session because they will have been
covered by the tape used to pressurise other veins treated during that
session. Depending on its size, a single blood vessel may have to be injected
more than once, but in any one treatment session a number of vessels may
be injected.
The
solutions used vary somewhat with the size of the vessel to be injected,
and your doctor will be able to decide which veins are to have which
solutions. Larger varicose veins often underlie spider veins. In such
cases it is thought that it is best to treat these vessels first.
Sometimes sclerotherapy is the appropriate therapy for these veins,
but sometimes surgery is required. The type of treatment necessary
is determined by the vascular ultrasound examination which gives a
precise diagnosis of any major superficial vein abnormalities. If
the varicose and reticular veins are treated first, often the spider
veins that were connected to these will disappear over the following
weeks without themselves being injected. Because of this it may be
advisable to space out the visits to allow maximal resolution of veins
following each treatment, thereby minimising the number of treatments
required.
[Continued] [Previous]
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