Sclerotherapy — what is it, photos before and after, contraindications, prices for sclerotherapy veins of the lower extremities
History of method
First began to remove the dilated vessels drugs that damage the vessel wall, physicians in 1853. At that time the method has not received wide distribution, as used at the time the drug was given to a number of complications.
Safe medications for removal of veins were obtained and tested only in 1946. Excellent results of treatment of thousands of patients a conservative way has allowed in many cases to abandon the traumatic surgical operations, which remain after the scars.
Currently, the distribution has received so-called foam sclerotherapy, which uses a drug with specific properties: the bulk of the drug accumulates in the place of its introduction and does not extend to adjacent vessels. This ensures additional safety during the procedure.
Normally, a person works several mechanisms to facilitate the movement of blood through the venous system toward the heart:
- the suction action of the chest on inspiration;
- the presence of elastic and muscle fibers in the wall of the vein, which prevent the hyperextension of the veins, while filling them with blood;
- the presence of special valves in the veins that conduct blood toward the heart and prevent backflow of blood;
- the mechanical influence of the muscles of the calf also contributes to the promotion of blood through the veins to the heart.
Vienna is located in the deep tissues are divided into superficial and deep. Direction of blood through the veins of a healthy person is as follows: the blood flows straight up and from the superficial veins to the deep and communicating veins.
The reasons that can result in varicose veins, a lot. However, the reasons should be certain genetic factors and hormonal influence.
- The influence of heredity.
In the us genetically a certain ratio of elastic and muscle fibers in the wall of the vein. Enough content of both these components allows Vienna to maintain a certain clearance, which is sufficient to move blood up and operation of venous valves (their closure in the midline).
If there is a genetic predisposition the amount of elastic and smooth muscle elements in the vein wall can be reduced. Can also be separate areas devoid of elasticity that will stretch the incoming blood more.
The presence of extensions in the course of the veins causes the venous valves cannot close tightly and inhibit the flow of blood towards from the heart.
Hemodynamics as a result, more disturbed, the venous wall is damaged increasing pressure and stretched even more. Formed a vicious circle, causing a painful process exacerbated and gradually spreading to nearby Vienna.
- Hormonal influence.
Many women know that varicose veins appear during pregnancy. The main reason for this high concentration of the hormone progesterone. To trigger the development of varicose veins can also long-term treatment with progesterone, which is shown in a number of diseases.
- Increased venous pressure.
Cause increased venous pressure may be a number of factors. The main one is pregnancy, permanent lifting weights, the presence of excess weight. Obstruction of blood flow leads to the expansion of the lumen of the veins.
The venous valves no longer meet in the midline and can not prevent backflow of blood. Gradually, circulatory disorders leading to damage of the vascular wall and loss of its elasticity.
Secondary causes that can trigger the disease or worsen it:
- the abuse of alcohol;
- low motor activity;
- a narrow, uncomfortable shoes with high heels;
- habitual constipation;
- the contraceptive pill;
- mismatched, uncomfortable clothes.
Treatment — pros and cons
At the beginning of the disease, problems with the veins are regarded as patients rather annoying cosmetic defect. Pain games, heaviness in the legs, swelling of feet and lower legs by evening, increasing gradually, because often perceived as a normal reaction to daily stress.
If you do not take measures to treatment in the early stages, with time, even at a relatively young age can get these symptoms of a serious circulatory insufficiency of the lower limbs, thrombosis, trophic tissue changes (peeling of the skin of the lower legs, thinning, pigmentation, formation of trophic ulcers).
The treatment of the advanced stages of the disease in most cases can not be carried out by a conservative (by injection sclerosant) that is required for operation and continuous maintenance therapy with drugs that improve circulation in the tissues of the lower extremities.
Benefits of sclerotherapy:
- procedure can be done on an outpatient basis, in one day, and the next day to return to work;
- unlike surgery there is no need to carry out the procedure sclerotherapy under General anesthesia;
- the procedure is painless;
- there is no risk of scarring after the removal of varicose veins introduction sclerosants.
The drawback is a high probability of recurrence of varicose veins. But in this case not dilate the veins into which were introduced the drug, and nearby vessels.
Mechanism of action
The drug is a medication used for the procedure of sclerotherapy.
The most frequently used names drugs:
- Ethoxysclerol (manufacturer of Chrysler, Germany);
- Fibrovan (STD, England).
The basis of the effect produced sclerosants the vessel, is the formation of a chemical burn of the endothelial lining of the cavity of the vein. The damaged vessel collapses (further contributes to tight bandaging of the legs after the procedure), its walls stick together, and then fused together. On the site of the varicose veins remains a scar heavy.
Video: Varicose veins without surgery
Types of sclerotherapy
- Foam (Foam-form therapy).
Feature of medicines for this species is their ability to form foam when mixed with air, which when the syringe is introduced into the cavity of the expanded veins.
During the introduction of the drug sticks to the walls of the veins and quickly closes its lumen. Since the drug is mixed with air in a ratio of 1:3 or 1:4, the amount of drug required is small. The drug is not covered in Vienna blood, a small amount of sclerosant enough to close the gaps in large diameter vessels.
This technique is applied in cases e when you need to remove vascular tumors with a diameter of 2 mm When the drug is injected into the lumen of the vessel using a thin needle.
- Echo-guided sclerotherapy.
The method used for the removal of large diameter veins and those veins that are located deep in the tissues. The needle from the syringe with the drug is introduced into the vessel lumen under ultrasound control. This eliminates the risk of introduction of sclerosant into the tissue.
Video: Non-surgical treatment for varicose veins
Doctors phlebologists most often perform this procedure on the vessels of the legs for the following reasons:
- the presence of varicose veins of the lower legs;
- expressed vascular grid;
- vascular spiders.
- strengthening effect from surgery regarding varicose veins of the leg;
- lymphangioma or hemangioma.
The procedure is not carried out in the following cases:
- during pregnancy;
- in the period of breastfeeding;
- in the presence of intolerance or Allergy to drugs for sclerotherapy;
- thrombosis and thrombophlebitis of leg veins;
- in the presence of inflammatory processes in the skin and subcutaneous tissue of the feet;
- the presence of heart disease in the patient.
In the preparatory phase of the consultation with the doctor-flebolog, which detects the presence of varicose veins, its extent, the presence or absence of complications of varicose illness of veins of the lower extremities.
In order to find out the status of the deep veins and the degree of hemodynamic instability is performed ultrasound of lower extremities vessels. Depending on the severity of varicose veins, presence of comorbidity, the doctor prescribes the optimal way of eliminating varicose veins. This may be surgery or sclerotherapy.
If the patient shows sclerotherapy, during the consultation stipulates the required number of procedures and the estimated number of injections for each procedure.
A few days before the procedure, you must:
- stop Smoking and drinking alcohol;
- stop taking the drugs based on acetylsalicylic acid and other means that contribute to the thinning of the blood and reduce its ability to clot;
- to postpone for a time the treatments that can lead to injury of the skin shins, irritation or inflammation (waxing, for example).
How is the procedure
- Sclerotherapy veins of the lower extremities.
To complete the procedure, the patient is placed, and the legs give elevated position so that the blood flowing from the veins of the lower extremities. A small amount of blood in Vienna will help to ensure that the drug will act more effectively on the walls of the veins and did not spread to other vessels. One procedure can be performed up to 10 injections. The time it takes from 20 minutes to 1 hour. Be administered the drug with a syringe and thin cannula.
The introduction of the drug may be slightly painful. For some time may feel soreness and itching at the site of injection. But the feeling of intensity is such that anesthesia is not required. Often for sclerosing the deep veins, the injection is made under ultrasound with Doppler. It allows you to monitor the injection site and avoid contact of sclerosant into the tissue around the vein. Immediately after injection, legs tight bandage.
- The methodology in the treatment of birthmarks.
To remove a point of vascular tumors method is used microsclerotherapy. Sometimes to enhance the effect of the treatment, the introduction of sclerosant is carried out simultaneously with laser exposure.
The recovery period
- Compression underwear.
After the procedure it is mandatory to wear elastic stockings with a high degree of compression. Usually wear them immediately after surgery and are not allowed to shoot the first 2-3 days after the introduction of sclerosant. Then a compression garment will need to wear only during the day.
- The locomotor activity.
For at least half an hour after the procedure, you need to move, for example, to walk leisurely about. During the first three days, you should not do fitness, gymnastics at the gym, it is best to limit time walking. During the first two weeks should not be constantly in standing or sitting.
- Control of the car.
Immediately after the procedure you cannot drive, as part sclerosant includes spirits.
- Thermal procedures.
A hot bath will not be able to take at least a month and a half. A visit to the sauna, steam room, sauna is better to postpone at least two months.
After the procedure there can be some functional disorders, which last from a few hours to a few days and go away without treatment. These include:
- itching of the skin at the injection site and tenderness along the vein;
- darkening of the skin over the vein, which was introduced sclerosant;
- burns of the skin and subcutaneous tissue in that case, if a small amount of the drug in the introduction caught in the fabric and not into the cavity of the vein;
- swelling feet and ankles after the procedure, which can last up to several days;
- peeling of the skin at the injection site.
Serious complications of the procedure:
- pronounced burning of the tissue with subsequent scar formation in the place where the subcutaneous tissue gets a high dose of sclerosant;
- venous thrombosis, thrombophlebitis.
Frequently asked questions
Which is better, laser or sclerotherapy?
To talk about the advantages and disadvantages of the methods can be long. But it will be better to speak about choosing a specific method, depending on changes of the veins of the individual patient, the degree of hemodynamic instability, the presence or absence of complications of varicose veins. The choice of method is better to trust the doctor-phlebologist, who is familiar and uses both of these methods in their practice.
How many sessions will be needed for complete removal of varicose veins?
For most patients, who have conducted the procedure in the early stages of development of varicose disease of the lower extremities, is sufficient in a single injection. In more rare cases, have to undergo 2-3 procedures.
How long will the result be seen?
To assess the final result from sclerotherapy should be after 2-3 months, when will all the functional disorders associated with the introduction of sclerosant, resolve bruising and swelling will take place.
What is dangerous?
Sclerotherapy dangerous thrombosis and thrombophlebitis. But according to statistics, the risk of these complications in surgical treatment of varicose veins even higher.
|Name of service||Price, RUB|
|Ultrasound of the veins of the legs||1000-2000|
|Microsclerotherapy (1 ampoule of the drug)||3500|
|Removal of vascular asterisks (drumstick or thigh)||10000|