Micro-Sclerotherapy & Ultrasound Guided Sclerotherapy

Ultrasound Guided Foam Sclerotherapy & micro-sclerotherapy are minimally invasive procedures for treating small varicose veins and spider veins. Sclerotherapy is considered the gold standard treatment for these types of veins due to its safety record and efficacy. It focuses on closing damaged superficial veins by injecting them with a medication called sclerosant. Here at The R Clinic whilst most sclerotherapy treatments are done using ultrasound imagery (i.e. US guided sclerotherapy), some are performed under direct vision or with assistance from vein visualization technology e.g., AccuVein.

Sclerotherapy can be a treatment on its own for spider veins and small varicose veins or can be used in conjunction with other procedures when required.

Sclerotherapy is the process of injecting a sclerosant solution into a vein. This special medication irritates the lining of the vein walls causing them to slough away and be absorbed naturally by the body. The vein collapses down and over the next few months the vein becomes a thread of scar tissue (sclerosis) and cannot be seen. As the body heals, blood is then re-routed to healthier veins improving your overall circulation. The sclerosant may be injected as liquid or foamed with CO2 depending on the location and types of veins needed to be treated. There are two commonly used sclerosants, Sodium Tetradecyl Sulfate & Aethosxysclerol, both medications are approved by the TGA for the treatment of varicose vein.

• Effective treatment for smaller vein – as a complement to endovenous thermal ablation, sclerotherapy is especially useful for recurrent varicose veins and veins that are too small to treat with endovenous catheter. Sclerotherapy is every effective treatment when performed on suitable veins 2.5mm-4mm in diameter.
• Minimal downtime – sclerotherapy is a highly tolerated procedure and requires no interruption to your daily activities. Most patients can return to work the next day.
• Simple outpatient procedure with no general or local anaesthetic required. Generally, take less than 30mins for a treatment
• Success rate of 75-90% (when used independently)
• Ultrasound guided injection allows for more accurate and effective treatment of the varicose vein hidden under the skin that is not visible to naked eye

Following the procedure, it is normal to expect some mild discomfort, mild swelling and bruising. Your skin may be tender to touch, gentle walking and wearing prescribed compression stocking will help manage and lessen the discomfort. Your legs may ache for a few days, and any trapped blood will need to be removed.

Varicose veins will generally disappear over 6-12 weeks. The spider vein will not disappear completely but should improve by about 60-80% or more depending on the number of treatments. If you want more resolution, then more treatments will be necessary. Optimal results can generally be seen around the 3-month mark.

• Prior to your treatment, you will first see our sonographer who will carefully mark out the areas to be treated using ultrasound, and you will also see our nurse who will take measurement of your legs to determine the size of your medical grade compression stocking
• Avoid taking iron supplement or blood thinner two weeks before your treatment
• Shower and remove any hair on the operative leg from ankle to around 3 finger widths into pubic hair the night before
• Bring your prescribed thigh high compression stocking to be put on after the procedure. If we order one for you, it will be here ready to be given to wear afterwards

• Topical numbing cream is often applied to minimise discomfort during injection
• The sclerosant is mixed with air through a special filter, which creates a fine foam making the solution more effective
• An ultrasound is used to visualize the problem veins and guide the needle into the vein, so the injections are done very accurately
• Each injection delivers around 0.1 to 0.4mL of the sclerosant and is injected at an interval of 2-3cm until the entire vein has been treated
• The duration of treatment is usually less than 30 minutes

• Wear compression stocking 24 hours a day for 7 days. This step is extremely important. Your compression stocking will help reduce bruises, swelling, pain and reduce DVT
• Your stocking should be worn to bed. If, however, you experience pain in the foot or heel at night, especially if this pain wakes you up, you MUST remove the stocking while laying down in bed and put it back on again in the morning BEFORE you get up
• Work – you can return to work as soon as you feel able to do so
• You should walk a minimum of 30 minutes each day for 2 weeks after treatment
• Avoid prolonged standing or sitting. If sitting, place the legs up and elevate them where possible.
• Avoid intense physical activities and any heavy lifting for the first 4 days.