Veinlite Assisted Sclerotherapy
Veinlite assisted sclerotherapy uses a sclerosing agent to effectively treat moderate to large varicose veins . The injected sclerosant irritates the walls of the vein, causing it to contract and shrink. The vein walls stick together and the vein eventually disappears. A specialized transilluminating device know as a Veinlite is utilized to better visualize the full extent of the varicosities as well as to locate its deeper origins. The solution is easily guided and delivered, making it an optimal choice for treatment.
The larger of the varicosities are normally treated first. Once the injection site is wiped with alcohol, a small amount of sclerosing foam is injected directly into the vein. Several injections are completed during one scelerotherapy session. The number of treatment sessions needed vary, depending on the number and size of veins treated, the necessary healing time and level of cosmetic expectation desired.
Sclerotherapy may cause minimal discomfort, most often in the form of a stinging or burning sensation and possible bruising and swelling at the injection site.
Compression stockings help to keep the injected veins collapsed during the recovery process
Refrain from taking Aspirin, Ibuprofen, or arthritis medications for at least one week prior to your treatment. These medications can increase your risk of bruising
Do not drink alcoholic beverages or smoke for 2 days both before and after your treatment as this may hinder the healing process
The morning of your appointment, shower and wash your legs with an antibacterial soap. Do no shave your legs the day of your appointment
Avoid applying cream or lotion to your legs the day of your appointment. (This includes tanning creams and sprays)
For your own comfort, it is recommended that you bring loose fitting shorts to wear during your treatment
Try to eat a light meal approximately an hour prior to treatment
If you tend to get lightheaded during medical procedures, you may want to consider having someone drive you home after your appointment
Bring your compression stockings with you to your appointment
Post – Treatment Instructions:
Leave the cotton balls on until bedtime shower and wash with antibacterial soap.
After leaving the office, walk for 30 minutes at a medium pace (either outside, on a treadmill, at the mall, etc.) immediately following injections.
Wear compression stockings all day/evenings for 5 to 7 days. Stockings can be removed at night while sleeping.
For the next 72 hours you must:
- Avoid hot baths and showers (no soaking in a hot tub / baths for one month following injections)
- Avoid alcohol and aspirin, ibuprofen (unless you are taking aspirin for a heart condition)
- Avoid high impact/intensity exercise including weight lifting, aerobics, running, etc.
- Avoid tanning beds for at least two weeks (you may get an irregular tan, but it is not harmful).
- You may apply moisturizing lotion after 24 hours.
Apply sunscreen liberally when exposed to natural sunlight for the next three months.
You may have some mild aching, bruising, itching in these areas. You can take Tylenol for discomfort or apply ice packs. Most people are able to return to work the next day.
Expected symptoms include firmness of the treated vein, tenderness, bruising that can last for a few weeks following treatment.
Start massaging treated veins 2 weeks post injections to help with healing.
What you should watch for post treatment:
In rare cases, you may experience prolonged or serious symptoms such as excessive pain, swelling, ulcers, numbness, discoloration or coldness in the limb. If this should occur, contact our office.
Less severe side effects that may occur include:
- Small blister if a small amount of fluid leaks out of vessels. These blisters heal quickly but a small brown freckle-like area of pigmentation may remain.
- Bruises when the walls of blood vessels are weak. Bruises can last from 1 week to 3 months.
- Muscle cramps may develop at the injection site, particularly when large blue veins are injected.
- A small, permanent scar rarely occurs at the site of injection. However, small brown freckles are not unusual at injection sites.
If, after a few days, swelling and redness develop, apply ice packs and take Ibuprofen 400mg four times daily. Notify our office as well.
How soon do the vessels disappear?
Fading of blood vessels continues for 1 to 6 months.
Frequently Asked Questions
1. How many treatments will I require?
The number of treatments each patient requires is dependent on the type and severity of the varicose veins. While most patients require 3 to 4 treatments, anywhere from 2 to 10 treatments may be recommended.
2. How long will the treatment take?
Treatment will normally take anywhere from 30 to 60 minutes.
3. How will my leg look when I remove the stocking?
There may be some marks which will disappear over a few months. Occasionally people are left with some bumps which feel very tender and may, or may not, be visible. These lumps are caused by blood seeping back into the vein and reacting with the sclerotherapy agent, forming a clot. As the clot breaks down, much as a bruise might, it becomes tender and can cause brown or blue stains on the surface of the skin.
Sometimes the skin will look inflamed because of trapped blood. The surgeon will advise you to take anti-inflammatories and arrange another visit to have the trapped blood released. This is done with a small needle, and occasionally requires a second visit to the clinic.
Possibility of Recurrence Post Treatment
There is a high success rate for the current treatments of varicose and spider veins, in comparison to the conventional surgical treatments. However, over time (generally years) there is the possibility that abnormal veins may develop as there is no cure for weakened vein valves.
Ultrasound may assist in keeping track of the leaking valves, and prompt continuous treatment when necessary.
The best option to assist in slowing down the development of new varicose veins is to wear gradient compression support stockings as much as possible during the day.
Ultrasound-guided sclerotherapy, also known as echosclerotherapy, is used to treat veins that are located further from the skin’s surface, making them difficult to see and inject. By using an ultrasound machine, deeper veins are easier to visualize, ensuring optimal results from the injections. This technique is appropriate for larger varicose veins buried deep below the skin.
The procedure begins with a leg examination while you are standing. Using ultrasound imaging, the anatomy and competency of the veins will be identified. After the mapping of your veins has been completed, you will be seated comfortably on the examining table.
A small amount of local anaesthetic will be injected under the skin and then a plastic coated needle (catheter) is positioned in the vein. This process is quite comfortable, as the area is frozen from the local anaesthetic. With the catheter in place, a medication (sclerosant) which closes the insufficient vein will be carefully injected and monitored on the ultrasound screen. A bandage will be placed over the injected area to provide compression, collapsing the vein network. You will need to leave the bandage on for 2 days and 2 nights after the procedure and wear the support stockings for a total of 7 days after the echosclerotherapy. These stockings are worn from 2 to 7 days when you are not in bed. Success rates are high, but sometimes the vein may fail to close or will re-open. In some cases, a second or third injection will be needed at a later date. Occasionally, in cases of treatment failure, surgery may be recommended.
Prior to the echosclerotherapy session, it is necessary to treat smaller veins with a diluted solution of medication to reduce the chance of an unexpected allergic reaction. This set of injections is done on a separate date.
Compression stockings must be worn following the procedure. These are provided at the time of the echosclerotherapy (there is an additional fee for these stockings). They can be reused for all additional treatments.
The procedure itself takes 10 to 15 minutes; however, scanning and bandaging add time, so plan to be at the clinic for at least 60 minutes.
You will need to follow the “Post Treatment Instructions” for 4 hours after the procedure, so plan to have the afternoon / night free. You may drive for a period of 30 to 40 minutes following the procedure, but a longer drive will mean that you need a ride so you can elevate your leg during travel time.
Avoid aspirin for 1 week prior to the procedure to reduce bruising.
Eat and drink well before you arrive for your treatment.
Stand as much as you can the day of the procedure so your veins are larger and easier to visualize. If you currently wear support stockings, you may also want to stop wearing your support hose a couple of days before treatment.
You must bring a pair of shorts or a bathing suit bottom to wear during the treatment for your privacy. Wear some comfortable loose clothing for your trip home
Long distance car trips or air travel should be avoided for 4 weeks after your treatment. If you are traveling any time close to your procedure date, please check with us.
You must notify us 48 hours in advance of an appointment change.
Possible Side Effects
The most common complication is an inflammation of the injected vein. It may appear anytime in the first month post injection and consists of a hard, tender cord along the injected vein. The discomfort is usually minor and is relieved by the application of ice and the use of support stockings.
There is always the possibility of an allergic reaction. This rare complication may range from an itchy rash (incidence of about 0.3% in the medical literature) to an anaphylactic reaction.
In very rare situations, deep vein thrombosis (blood clots) and pulmonary embolus can occur. The incidence of this is much less than 0.1% and 0.01% respectively.
There are 2 other exceptionally rare complications that may arise from the sclerosing agent leaking from the vein into the subcutaneous tissue or being introduced into an artery. This can result in an ulcer, injury to skin or muscle tissue which may cause scarring. Permanent muscle damage is an extremely remote possibility.
You will need to come for a reassessment of your veins after approximately four weeks. An ultrasound will determine how well the veins responded to treatment. There is no fee for this recheck. However, if a second treatment is required, the usual fee would apply.
Post Echosclerotherapy Instructions
Go directly home and elevate your legs above your heart for a period of 4 hours. During this 4 hour period, every 45 minutes ensure that you get up and walk for 15 minutes.
Following the period of leg elevation, exercise your legs for 30 minutes (e.g. a brisk walk or cycling).
Any leg discomfort should respond to leg elevation, leg exercise, or Ibuprofen (Advil).
Call immediately if you have leg swelling, marked leg pain, chest discomfort, or shortness of breath.
If there is localized tenderness or lumpiness in the treated vein, apply ice for 15 minutes, four times a day.
At any time, if you are having more than mild discomfort, contact our office.
Leave the compression bandage on for 2 days and nights unless it is causing skin irritation or blistering.
The stocking must be reapplied before you get out of bed and worn during the day until 7 days after your Echosclerotherapy.
It is best to shower (no baths) at night just before you retire to bed.
If you experience foot pain or numbness, the heavy compression stocking should be removed when lying in bed at night.
Keep your bandage dry. If you wish to shower in the first two days, you must leave the bandage and a thigh-high support stocking on your treated leg. The leg should be covered with a plastic garbage bag sealed with a towel wrapped around the top of the leg to keep it dry.
Exercise for 30 minutes each day until your next appointment.