South Coast Cosmetic, Skin & Vein Clinic



center-44831000ULTRASOUND GUIDED SCLEROTHERAPYUltrasound guided sclerotherapy was developed in Australia, USA, Canada and France in the late 1980s. It is the process of injecting varicose veins that are visible on the ultrasound monitor but are not visible externally. It enables the eradication of medium sized varicose veins as a rooms procedure. Patients do not lose time or income from work, are able to continue normal daily activities, do not undergo anaesthesia or hospitalisation and have no stitches or scars. This is achieved with a procedure that takes about half an hour. Abnormal reverse flow of blood back into the leg (reflux) is the fundamental problem of varicose veins. UGS eradicates reflux by closing the veins.Sclerotherapy is the injection of a solution (sclerosant) into varicose or smaller veins to cause them to close and subsequently disappear. This practice has been used for many years to treat varicose veins and surface veins.There is no limit to the size of varicose veins that can be treated by this method, though larger veins respond better to endovenous laser. The superior safety and cost effectiveness of ultrasound guided sclerotherapy should be considered when a choice of treatment exists. Over the past 15 years the understanding, application and refinement of sclerotherapy techniques has created a very safe and effective treatment for varicose veins.Following the initial consultation and assessment, a duplex Doppler study is required to create a map of the superficial veins and to assess the competence of deep veins. This is essential information that enables treatment of all sources of reflux. The map is our guide during the treatment and is a reference point should varicosities occur.PROCEDUREUltrasound guided sclerotherapy usually involves up to 10 injections into the saphenousvein – most commonly from the groin to the knee. The sclerosant is injected as a foam which provides extensive coverage of the varicose veins with small doses of sclerosant. Afterwards, a compression stocking is worn for 2 weeks. A 30 minute daily walk is mandatory. Patients are reviewed in 6 weeks and 6 months after the initial treatment. Side effects and complications are similar to those for standard sclerotherapy.People who are prone to developing varicosities may develop more with time. With proper assessment, non-surgical techniques should achieve the best possible results for the longest period of time with minimal risk and discomfort.The cost of the procedure does not include subsequent treatments for cosmetic surface veins. A Medicare rebate is available for ultrasound guided sclerotherapy.BEFORE TREATMENTYou will be asked to sign a consent form for the procedure.The leg is commonly treated from the skin crease of the groin to the ankle and needs to be accessible. This enables the effectiveness of the procedure to be assessed along the entire length of the veins to be treated. Moisturiser on the skin does not affect the treatment.AFTER TREATMENTTo ensure the success of the treatment it is essential to observe the following instructions.You are able to drive home after the procedure.Walk for at least half an hour a day for 6 weeks.Continue to wear the stockings during the daytime. Avoid standing still for long periods of time if practical.You will be able to carry on with your normal lifestyle, however, you should avoid vigorous exercise or strenuous activities (such as tennis and aerobics) for the first few days after treatment.You may experience slight aching/pain in the legs in the first few days after treatment. If this occurs, take 2 Nurofen tablets three times daily. Do not specifically rest and continue to walk as before. If you have any severe or continuous pain or swelling of the leg please contact us on 4227 2000.Should the stocking cause any disturbance at night, remove it. The stocking is far less important when lying flat.Trapped blood is relatively common. The treated veins can become firm, red. And/or tender up to 3 months after the procedure. This is unpleasant but not serious. If it causes significant pain contact the clinic as trapped blood can usually be released and the symptoms improved. It may look infected, however antibiotics are inappropriate (unless you have a fever). It generally resolves in a week or so and normally responds well to anti-inflammatory tablets.Follow-up appointments will be made for you following treatment. Please ensure you keep these appointments so that Dr Mizori can review your PLICATIONSThe common side effects and complications are:Blood trapping can form tender lumps along the course of treated varicose veins. It is harmless but may be tender, red, and angry. Blood can be drained from these lumps by needle prick. This can occur 1-12 weeks after the procedure and will hasten the resolution of any tenderness and help prevent pigmentation of the skin. Blood trapping is most common in large varicose veins.Aching in the leg can occur during the treatment and for the first day or two following treatment. It is more common following the treatment of larger varicose veins and is usually relieved by walking. Nurofen, Voltaren rapid or Panadol tablets may be taken if necessary.Brown lines or mark on the skin at the sites of treated veins can occur when blood breaks down , leaving iron behind in the skin. These pigmented areas are composed of haemosiderin, an iron containing pigment, and are common in patients who have navy-blue spider veins treated. This will generally disappear within months, occasionally longer. In a small percentage of patients it can persist for years.Matting is the name given to networks of fine red veins which develop near the site(s) of previous injections. The thighs are the most common site. Some areas of matting resolve spontaneously, and some resolve with further treatment. Matting is more common in patients with extensive surface veins, patients who are overweight or have a very fair complexion.If you have any questions, concerns, or problems please contact South Coast Skin & Vein Clinic on 4227 2000. ................
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