What is Foam Echosclerotherapy?
Foam Echosclerotherapy is an ultrasound guided injection technique for the treatment of varicose veins; particularly of the saphenous veins. These veins are the larger superficial veins of the legs. They are not readily accessible to injection, and in the past, were only treatable with surgery. The purpose of Echosclerotherapy is to sclerose (to close) these veins near their site of origin. This treatment is an alternative to the previously needed surgeries.
Greater Saphenous Vein (The vein of the inner thigh)
During your appointment, your legs will be examined with a physical examination and with the use of an ultrasound. Once your anatomy has been established with the use of an ultrasound, a small amount of local anesthetic will be infiltrated under the skin and plastic catheters will be positioned in the saphenous vein (this procedure, as well as the entire process, is almost painless). Then a small amount of saline will be injected through the catheter and monitored on the ultrasound screen to confirm placement of the catheter in the vein. When good flow is confirmed, the medication will be injected into the vein.
Once all medication has been put into the vein, a foam bandage will be placed along the injected vein and your entire leg will be covered with a heavy weight thigh high support stocking.
Short Saphenous Vein (The vein on the back of your leg)
When the short saphenous vein is injected, you will be placed in a comfortable face down position. The same procedure as described for the greater saphenous vein will take place. Following the procedure, a foam bandage will be applied.
How long before I should return for my next visit?
There is no fee for this ultrasound appointment; however, if a second treatment is required, there could be an additional fee.
Echosclerotherapy treats the Greater Saphenous or Short Saphenous veins – sclerotherapy will be required to improve surface and spider veins. The number of sclerotherapy sessions will vary but will likely be biannually for maintenance.
How long will the procedure take?
The procedure itself takes approximately 15-30 minutes. However, allowing for preliminary scanning and bandaging after the treatment, plan on being in the clinic for 45-60 minutes.
Is there any preparation prior to Echosclerotherapy?
It is necessary to treat some smaller veins with a dilute form of medication to be sure that you will not have an allergic reaction. We call this treatment your preliminary injections. There is a fee for this treatment and you will also be required to wear lightweight support hose for five days to seven days afterwards
What can be expected after the treatment?
Immediately following the injection, some patients perceive a slight discomfort along the course of the injected vein. This, however, is very transient and usually disappears within a few minutes. As the vein closes over the next few weeks, there is bruising and tenderness as a lumpy cord forms. Your body will reabsorb the cord in about 6-18 months.
Rather than taking baths during this time, we recommend brief showers. To keep your bandage dry, you may wrap a towel on your thigh (just above your bandage) and then place your leg in a large plastic bag, which you tape tightly. After four days you can remove the bandage but you must continue to wear the support hose for an additional three and a half weeks during the day only. Immediately following the procedure, you must return home and lay flat with your leg straight for a period of four hours. Once every hour during this period, you can get up and walk around for 5-10 minutes.
It is advisable to not travel for two months following the Echosclerotherapy procedure; should you need to travel please discuss this with the doctor at your visit.
Can I exercise following treatment?
Walking is the preferred activity for the next four weeks and it is helpful in obtaining optimal results from the echosclerotherapy. However, exercise can start only after the 4 hour period of lying flat with a straight leg that is required immediately after the treatment. As previously mentioned, daily walking is best activity until you have your follow up ultrasound. Avoid weight lifting, high impact aerobics, cycling or sports for four weeks.
What are the possible complications of Echosclerotherapy?
The most common complication is an inflammation of the injected vein. It usually appears within the first few weeks after the procedure and consists of a hard, tender, reddened cord along the injected site. The pain is usually minor and is relieved by the application of ice and the use of support stockings and anti-inflammatory medication.
Despite having preliminary injections, there is always a possibility of developing an allergic reaction to the medication. This rare complication may range from a slight tingling sensation with red blotches on the skin, to an anaphylactic reaction.
In the bigger varicose veins, blood can be trapped with the treatment. This trapped blood in the veins can cause increased tenderness and may require draining three weeks after the treatment.
Exceptionally rare cases of deep vein thrombosis and pulmonary embolus have been reported in medical literature.
Will I be able to drive home after the procedure?
Yes, we allow for a period of 40 minutes driving time before you actually get home and proceed to lay flat with your leg straight. If you normally feel faint or dizzy following procedures, it is advisable to bring someone with you to drive you home.
What if I live more than 40 minutes away from the office?
Please advise us prior to your appointment if this is the case so that we can direct you as to how you should proceed. It is advisable that you bring someone to drive you home.
Please bring your support stockings for each appointment. If you have any questions or concerns regarding the treatment you are welcome and invited to call the office anytime. After hours, there is always a designated physician on call who is qualified to answer your questions (403-253-2555).