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Echo or ultrasound guided sclerotherapy


The word “varicose” is derived from Greek meaning dilated, tortuous and elongated. Varicose veins occur when veins in the legs lose their ability to propagate the blood towards the heart, either due to defective valves, weak vein walls or both. The blood is then pulled down by gravity and slowly stretches the vein, which then becomes tortuous and ropy. The reason this occurs is unknown, but heredity, lifestyle, occupational and hormonal factors play a role in the development of varicose and spider veins. The latter are in essence just miniature varicose veins and may be the first indication of deeper underlying pathology.


There have been many advances in the treatment of varicose veins since the introduction of surgery in 1851 but the application of duplex ultrasound has revolutionized the diagnostic capabilities and treatment modalities available. Varicose veins routinely follow a different course from one leg to another and ultrasound technology allows “mapping” of all diseased vein segments, not visible or palpable on the surface, right up to their origin, which is usually at the point of “reflux“ from the deep system. It also enables injection of the sclerosing agent into the varicose vein under direct ultrasound guidance, either through a needle or via catheter and treated right up to the source. In addition, the long or short saphenous vein can be injected (chemically stripped) along its path and its tributaries can subsequently be either injected or removed via tiny incisions. The technique is especially useful to treat recurrences following a previous surgery of the varicose vein or sclerosis of incompetent perforators such as a popliteal fossa perforator. Imaging studies enable assessment on effectiveness of the treatment and monitoring for potential side effects and early recurrences.


Recently a modified technique first introduced in Spain, has gained popularity around the world. It involves using a foam solution of sclerosant during ultrasound-guided sclerotherapy. The foam solution is more effective because it remains in the vein longer than the liquid solution while more effectively sealing off the vein in a more diffuse and uniform fashion.


Regardless of the type of varicose veins you suffer from or if you have recurrences following vein surgery, a custom designed treatment course by an experienced professional may be just the solution you have been waiting for. 

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