Sclerotherapy for Leg Veins

Overview / Definition Sclerotherapy is a medical procedure used to eliminate varicose veins and spider veins by injecting a sclerosing agent directly into the affected veins. This agent irritates the lining of the vein, causing it to close off and eventually be absorbed by the body. Epidemiology Leg vein disorders, including varicose veins and spider veins, are common, affecting approximately 30-40% of adults in the United States. Women are more frequently affected than men, with a ratio of approximately 3:1. Risk factors include: Gender: Higher incidence in females due to hormonal factors. Age: Incidence increases with age. Family history: Hereditary predisposition is significant. Pregnancy: Increased blood volume and hormonal changes. Obesity and prolonged standing: Increased venous pressure. Pathophysiology / Mechanism Venous insufficiency, characterized by the malfunction of the valves in the veins, leads to blood pooling and increased pressure. Sclerotherapy works by: Injecting a sclerosing agent that irritates the endothelium of the targeted vein. Inducing an inflammatory response that results in fibrosis and occlusion of the vein. Forcing the body to reroute blood flow through healthier veins. Clinical Presentation Patients with varicose veins may present with: Visible twisted and bulging veins. Leg fatigue or heaviness, especially after prolonged standing. Swelling in the legs and ankles. Skin changes such as eczema or hyperpigmentation. Possible complications such as venous ulcers. Diagnosis / Workup The diagnosis of venous insufficiency typically involves: Clinical examination: Visual inspection and palpation of the veins. Duplex ultrasonography: Gold standard for evaluating venous anatomy and function. Photodocumentation: Useful for tracking treatment progress. Treatment / Management Sclerotherapy is the mainstay treatment for superficial leg veins. Key steps include: Patient selection: Ideal candidates should have no contraindications like allergies to t