A Closer Look at How Sclerotherapy Works

Varicose veins are a common condition, one of the early stages of vein disease that affects some 3 in 10 adults. Often considered more of a cosmetic than a medical issue, varicose veins — red, blue, or purple protrusions snaking across the legs — can be painful and cause skin rashes, and they may lead to more serious stages of vein disease, so you might want to have them removed. One of the most common ways to alleviate the problem is sclerotherapy.

At Northwest Houston Heart Center, our fellowship-trained cardiologists, Dr. A. Adnan Aslam and Dr. Roy Norman, diagnose and treat varicose veins at our four offices in the Houston, Texas, area. One of the most common techniques they use is sclerotherapy, so let’s take a closer look at how that procedure works.

Chronic venous insufficiency — where it all starts

When functioning properly, your circulatory system uses arteries to take oxygenated and nutrient-rich blood from the heart and deliver it to the body; for the return trip, the veins transport the now- oxygen depleted blood. There’s just one problem on the back end — the veins have to move the blood against the pull of gravity, so they’ve devised a workaround. They contain a series of one-way valves that close as soon as the blood passes through, preventing backflow.

Weak vein walls or high blood pressure can damage the valves, though, which then can’t close completely. Blood can flow back along its track, becoming sluggish, and the blood pools around the valves. This condition is known as chronic venous insufficiency, as the flow is insufficient to meet the body’s needs.

In addition, the increased pressure against the weakened vein walls causes the vessels to become engorged. If the vein is close to the skin’s surface, you see reddish or purplish, ropy swellings — varicose veins.

Varicose veins

While varicose veins can occur anywhere in the body, they’re most common in the feet and legs, where your body’s weight puts the most pressure.

Other than discolored protrusions, varicose veins produce:

• Swollen ankles and feet
• Burning or throbbing feelings in your legs
• Muscle cramps, especially at night
• Aching, heavy legs
• Thin, dry, and itchy skin over the affected vein

The symptoms usually worsen when the weather is warm or when you’ve been standing for a long time. They may be eased if you elevate your legs or walk.

How does sclerotherapy work?

Sclerotherapy involves injecting the varicose vein with a solution that irritates the vein lining, causing it to wither away. Blood from that vein is then rerouted to nearby healthy veins.

The procedure lasts 30-45 minutes, doesn’t require any special preparation or, in most cases, anesthesia. We do ask if you’re having sclerotherapy on your leg or legs that you wear shorts and arrange for transportation home afterward.

During the procedure, the doctor injects the sclerotherapy solution into the damaged vein, either with or without ultrasound guidance. The solution is known as a sclerosant, and it irritates the blood vessel, causing it to swell. The swelling cuts off the flow of blood, and the vein shrinks as a result.

Or, the cardiologist may insert a catheter into the blood vessel, followed by a sclerosant made of 90% alcohol. You might feel a tingling or burning sensation as the solution goes in, or you may feel nothing at all.

Following the injection, the doctor massages the area to prevent blood from reentering the vein, and you’ll probably need to wear compression stockings for a week or so to control swelling and aid blood flow. You’ll also need to remain active to prevent blood clots from forming.

If you have multiple varicose veins, the doctor likely will treat them in more than one session. In most cases, several sessions are needed to collapse some veins completely. 

Studies suggest that sclerotherapy for varicose veins is effective in 50-80% of cases. Your doctor follows up with you about six weeks after the procedure to determine if you need additional treatment. If sclerotherapy isn’t successful, you may need to consider alternative treatments, including surgery.

Are your legs showing the colored signs of vein disease? The doctors at Northwest Houston Heart Center recommend you come in for treatment, which may include sclerotherapy, as soon as possible to nip it in the bud. To schedule an evaluation, call us at any of our locations — Tomball, Cypress, Magnolia, and The Woodlands, Texas — or book online today. You can also text us at 832-402-9518.