SCLEROTHERAPY INFORMED CONSENT
This form is designated to provide you with the information you need to make an informed decision about whether to have sclerotherapy performed. If you have any questions or do not understand any potential risks, please do not hesitate to ask us.
What are varicose veins?
Varicose veins are veins that have become dilated. They impede blood flow and hinder the return of blood from the legs to the heart. When the valves in a vein become damaged, they are unable to function properly and reflux can occur. In other words, blood may flow backwards, which can lead to congestion and swelling of the veins. The blood also can back up and cause spider veins superficially in the skin.
What is Sclerotherapy?
Sclerotherapy is “the gold standard” fro eliminating varicose veins and superficial telangectasias (spider veins) by injecting a solution called sclerosing agent into the vein. The solution irritates and dries out the cells lining the blood vessel so that it stops carrying blood. The body slowly replaces the blood vessel with an invisible scar. The circulation is not harmed because blood is re-routed through healthy veins.
What causes varicose veins and spider veins?
The cause is unknown, although heredity seems to play an important role. Varicose veins and spider veins can be aggravated by pregnancy, birth control pills, hormonal therapy, prolonged periods of sitting or standing, obesity, aging of the tissues, trauma, or tight clothing.
Does Sclerotherapy work for everyone?
About 80% of people who have sclerotherapy performed will see significant improvement in their veins, although complete resolution is rare. Unfortunately, there is no guarantee that sclerotherapy will be effective in every case. Approximately 10% of patients who undergo sclerotherapy have poor to fair results. “Poor results” means that the veins have not totally disappeared after six treatments. In very rare instances, the patient’s condition may become worse after sclerotherapy treatment.
How many treatments will I need?
The number of treatments needed to clear or improve the condition differs from patient to patient, depending on the extent of varicose and spider veins present. One to six or more treatments maybe needed; the average is three to four. Individual veins usually require weeks to months. Sclerotherapy does not prevent new veins from forming. The same area should not be injected for 3 to 4 weeks to allow for complete healing.
What are the most common side effects?
- Itching – You may experience mild itching along the vein route. The itching can last 1 to 2 days.
- Transient Hyperpigmentation – Approximately 30% of patients who undergo sclerotherapy notice discoloration or light brown streaks after treatment. This is caused by the sudden release of blood into the surrounding skin. In rare instances, this darkening of the vein may persist for 4 to 12 months.
- Sloughing – Sloughing occurs in less than 3% of patients who receive sclerotherapy. Sloughing consists of a small ulceration at the injection site that heals slowly. A blister may form, open and become ulcerated. The scar that follows should return to a normal color.
- Allergic Reaction – Very rarely, a patient may have an allergic reaction to the sclerosing agent or the tape.
- Bruising – Bruising may occur if the veins are weak and small amounts of blood escape into the skin. Certain medications (e.g. aspirin, ibuprofen) may increase the incidence of bruising.
- Swelling of the legs – Swelling is unusual, but may occur in patients whose feet or ankles are treated or in those who stand for long periods of time. The swelling is not dangerous and is treated by elevating the legs and support stockings.
- Blistering, Redness and Irritation – Blistering, redness and irritation may develop as a reaction to the adhesive tape used for compression.
- Tenderness, Bruising or Firmness – (especially along a larger vessel) in the treated area, may last for varying periods of time. This can be minimized by the use of support hose after treatment.
- Sometimes lumps of old blood may accumulate in the larger veins treated by sclerotherapy. Strict use of support hose minimizes this possibility. The old blood never causes internal problems.
- Pain – A few patients may experience moderate to severe pain and some bruising, usually at the site of the injection. The veins may be tender to the touch after treatment, and an uncomfortable sensation may run along the vein route. The pain is usually temporary, in most cases, lasting 1 to 7 days.
What are the other side effects?
Other side effects include a burning sensation during injection of some solutions, neovascularization (the development, usually temporary, of new tiny blood vessels), temporary superficial blebs or wheals (similar to a hive), and very rarely, a wound infection, poor healing, scarring and an intra-arterial injection.
Phlebitis is a very rare complication, seen in approximately 1 of every 1,000 patients treated for varicose veins greater than 3 to 4 mm in diameter (larger vessels). The danger of phlebitis include the possibility of pulmonary embolus (a blood clot to the lungs) and post-phlebitis syndrome, in which the blood clot is not carried out of the legs, resulting in permanent swelling of the legs.
Are there other types of procedures to treat varicose veins and spider veins?
Vein stripping and/or ligation (closure) may also be used to treat certain types of large varicose veins. You may be referred to a vascular surgeon from treatment of these veins. Laser treatment works well for small red vessels or red matted (blushy) areas, but do not work as well for the more purple vessels. Laser treatments are also more expensive and can cause scarring and hyperpigmentation.
Instructions for Sclerotherapy:
- Do not shave your legs or apply moisturizer 24 hours before treatment.
- Eat a light breakfast or lunch an hour or so prior to your appointment.
- Bring shorts to wear during the procedure and slacks to wear out of the office.
- Purchase a pair of support hose (12-18mmHg) and bring them to your appointment. You will be wearing them after the procedure to go home in.
- Do not take any aspirin, ibuprofen (Motrin), or Aleve products 2 weeks prior to treatment.
Post Sclerotherapy Instructions:
- Support hose should be worn for 3 to 7 days following sclerotherapy.
- Walk for 30 minutes following injections.
- Normal activities may be resumed immediately, but avoid strenuous, high impact exercise for 72 hours.
- If you have a long drive home, keep the legs moving and make frequent stops for walking every 20 minutes.
- Avoid standing without moving about. If you must stay in one place, move your feet and toes frequently.
- No hot baths or hot tubs for 2 weeks.
- Support hose may be purchased at Osco Home Health or Walgreen’s. Some common brands are Futura or Jobst.
To schedule and appointment, please call and ask for a 30 minute sclerotherapy appointment. There is a $100 deposit which will be forfeited if the appointment is cancelled less than 24 hours before appointment.