Sclerotherapy

What is sclerotherapy?

Sclerotherapy is a minimally invasive procedure which is used to treat abnormal or enlarged blood vessels, usually varicose veins. During the procedure, a solution (a special type of alcohol or foam) will be injected directly into the vessel, causing the vessel to collapse, re-routing the blood into healthier veins. The collapsed vein can eventually be reabsorbed into the body.

How does the procedure work?

You will be anaesthetised for the procedure. The interventional radiologist may take one of two approaches to performing the sclerotherapy. The first possible way to carry out the procedure is by inserting catheters into a blood vessel and then injecting a solution of 90% alcohol into the affected vein, causing the vein to become blocked. This is known as an endovascular approach.

The other way in which the interventional radiologist may perform the procedure is a percutaneous approach. For this approach, the interventional radiologist directly injects the solution into the selected vessel or vessels, usually guided by sonography.

Recently, other minimally invasive alternatives have been used as alternatives for patients undergoing sclerotherapy, such as laser or cryoablation.

Why perform it?

Sclerotherapy is recommended as a treatment as it has a higher rate of success than other methods.

What are the risks?

There are a number of severe risks associated with this procedure. The substance used in the procedure may extend into other veins, or the patient may experience pain if the level of anaesthesia is insufficient. If the interventional radiologist uses a percutaneous approach, damage to the skin is possible.

Bibliography

1. Rabe E, et al. European guidelines for sclerotherapy in chronic venous disorders. Phlebology. 2013 Apr 4.

2. van der Vleuten CJ, Kater A, Wijnen MH, Schultze Kool LJ, Rovers MM. Effectiveness of Sclerotherapy, Surgery, and Laser Therapy in Patients With Venous Malformations: A Systematic Review. Cardiovasc Intervent Radiol. 2013 Nov 7.