Compression sclerotherapy The Phlebology Clinic / Services / Venous treatments / Compression sclerotherapy Introduction Key information Description of treatment Laser vein sealing Vein bonding Introduction Compression sclerotherapy is a group of minimally invasive procedures on the venous system that form the foundation of modern phlebology. This method, which is used to treat diseases of the venous system, is based on the insertion of a special agent, called a sclerosant (obliterating agent). The sclerosant induces controlled irritation of the vein wall, leading to fibrosis and closure of the vein, ultimately eliminating the abnormal blood flow. The origins of the use of sclerotherapy date back to the 19th century, but it was not until after 1920 that the method gained popularity as an alternative to surgical treatment of varicose veins. And so it remained for the next 50 years. It was not until the introduction of ultrasound equipment that the method was developed rapidly and a technique called echosclerotherapy (ultrasound guided foam sclerotherapy). The striking power of the foam created from the detergents used for obliteration was much greater and made it possible to close much larger venous vessels than before. Name compression sclerotherapy reflects the fact that the treatment combines two key activities: the injection of sclerosant and the application of postoperative compression therapy. Compression therapy, using devices such as compression stockings, is essential to increase the effectiveness of the treatment. Its use increases the effectiveness of the treatment and perioperative safety (reduces the risk of inflammatory and thrombotic complications). Compression sclerotherapy at the Phlebology Clinic At Phlebology Clinic We offer a wide range of compression sclerotherapy treatments, tailored to the individual patient's needs. We perform most of these treatments in a proprietary manner. The most common types of sclerotherapy treatments used in daily practice include: micro-sclerotherapy - a variant of sclerotherapy involving the precise closure of small vessels such as 'spider veins' (telangiectasias) and reticular veins; needle sclerotherapy - a traditional technique using liquid sclerosant, performed under visual control or with a skin illuminator; echosclerotherapy - a method in which sclerosant (usually in the form of foam), is administered under the control of an apparatus and ultrasound probe, allowing for precise treatment of larger venous trunks; catheter sclerotherapy - An intravenous variant of echosclerotherapy, dedicated to the treatment of large venous trunks, often assisted by tumescence; mechano-chemical obliteration - a modern approach to the application of foamed sclerosant into the vessel, combining the chemical action of the sclerosant with mechanical damage to the endothelium of the vein, e.g. using the Flebogrif system or the ClariVein system. Compression sclerotherapy - what does it involve? Classification of obliterating agents The sclerosants (or obliterating agents) used today can be divided into three main groups, depending on their mechanism of action. In everyday practice, detergent-based sclerosants are most commonly used due to their high safety profile and efficacy. osmotic agents are hypertonic solutions of glucose (not very effective, causes severe pain on administration) and sodium chloride (rarely used because of the risk of tissue necrosis if extravasated); detergents (surfactants): act by inducing damage to the vascular endothelium, leading to its fibrosis. Preparations such as polidocanol (Aethoxysklerol) or tetradecyl sodium sulphate (FibroVein, STS) belong to this group. Polidocanol is available in different concentrations (e.g. 0.25, 0.5, 1, 2 and 3%) and also has topical anaesthetic properties. STS is an anionic detergent, used in concentrations of 0.2%, 0.5%, 1% and 3%. Preparation of foamed sclerosant using the Tessari method. The most common form of administration of modern detergent sclerosants. irritants (chemical): act by denaturing proteins and directly damaging the vessel wall; these include iodine, chromium and alcohol preparations (e.g. ethanol 70-96%); now less commonly used due to high side-effect profile and significant pain on administration and high induction of necrosis. Key information on the venous procedure TYPE OF TREATMENT using: vision, ultrasound, backlighting INVASIVENESS minimum (1/5) TREATMENT AREA whole body PERFORMING ENSEMBLE phlebologist, nurse assistant DURATION 15-60 minutes TYPE OF ANAESTHESIA none, local, tumescent BOLDNESS minimum (1/5) RISK OF COMPLICATIONS minimal to low (1-2/5) CONVALESCENCE 4-14 days What can be treated with compression sclerotherapy? Compression sclerotherapy is one of the most comprehensive treatments for venous problems. Phlebological indications for sclerotherapy include: vascular spider veins (telangiectasias) and dilated reticular veins; Varicose veins of various diameters, including atypical varicose veins on the legs derived from pelvic venous insufficiency; venous insufficiency in the main trunks of the superficial system (saphenous, accessory posterior and anterior veins and saphenous veins) and varicose veins secondary to these; recurrent venous disease with secondary varicose limbs; varicose veins of the intimate area (usually post-pregnancy); Pelvic varicose veins secondary to pelvic venous insufficiency; venous malformations. Typical venous lesions in a patient with pelvic venous insufficiency to be treated with compression sclerotherapy: (1) extensive telangiectasias and venulectasias of the posterior runoffs; (2) spider veins of the lateral thighs (3) extensive spider veins of the supracostal inflow (4) varicose veins of the lateral runoffs. Compression sclerotherapy is an indispensable part of hybrid treatments, in which we use 3-4 techniques to treat venous disease simultaneously. Price range Phlebology Minimally invasive venous procedures performed under ultrasound guidance catheter-based echosclerotherapy of varicose veins assisted by tumescence (one leg) ** PLN 1500 Make an appointment tumescence-assisted varicose vein injection echosclerotherapy (one leg) ** PLN 1000 Make an appointment Foam compression varicose vein echosclerotherapy (one leg) ** PLN 700 Make an appointment compression microsclerotherapy of spider veins and reticular veins (one leg) ** PLN 700 Make an appointment mechano-chemical obliteration of varicose veins with the FLEBOGRIF system (one leg) *** 3200 zł Make an appointment sclerotherapy treatment performed in an area of the body other than the lower limb (e.g. perineum, labia, buttocks, breasts, etc.). 800 PLN Make an appointment Patient preparation for compression sclerotherapy treatment Before undergoing compression sclerotherapy the patient should: undergo a Doppler ultrasound examination of the veins of the lower limbs, pelvis and abdominal cavity and consult the treatment method with a phlebologist; inform the doctor performing the procedure of all past and current illnesses, medications, allergies and family history; read the information booklet and the content of the consent before sclerotherapy treatment; in the case of women, report the possible possibility of pregnancy (pregnancy is a contraindication to compression sclerotherapy); familiarise yourself with the possibilities of the procedure and the limitations of the method, as well as potential postoperative inconveniences (e.g. the need to wear a compression stocking for 7-14 days after the procedure and to avoid the sun for 4-6 weeks after the sclerotherapy procedure). Description of compression sclerotherapy treatment The compression sclerotherapy procedure is carried out in an outpatient setting, without the need for hospitalisation. It usually lasts between 15 and 40 minutes. The sclerotherapy procedure consists of the injection of an obliterating agent into the lumen of the affected venous vessel (the so-called 'sclerosant'). sclerosant). This agent causes irritation of the venous vessel wall, which consequently leads to its fibrosis and closure by overgrowth mechanism. The sclerosant application technique, type, concentration and volume are selected individually to the patient's needs and applied to the specific clinical situation. Microsclerotherapy of vascular spider veins is, against all appearances, one of the more difficult phlebological procedures, requiring a thorough haemodynamic analysis of their formation. The strategy of the procedure itself and its good planning (also in time) are the most important elements of performing compression sclerotherapy. They require the phlebologist to have considerable experience in performing this type of venous procedure. The sclerotherapy procedure is minimally invasive and does not require anaesthesia. After the procedure, compression devices are worn for about 7-14 days (they have to be worn from morning to evening). The entire treatment procedure may require several sessions at 2-6 week intervals. Management after sclerotherapy treatment After the compression sclerotherapy procedure, it is crucial to strictly follow the recommendations of the phlebologist. Immediately after treatment - i.e. after the nurse has put on the compression devices - the patient should take a short, brisk walk (preferably about 30-40 minutes). This is an important part of thrombosis prophylaxis. The stocking or compression stockings worn after the procedure should be worn as prescribed by the doctor (usually for 7 to 14 days after the procedure). The compression stockings should be worn during the day, taking them off only at night. Compression therapy in the post-operative period reduces transient swelling and is crucial to the effectiveness of the treatment (it compresses the walls of the injected veins, promoting their fibrosis and closure). The entire treatment process may require 2-5 obliteration sessions, usually performed at 2-6 week intervals. Follow-up visits after the treatment are necessary to monitor the condition of the vessels and confirm the effectiveness of the treatment. In the longer term, after the treatment has been completed, patients are required to have periodic follow-ups, which include medical consultations and Doppler ultrasound of the veins of the lower limbs. Contraindications to compression sclerotherapy treatment To absolute contraindications sclerotherapy treatments include: Significant allergy known to the patient to the sclerosants used; venous thrombosis in the acute phase (superficial or deep vein thrombosis); pregnancy; severe systemic disease and its exacerbation; severe infection (local or generalised); advanced arteriosclerosis of the lower limbs preventing the use of compression therapy; Significant immobilisation preventing the use of compression devices; overt heart defect, e.g. confirmed atrial septal defect. To relative contraindications include: shin swelling of unclear aetiology; asthma and other allergic diseases; confirmed hypercoagulability (thrombophilia); breastfeeding (early postpartum phase); susceptibility to migraines; a history of deep vein thrombosis. Complications of compression sclerotherapy treatment Despite the high safety profile of sclerotherapy treatments, complications can occur after them, as after any procedure on the venous system. These are divided into two groups: light complications (more common): skin discolouration - usually transient - affects 10-30% patients; segmental inflammation of injected vessels, thickening along the course of veins, pain and discomfort at injection sites, enhancement of small vessels, skin necrosis (below 1%); severe complications (very rare): anaphylactic shock (related to sensitisation to the preparation used); deep vein thrombosis with pulmonary embolism. At the Phlebology Clinic we make every effort to minimise the risk of complications and our specialists remain available to patients during the recovery period. If you experience any worrying symptoms, please contact our Registry immediately. Treatment methods 01 / Microsclerotherapy 02 / Foam sclerotherapy 03 / Catheter sclerotherapy 04 / Sclerotherapy of varicose veins of the intimate area Feedback from our patients Every positive review makes us proud and motivates us to keep going. Please add feedback and share your treatment story with others 🙂 . Do you appreciate our care? Add your opinion! Add your opinion to Google All opinions The pelvic vein embolisation and venoplasty procedure was performed in September. From the very patient service at the reception desk in the clinic to the procedure in the hospital ward - no reservations. Everything thoroughly explained, procedure painless. Hospital ward, neat and clean. Specialists very polite, professional approach. I came here the first time on the recommendation of your gynaecologist and I don't know if I would like to look for another clinic in Poland to deal with my problem. I have full confidence in these people and I know that I am in good hands 🙏🏻 żelika Wójcik Opinia z: 5/5 Make an appointment at the Phlebology Clinic Book an appointment
