Sclerotherapy for Varicose Veins

Sclerotherapy for Varicose Veins

Treatment Duration

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1 Hours

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1.5 Hours

Treatment Cost

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40,000

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1,00,000

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Sclerotherapy for Varicose Veins

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About

Causes of Varicose Veins:

  • Long-standing hours increase the pressure in the veins of the lower body.
  • Obesity
  • Pregnancy
  • Family history of varicose veins
  • menopause
  • age > 50

 

Signs and Symptoms:

  • Bulging of legs
  • Bluish veins
  • Swelling of thighs and/or calves
  • Aching pain
  • A feeling of heaviness in the legs and feet
  • Itching in legs
  • Changes in skin colour
  • Nighttime leg cramps

Sometimes, varicose veins can limit your activities. Your symptoms may get worse when you sit or are on your feet for long periods, and they may get better when you lie down or put your feet up.

 

Indications:

Initially, conservative management is advisable, like wearing compression socks or stockings, avoiding long sitting/standing hours, exercising regularly/losing weight to increase blood circulation, keeping legs elevated to increase the reverse flow of blood to the heart.

A doctor should be consulted if symptoms persist and worsen, such as,

  • The continuous pain, burning, and tenderness in the legs
  • Skin sores and ulcers.
  • Blood clots.
  • Bleeding from the veins
  • Surgery is also advisable if there is distress and concerns about aesthetics.
  • Early surgery is always better to prevent complications.

 

What to expect if surgery is delayed

If untreated, varicose veins may cause severe complications like,

  • Vein rupture or collapse, which can cause bleeding and loss of blood
  • Deep vein thrombosis (DVT) - It is a medical condition that occurs when there is a blood clot in one or more of the deep veins in the body causing pain and swelling in the affected region. The blood clot can rupture and travel to the lungs, causing a pulmonary embolism (blockage in lungs), causing difficulty in breathing, increased heartbeat, and may be life-threatening.
  • Thrombophlebitis - Enlarged deep veins of the leg cause pain, swelling, and redness, indicating the formation of blood clots that needs immediate medical attention.
  • Skin discolouration - Affected skin area may appear reddish-brown due to increased pressure and fluid leakage to surrounding tissues.
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Procedure Description

Varicose veins can be treated by:

1. Sclerotherapy: A liquid solution (sclerosant) or foam is injected directly into the vein, which will collapse the vein gradually. The sclerosant used is sodium tetradecyl sulphate which scars the vein, and it gradually disappears. No incision or anaesthesia is required. It is used for spider veins(tiny varicose veins on the surface of the skin). For large veins, the sclerosant is converted into foam and injected into the veins to cover a large surface area.

2. Surgical removal of the affected veins: Surgery is one of the most effective ways to relieve varicose vein symptoms. Anaesthesia is required for surgery, and in most cases, it is an outpatient procedure. Standard Surgical procedures are:

  • Vein Ligation and stripping: In this procedure, veins are tied with a flexible wire and removed through small incisions made at 2 or 3 levels in your thigh. Veins in your leg (below the knee) are not stripped to prevent injury to nerves of the lower limb. Damaged Varicose veins are tied at one end by a thin, flexible plastic wire which is inserted from the groin incision and then pulled out from the incision near the ankle area.
  • Phlebectomy (Not done these days): Multiple minor cuts are made along the vein, and then the vein is pulled out using hooks and removed by cutting the vein into several pieces.
     

3. Minimal invasive techniques 

The vein is sealed from inside instead of complete removal. A thin tube (catheter) is inserted and pushed along the vein, and thermal energy is used to seal the vein. Heat can be produced in two ways:

  • Endovenous Laser Ablation (EVLA): In this procedure, laser energy is used to produce heat. A laser fibre is inserted into the catheter (with the help of an ultrasound) to produce heat and destroy the wall of the vein. The damaged veins collapse, get absorbed by the body and disappear slowly with minimal discomfort.
  • Radiofrequency Ablation (RFA): In this procedure, electromagnetic waves(Radio waves) are used to produce heat. Here a fibre is inserted into the catheter(with the help of an ultrasound), which emits radio waves and destroys the wall of the vein. The veins collapse and are gradually reabsorbed by the body. Compared to EVLA, the temperature of heat produced to destroy the vein is much lower here, which results in lesser discomfort.
  • Laser Treatment: High-intensity laser beams are used to destroy the veins. No incision is required.
  • Endoscopic vein surgery: This procedure is used in advanced cases associated with leg ulcers where other techniques fail. A small video camera is mounted at the end of a thin tube and inserted into the vein through a  small cut in your skin near a varicose vein. A surgical device at the end of the camera is used to close the vein.

 

What to expect/plan before surgery

  • A physical examination will be performed by the doctor to locate the damaged veins.
  • The doctor may use an Ultrasound device and Duplex scans for a detailed view.
  • Consent has to be signed prior to the surgery.
  • Fasting (nil by mouth) is advised for 6-8 hours prior to the surgery if the surgery has to be performed in general anaesthesia.
  • Appropriate travel arrangements should be made for going home after the procedure.

 

What to Expect During Surgery 

  • Varicose vein stripping usually takes 60-90 minutes and is an outpatient procedure (patient is discharged the same day or the next day)
  • A hospital gown is provided for a dress change.
  • Either general anaesthesia (patient will be unconscious during the entire procedure) or spinal anaesthesia (patient will be conscious but only the lower body will be numb) is given before the procedure.
  • Anti-anxiety medication may be given before the procedure to ease nervousness.
  • In this procedure, small incisions (cuts) will be made on the top and bottom of damaged veins. The top one will be near the groin, and the other one will be behind the ankle or knee. Damaged Varicose veins are tied at one end by a thin, flexible plastic wire which is inserted from the groin incision and then pulled out from the incision near the ankle area.
  • Bandages and compression stockings will be placed on the leg.

Risks & Complications

Varicose vein stripping is a safe and low-risk surgical procedure. However, there are a few potential risks associated with surgeries:

  • An allergic reaction to anaesthesia
  • Skin infection 
  • Heavy bleeding
  • Blood clots
  • Scarring
  • Bruising
  • Nerve injury leading to numbness and tingling or foot drop (very rare).

Expert Doctors

Dr. Shiblee Siddiqui
Hexa Partner

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12+ Years

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Dr. OP Jain
Hexa Partner

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51+ Years

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NABH Accredited Hospitals

Sri Sairam Hospital - Multispeciality Hospital in BTM
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Balaji Superspeciality Hospital
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Balaji Superspeciality Hospital

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Frequently Asked Questions (FAQ)

Not really, but losing weight will surely help in reducing the risks of many other health problems. It will also decrease the pressure on the lower body, mainly legs and feet, preventing the formation of new varicose veins. After losing weight, existing varicose veins may become more noticeable and take a long time to go away slowly. Additionally, staying hydrated and doing specific mild exercises can further help to ease the symptoms.
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Most patients will experience some minor side effects following varicose vein treatment, including discolouration or bruising in the treatment area, along with some minor swelling. These effects will disappear soon after treatment. Other risks or side effects can vary depending on the type of treatment. The most significant risk is that of a blood clot forming in the veins. This can break off and travel to the lung veins, causing deep venous thrombosis (DVT) and pulmonary embolism, but wearing your compression garment following surgery and getting the recommended amount of activity can help ensure blood flow remains uninhibited, significantly reducing the risk of clot development. The possible side effects of these treatments are: • Slight soreness • A tingling sensation or numbness over the thighs and calves. These sensations are often temporary and can be relieved by medication. • In rare cases, patients may develop some darkening (pigmentation) in the area of the skin which has been treated. This darkening can be effectively treated with skin creams.
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Ruptured Varicose veins can be alarming. Often, veins burst due to excess pressure, so the bleeding can be rapid and profuse. Here are two ways bleeding can occur: • Internal If a varicose vein ruptures but the skin is not broken, you will experience bruising. Internal bleeding from any source can cause dizziness or fainting if enough blood is lost. If you have any of these symptoms, visit your vein care specialist or nearest emergency room to avoid too much blood loss or complications. • External If a varicose vein ruptures and the skin is broken, you will experience significant bleeding. Apply immediate pressure to the area with a towel or cotton t-shirt, and elevate your legs above your heart. This will help slow or stop the bleeding while you seek medical attention. To avoid excessive blood loss, visit your vein care specialist or the nearest emergency room as soon as possible.
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Varicose veins surgery is a low-risk surgical procedure, and some patients might experience bruising, swelling, skin discolouration and slight pain after varicose veins surgery. Doctors are of the opinion that surgery effectively relieves varicose veins symptoms in comparison to non-surgical treatments. Surgery for varicose veins serves both aesthetic and medical purposes in a safe manner. About 80% of the people who undergo varicose vein surgery notice that symptoms such as swelling, heaviness, and throbbing pain alleviate significantly or vanish entirely.
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Chronic Venous Insufficiency occurs when the tiny, one-way valves that control the flow of blood through your veins become damaged. In normal veins, these valves open to allow blood to flow through on its way to the heart and then close again. When these valves become “leaky,” they allow blood to flow back into the veins and collect there. This is what causes these veins to become enlarged and take on the bluish-purple colour of deoxygenated blood that you can see on the surface of the skin as spider veins and varicose veins. This is just the first stage of CVI, however. The six most common stages of CVI (chronic venous insufficiency) Although each case is slightly different, the following six sets of symptoms appear often enough and in enough patients that we can safely categorize them as reflecting predictable “stages” of the disease. • Stage one – spider veins. These small, reddish-purple veins – visible on the legs, ankles, neck, face, and other areas – are not necessarily related to varicose veins, but they are caused by the same underlying CVI. They are more common in women than in men. • Stage two – enlarged, ropy varicose veins. These swollen veins are, in many cases, “stage one” of the disease, because as noted, they are not necessarily preceded by spider veins. This is the stage at which people often first become aware that they have vein disease. The swollen veins may be accompanied by itching, burning, or numbness along the veins themselves and by tired, weak, or achy legs. This is the best stage at which to treat them. • Stage three – oedema (swelling), but without skin changes. In this stage, swelling of the legs and ankles increases because CVI has impaired the circulatory system’s ability to reabsorb fluid. Elevation of the limbs may help but will not cure the disease or reduce the swelling much. • Stage four – skin changes and discolouration: As the disease progresses, venous congestion and poor circulation can lead to changes in skin colour and texture. The skin on your legs can become reddish-brown or white in colour and take on a more leathery texture that leaves it brittle and prone to injury. • Stage five – skin changes with healed ulceration: In this stage, scratches or injuries to the toughened skin may heal with treatment, often leaving scars. • Stage six – skin changes with active ulceration: In this final stage of CVI, injuries to the skin and leg ulcers refuse to heal even with treatment and can leave your legs literally covered with bleeding, open sores.
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Laser treatment is the advanced modern surgery for varicose veins. Nowadays, doctors prefer this laser-based treatment because it is minimally invasive in nature. One of the significant advantages of laser treatment is that there is no involvement of cuts or incisions. • Minimally invasive procedure It is only the precise, high-intensity laser beam that directly acts on the affected vein to diminish the swelling and inflammation due to blood accumulation. The use of high-intensity laser pulses makes the procedure of laser treatment simpler yet very effective. • High Success Rate The success rate of laser treatment is very high (more than 90 %) in comparison to conventional treatments for varicose veins. This means that there are nil chances of recurrence of varicose after laser treatment. • Nil Risks Of Complications No requirement for bandage as there are no major incisions or wounds there are no chances of bleeding, infections, and blood clots when you undergo laser treatment as there are no big incisions or stitches. On the other hand, the chances of complications are much higher in traditional surgery for varicose veins. No long terms scars • The short and smooth recovery period The conventional procedure of surgery extensively uses cuts, incisions, and stitches, making it very complex. Hence, it takes a number of days to recover from such a complex surgery. Whereas the recovery period after the laser treatment of varicose veins is a very short and smooth, complete recovery in just 2-3 days.
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At Hexahealth which has top doctors, top surgeons and the best hospitals empanelled in their network in Delhi, you can avail the best and most effective laser treatment at an affordable cost.
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Your primary care doctor may diagnose your varicose veins and give you the recommendation to see a vascular specialist for treatment. These specialists most commonly are doctors from the following specialities: interventional radiologists, vascular surgeons, dermatologists or plastic surgeons.
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If you plan on having surgery for varicose veins, you are probably wondering what the experience will be like after the treatment. The truth is that outcomes vary based on how well you adhere to your after-surgery instructions. Here are the top 20 tips for ensuring the best possible outcome after your varicose vein surgery. 1. Rest You need to take it very easy for at least 7 days. This will help you avoid bruising, excessive bleeding, and pain. Sleep aids in recovery too, so get your rest. 2. Increase Activity Slowly Don’t rush into exercise after your surgery. Take it slow to make sure that incisions don’t open up and that blood flow returns to normal. 3. Bathing Is a No-No There is no showering or bathing, at all, for at least two days after your surgery. You can take a sponge bath, as long as you avoid the incisions. 4. Ice It Ice can go a long way to reducing pain, swelling, and bruising. Ice your incisions for 10-20 minutes every 2-3 hours. 5. Elevate Your Legs Keep the blood flowing to your heart by keeping your legs elevated. This takes pressure off of your veins and allows them to heal faster. 6. Ask About Sleep Sleeping can be tough right after vein surgery. Talk to your doctor about home remedies, over-the-counter drugs, and prescription medications for sleep. Have them ready before you get home from surgery. 7. The Pain Gets Worse Before Getting Better Most people say that the pain of vein surgery peaks on days 8-10 and then gets better. By day 14, your pain should be minimal. 8. Expect Bruising Bruising after vein surgery is common. Your legs might be black, blue, or even green. The bruises should go away over two or three weeks. 9. Wear the Compression Stockings Most people don’t like the feel of compression stockings, but they can speed recovery after vein surgery and minimize scarring. Do your best to wear these stockings for at least two weeks after your surgery. 10. Walk for 10 Minutes Every Day After the first two days of rest following varicose vein surgery, try to get at least 10 minutes of walking in every day for two weeks. This can really speed the healing process 11. Check Your Incisions Infections are rare, but they can occasionally happen after varicose vein surgery. Check your incisions at least once every day to look for redness, swelling, pus, and other signs of infection. 12. Depressurize Don’t sit or stand for too long in the first 1-2 months after your surgery. Keep your legs elevated to promote healing and give your vasculature time to reestablish blood flow. 13. Time Off Most people need just two weeks off after vein surgery. If your job requires a lot of sitting or standing (e.g. driving trucks), then you may need 4-6 weeks off to ensure full recovery. 14. Never Use Hydrogen Peroxide Hydrogen peroxide is great for killing bacteria, but it can really slow wound healing. Once you are given the okay to clean your wounds at home, do so with soap and water. Never use hydrogen peroxide or alcohol to clean a surgical incision. 15. Don’t Drive Wait at least two days to drive after vein surgery. Not only do you risk reopening incisions while driving, you won’t have normal reaction times either. 16. Be Patient It can take up to a year to fully recover after vein surgery. Be patient with the process and talk to your doctor if you have concerns.
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