Superficial venous insufficiency has been treated since the 4th century. Different authors documented a different method for this treatment such as compression therapy, cautery, ligation etc. but the most inventive and latest method is sclerotherapy. This article enlightens the sclerotherapy and its importance

Definition of Sclerotherapy

Before moving toward the importance of this therapy, it is important to know what exactly this therapy is. So, in simple words, it acts by destroying the endothelium of the vein, as a result, the abnormal vessel becomes occluded and fibrosis occur. It can be primary therapy along with other percutaneous treatments for large and deeper veins.

 Historical Overview of sclerotherapy

History of sclerotherapy goes back in 1680’s but the latest technique is documented in the early 20th century. In advance technique, initially, carbolic acid and mercury percolate is used then quinine is given to the patients. Still, scientists are experimenting and struggling to get more compatible and efficient therapy with excellent results.

Probable Uses of Sclerotherapy

  • This therapy is often used to treat telangiectasia in lower extremity veins
  • It is used for smaller varicose veins
  • This is helpful for the treatment of reticular veins
  • Hemorrhoids are also treated by this therapy
  • It is rarely used in Hydrocele
  • Chronic nose bleeding can also be stopped easily by this therapy
  • Its use is also seen in esophageal varices treatment

 Types of Sclerotherapy

  • Sclerotherapy with ultrasound
  • Injection Sclerotherapy
  • Foam Sclerotherapy

Sclerosant is an irritant that is injected into the targeted vessel which causes fibrosis and occlusion of vessels, consequently causes shrinkage of the vessel. Sclerosant is the most common irritant used in this therapy from many others. It is used therapeutically may have some chemical and physical effects on the targeted vessels to produce a controlled response. Most common agents of Sclerosant are:

  • hypertonic (23.4%) saline and Sclerodex.
  • Ethanol
  • Glucose
  • Sodium tetradecyl sulfate
  • Sodium Morrhuate
  • Ethanolamine oleate
  • Polidocanol
  • Chromated glycerin 72%

Ideal properties of Sclerosant:

  • It should have good stability
  • It must be hyperosmolar
  • It has optimum thermogenic properties
  • It should be non-Nero inflammatory
  • It should cause full thickness, shrinkage of the vessel with heart thrombus formation.
  • This should be non-toxic
  • It must be painless
  • Easy handling must be its primary property

 Pros and Cons of Sclerotherapy

It is not time-consuming. This therapy has little or no effects on patients after treatment. But now the question is does Sclerotherapy hurt.The answer is very simple, none of the treatment is 100% efficacious for every patient. It is common to have desaturation, scars, bruises, and swellings at the treated area which can be resolved within a few days. Other few adverse effects which are related to this therapy include:

  • Back pain
  • Headache
  • Thrombus formation

Contraindication

  • Pregnancy
  • Thrombophlebitis
  • Allergy to Sclerosant
  • Any infection
  • Severe Atrial disease

What are the Substitutes of Sclerotherapy Therapy?

Sometimes the problem is not that much severe which need any kind of medical treatment or therapy. Small changes in lifestyle, physical activity and rest can prevent the veins from becoming a major problem. But there are some other alternative therapies to treat veins problems. A patient can go for Cryotherapy which is freezing vain technique to treat veins problems. Moreover, laser therapy and vein ablation therapies are also used by many doctors to treat such issues. Another way is surgery either to close or remove the vein in order to remove the problem.  

In the end, this therapy is basically a common and noninvasive way to treat affected veins. It is effective and popular in people as it has less serious side effects on patients. But still, if you have queries and insecurities related to its procedure, threat and advantages, it’s better to consult your doctor and take decision according to their advice.