Sclerotherapy is a non-surgical office procedure that can treat most diseased surface veins.
Medication is injected into a vein using a small needle.
The medication irritates the vein walls so that they stick together and are gradually reabsorbed by the body.
Eliminating these diseased veins actually improves the circulation and makes the legs healthier.
What will happen in the first consultation?
You will be asked questions regarding your past health, medication history and symptoms. An ultrasound exam may be performed and Dr. Hynscht will examine your legs. You will have an opportunity to discuss the treatment and ask any questions.
From your assessment, if Dr. Hynscht determines that you have a competent greater saphenofemoral junction or have have previous vein stripping or ligation, you may be recommended for sclerotherapy.
If the veins are small, flat “spider veins”, then treatment can often begin on the first day.
If you are assessed to have reflux at the greater saphenofemoral junction, you will be referred to a vascular specialist for ligation or ultrasound guided ablation before they can return for treatment at the Simcoe Vein Clinic. With your permission, Dr. Hynscht will notify your family physician and complete the referral on your behalf.
What causes vein problems?
Veins carry blood from the legs back to the heart through one-way valve systems. When there is a weakness in the vein wall or a faulty valve, the valve stretches and no longer closes properly. The veins become filled with blood that can’t flow normally, causing pain, swelling, discoloration, sores that won’t heal, blood clots and other problems.
How many treatments are required?
Depending on the type and severity of the varicose veins, the average number of treatments is anywhere between 3 and 5, however as many as 10 treatments may be required.
The larger vessels only require a few (3 or 4) well placed needles with a stronger solution. They must be treated first.
The smaller spider veins may require many points of injection with a weaker solution. The injections will be stopped at any time if the patient so requests.
The number of injections is less important that the type of sclerosing agent used, its dosage, the site of the injections and the skill of Dr. Hynscht.
The diagnosis and treatment of significant problems due to large diseased veins are sometimes covered by O.H.I.P. Veins that are greater than 5mm are covered by OHIP.
Spider and reticular veins are considered “cosmetic” and therefore do not qualify for most insurance plans. Spider and reticular vein sclerotherapies are paid for by the patient.
The compression stockings that are recommended are often included in private medical insurance plans and/or will need to be purchased by the patient. Most third party/ extended health insurance plans cover the cost of compression stockings. Patients will be required to purchase and wear compression stockings as part of their treatment. They can either bring their own or if they don’t have compression stockings, measurements will be taken at the clinic for Sigvaris custom stockings. It is essential for patients to wear compression stockings to achieve maximum results.
Why Choose the Simcoe Vein Clinic?
Dr. Hynscht has been specially trained to treat varicose and spider veins by an internationally recognized Canadian physician with expertise in the field of sclerotherapy.
Diagnosis & Treatment
Diagnosis starts with a careful medical history and physical exam. Diagnostic tests are often needed to evaluate the extent of disease.
If treatment is indicated, each treatment takes about 20 minutes.
The number of treatments depends on the severity of the problem. Discomfort after treatment is rare. Most patients leave the clinic and go directly back to work. We recommend that patients walk for 20 minutes after each treatment.
What are the most common side effects?
All medical treatments entail a certain degree of risk. This will be discussed during your first visit and consent to treatment must be signed before the injections are started. Fortunately, when injections are undertaken by well trained professionals, complications rarely arise.
In the first few days itching, bruising, aching, redness and swelling are common. Most of these symptoms resolve spontaneously. You may take Tylenol (acetaminophen), but do not take ASA or related compounds (aspirin, naproxen, and ibuprofen) since they may increase bleeding. It may help to elevate the legs and rotate the ankles. Some patients (particularly those with fair skin) notice small red circles or brown lines after treatments. These are due to the pigment of blood or inflammation and usually resolve within 1 month. 90% of the discoloration’ resolves within 1 year. A superficial blood clot may develop at the injection site which causes a lump. This will disappear in 2-8 weeks. A small superficial ulceration of the skin overlying the injected vessel may occur. It can leave a small scar. “Matting” refers to the development of new tiny blood vessels in the treated vessel. This temporary phenomenon occurs 2 to 4 weeks after treatment and usually resolves within 4 to 6 months. It occurs in up to 18% of women receiving estrogen therapy (for menopause) and 2 to 4 % of all patients. You will be monitored at the clinic for an allergic reaction (very rare) which can include hives, shortness of breath and swelling around the airway. If this occurs at home, seek medical attention immediately.
In addition to the side effects listed above there are several complications which are unique to varicose vein treatment. Phlebitis may develop at the site of injection as a firm nodule. This resolves with elevation of the legs, application of a cool pack, rotation of the ankles, tensor bandage and ibuprofen by mouth. Deep Venous Thrombosis (DVT) is a very rare complication, seen in approximately 1 out of every 30,000 patients treated for varicose veins greater that 3 to 4 mm in diameter. DVT will be recognized by pain and swelling of the entire foot. The possible dangers of DVT include the possibility of a pulmonary (lung) clot and post phlebitis syndrome, in which the blood clot is not carried out of the legs, resulting in a permanent swelling of the legs. If the sclerotherapy solution becomes lodged in an artery instead of a vein, its occlusion may cause an interruption of the blood supply to an area outside of the limb.
What should I do before a treatment?
Do not take aspirin, ibuprofen or other arthritis medicine for 2 days before and after you treatment because these medications can increase bruising.
Do not drink alcoholic beverages or smoke for 2 days before and after your treatment. They may impair healing.
Shower and wash your legs thoroughly with an antibacterial soap. Do not shave your legs the day of your appointment.
Do not apply any cream or lotion to your legs, including tanning cream.
Bring loose fitting shorts to wear during the treatment.
Eat a light meal or snack 1 – 1½ hours before your appointment.
If you sometimes get lightheaded during medical procedures, consider bringing someone to drive you home.
What should I do after a treatment?
After your treatment, please walk for 20-30 minutes at a medium pace in order to clear the deep venous system. Walking daily for about 20 minutes is beneficial.
You can expect:
- Mild aching, bruising, itching
- Take Tylenol for discomfort or apply ice packs
- Most people are able to work and do normal activities the next day
Please avoid for 48 hours:
- Anti-inflammatories unless taking ASA for heart condition
- Hot bath/shower (no hot tub soaking for 1 month)
- High intensity exercise including weight lifting and aerobics
- Leave them on for 24-48 hours then remove bandages, tape and cotton
- Wash legs with antibacterial soap
- Wash bandage wraps with stocking solution
- Hang to dry
- Iron them when they are still slightly damp and roll them up Bring them back for the next visit.
Wear stockings for 14 days post treatment
- Days only – take them off at night.
- Wear your stockings RELIGIOUSLY for 2 months !!!!
If, after a few days, swelling and redness develop
- Apply ice packs and take Ibuprofen 400 mg 4x daily
- Call the office for advice.
Make a follow-up appointment with Dr. Hynscht in 2-4 weeks after the injection for a recheck. Remember – varicose veins are a chronic disease. Control and prevention are the keys to successful treatments, but unfortunately, recurrences are common.
Call us at any time if you have questions call 519-410-7440 or email Dr. Hynscht at firstname.lastname@example.org