Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphen
CPT4 code
Name of the Procedure:
Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (e.g., great saphenous vein, accessory saphenous vein).
Summary
This procedure involves injecting a special foam solution into a problematic vein in the leg, using ultrasound to guide and monitor the treatment. The foam causes the vein to close off, helping improve blood flow in the leg.
Purpose
This procedure addresses varicose veins, particularly when a large trunk vein like the great saphenous vein becomes incompetent or is not functioning properly. The goal is to relieve symptoms such as pain, swelling, and heaviness in the leg, and to improve the appearance of the veins.
Indications
- Visible varicose veins
- Leg pain or aching
- Swelling in the legs
- Heaviness or tiredness in the legs
- Skin changes or ulcers due to poor vein function Candidates are typically those who have not found relief from conservative treatments like compression stockings.
Preparation
- Follow any fasting instructions provided by your healthcare team.
- You may need to stop taking certain medications, such as blood thinners, as advised by your doctor.
- Inform your doctor about any allergies or medical conditions.
- A pre-procedure ultrasound may be required to assess the vein.
Procedure Description
- Preparation: You will lie down in a comfortable position, and the treatment area will be cleaned and disinfected.
- Ultrasound Guidance: An ultrasound device is used to locate the incompetent vein.
- Injection: A small needle is used to inject the foam sclerosant into the vein.
- Compression Maneuvers: The healthcare provider may use manual compression or compression bandages to help the foam spread evenly within the vein.
- Monitoring: Ultrasound is continuously used to ensure the foam is effectively closing the vein.
- Conclusion: The needle is removed, and a compression bandage or stocking is applied.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
This procedure is usually performed in an outpatient clinic or a specialized vein treatment center.
Personnel
- Vascular surgeon or a specialist in vein treatment
- Ultrasound technician
- Nursing staff
Risks and Complications
- Bruising or redness at the injection site
- Swelling or discomfort in the treated leg
- Rarely, allergic reactions to the sclerosant
- Very rare risk of deep vein thrombosis (DVT) or blood clots
Benefits
- Relief from symptoms like pain and swelling
- Improved appearance of the leg
- Minimal downtime with quick return to normal activities
Recovery
- Wear compression stockings as directed for a few days or weeks.
- Avoid heavy exercise or prolonged standing for a few days.
- Follow-up appointments may be necessary to monitor the treated vein.
Alternatives
- Conservative treatments like compression stockings
- Thermal ablation (laser or radiofrequency)
- Surgical vein stripping
- Clarified liquid sclerotherapy
Each alternative has its pros and cons which should be discussed with your healthcare provider.
Patient Experience
During the procedure, you might feel slight discomfort from the needle insertion and mild pressure during the injection. Afterward, there might be mild bruising or swelling, which generally resolves quickly. Pain management with over-the-counter pain relievers and wearing compression stockings can enhance comfort and promote healing.