36471 Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg

Name of the Procedure:

Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg

Summary

This procedure involves injecting a sclerosant solution into multiple incompetent veins in the same leg to cause them to close and eventually disappear. It is commonly used to treat larger varicose veins rather than smaller spider veins (telangiectasia).

Purpose

The procedure aims to improve circulation and reduce symptoms associated with varicose veins, such as pain, swelling, and a heavy feeling in the legs. It also helps in improving the cosmetic appearance by reducing the visibility of bulging veins.

Indications

• Painful varicose veins
• Swelling in the legs
• Heaviness or aching in the legs
• Skin changes or ulcers due to poor venous circulation
• Previous unsuccessful conservative treatments like compression stockings

Preparation

• Patients may be advised to avoid blood-thinning medications and supplements before the procedure.
• Compression stockings should be worn as directed before and after the procedure.
• No fasting is typically required.
• A complete medical history and ultrasound examination of the veins may be conducted.

Procedure Description

1. The patient lies down, and the leg is cleaned with an antiseptic solution.
2. The healthcare provider uses a fine needle to inject the sclerosant solution into the targeted veins.
3. The procedure may involve multiple injections along the length of the incompetent veins.
4. Ultrasound guidance is often used to ensure accurate injection.
5. Compression bandages or stockings are applied immediately after the injections.

Duration

The procedure usually takes about 30 minutes to an hour, depending on the number of veins treated.

Setting

The procedure is generally performed in an outpatient clinic or a hospital outpatient department.

Personnel

• A vascular specialist or phlebologist
• A nurse or medical assistant

Risks and Complications

• Pain or bruising at the injection site
• Allergic reactions to the sclerosant
• Skin discoloration around the treated area
• Formation of blood clots in deep veins (rare)
• Inflammation or ulceration at the injection site

Benefits

• Relief from symptoms like pain and swelling
• Improved appearance of the treated leg
• Enhanced circulation
• Benefits may start to become noticeable within a few weeks as the treated veins begin to disappear.

Recovery

• Patients are usually advised to walk immediately after the procedure to promote circulation.
• Compression stockings should be worn for a specified period.
• Avoid strenuous activities and prolonged standing or sitting for a few days.
• Follow-up appointments may be necessary to monitor progress and perform additional treatments if needed.

Alternatives

• Compression therapy (e.g., wearing compression stockings)
• Endovenous laser therapy (EVLT)
• Radiofrequency ablation (RFA)
• Surgical vein stripping and ligation
• Conservative management with lifestyle changes

Each alternative has its own set of pros and cons, varying in invasiveness, recovery time, and effectiveness.

Patient Experience

• The procedure involves minimal discomfort, akin to a pinprick during the injections.
• Some patients may feel a slight burning or tingling sensation as the sclerosant is injected.
• Post-procedure, there may be some minor swelling, bruising, or redness, all of which typically resolve within a few weeks.
• Pain management usually involves over-the-counter pain relievers if needed.
• Most patients can resume normal activities shortly after the procedure, following their doctor's specific instructions.