36466 Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vei

Name of the Procedure:

Injection of non-compounded foam sclerosant with ultrasound compression maneuvers (Ultrasound-Guided Foam Sclerotherapy)

Summary

Ultrasound-Guided Foam Sclerotherapy is a minimally invasive procedure used to treat varicose veins. It involves injecting a special foam solution into the affected vein while using ultrasound imaging to guide the process and ensure the foam is distributed properly.

Purpose

This procedure is aimed at treating varicose veins, which are swollen, twisted veins that often appear on the legs. The goal is to close off the affected veins, improving blood flow and reducing symptoms such as pain, swelling, and discomfort.

Indications

Ultrasound-Guided Foam Sclerotherapy is indicated for patients with:

• Large varicose veins (e.g., great saphenous vein, accessory saphenous vein)
• Symptoms such as leg pain, swelling, or skin changes
• A diagnosis of chronic venous insufficiency
• Veins that have not responded to other treatments

Preparation

Patients may be advised to:

• Avoid eating or drinking for a few hours before the procedure if sedation is being used
• Stop taking certain medications, like blood thinners, as directed by their healthcare provider
• Wear loose, comfortable clothing to the appointment
• Inform their healthcare provider of any allergies or medical conditions

Procedure Description

1. The patient lies down, and the targeted veins are identified using ultrasound imaging.
2. The area is cleaned and sterilized.
3. A small needle is inserted into the vein, and a foam sclerosant solution is injected.
4. Ultrasound is used continuously to guide the needle and ensure proper distribution of the foam.
5. Compression techniques are applied to help disperse the foam throughout the vein.
6. The procedure is repeated for multiple affected veins as needed.

Duration

The procedure typically takes 30-60 minutes, depending on the number of veins being treated.

Setting

This procedure is usually performed in an outpatient clinic or a specialized vein treatment center.

Personnel

The procedure is conducted by a vascular surgeon or a specially trained physician, often assisted by a nurse or ultrasound technician.

Risks and Complications

Common risks include:

• Pain or bruising at the injection site
• Temporary swelling or redness Rare complications may involve:
• Blood clots
• Allergic reaction to the sclerosant
• Skin ulceration

Benefits

• Significant reduction in varicose vein symptoms
• Improved leg appearance
• Minimal downtime and faster recovery compared to surgical options

Recovery

• Patients are usually able to walk immediately after the procedure.
• Compression stockings may need to be worn for a period of time as advised by the physician.
• Avoid strenuous activities for a few days.
• Follow-up appointments to monitor progress and ensure the veins are adequately closed.

Alternatives

• Laser therapy
• Radiofrequency ablation
• Surgical vein stripping Each alternative varies in terms of invasiveness, recovery time, and effectiveness, and should be discussed with the healthcare provider.

Patient Experience

Patients may feel a mild pinch when the needle is inserted and some pressure as the foam is injected. Post-procedure, they might experience mild discomfort or bruising, which can typically be managed with over-the-counter pain medications. Most can resume normal activities within a day, with noticeable improvement in symptoms soon after.