Sclerotherapy

Abstract

Sclerotherapy involves the injection of a caustic solution into an abnormal vein so as to cause localized destruction of the venous intima and obliteration of the vessel. Over the past 50 years, improvements in the technology have greatly enhanced the results achievable with sclerotherapy. To ensure optimal results, it is essential to have a thorough knowledge not only of the technique but also of the indications, expected outcomes, and possible complications associated with the procedure. This review covers preoperative evaluation, operative planning, technique and complications associated with sclerotherapy. Figures show a 63-year-old woman before and after two treatments with 0.2% sodium tetradecyl sulfate, a 52-year-old woman  before and after two treatments with 0.5% sodium tetradecyl sulfate, a 36-year-old woman before and after four treatments with a combination of 0.5% and 0.2% sodium tetradecyl sulfate, the standard hand position for sclerotherapy, skin necrosis on the left posterior calf of a 48-year-old woman after ultrasound-guided sclerotherapy,  a 56-year-old woman before treatment and with residual hyperpigmentation after treatment with 0.2% sodium tetradecyl sulfate, and telangiectatic matting in a 43-year-old woman after treatment with 0.2% sodium tetradecyl sulfate. Tables list complications of sclerotherapy, suggested polidocanol (POL) and sodium tetradecyl sulfate (STS) concentrations for liquid and foam sclerotherapy, materials needed for sclerotherapy, and absolute and relative contraindications for sclerotherapy for varicose veins.  Key Words: Varicose veins, Chronic venous insuffiency, sclerotherapy, foam sclerotherapy, reticular veins, venous disorders This review contains 7 highly rendered figures, 4 tables, and 29 references.