The vessels that carry blood back to the heart are called veins. These veins contain valves that ensure unidirectional blood flow towards the heart. Blockages or excessive pressure in the veins prevent these valves from closing properly, causing backward leaks (blood reflux). As a result, the superficial veins in the legs expand, lengthen, and varicose veins form with a twisted appearance. Cramps at night, itching, bloating, and pain upon standing are common complaints. Varicose veins can be capillary - C1 type - in the skin and under the skin, and C2 type in the external main vein.
Sclerotherapy,C1 type skin and sclerosing (astringent) into the spider web-like veins under the skin. It is a method of completely closing the vascular space by injecting a solution.
Sclerotherapy process
-In a horizontal position, the determined area on the leg is wiped with antiseptic solution and a very thin infusion is applied into the varicose vein. It is entered with a needle,
-Lauromacrogol (polidocanol) at the required dose and concentration (0.5%, 1%, 2%) is injected into the vein with a special technique (in liquid or foam form).
-Then, a tampon is placed on the treated varicose vein to apply compression and it is taped tightly.
-Elastic Compression socks are worn and then brisk walking is done for half an hour.
The success of sclerotherapy depends on the compression treatment performed after a complete and careful application.
Side effects of Sclerotherapy:
Due to possible side effects, the treatment must be performed by a Vascular Surgery Specialist in a hospital environment. The side effects of the drug used are as follows in the light of the package leaflet information:
Commonly(rate of 1-10 in a hundred patients)
- Procedure Formation of temporary new vessels in the area that were not visible before treatment (neo-vascularization), regional blood accumulation (hematoma),
- Darkening of the skin (hyperpigmentation), blood leakage under the skin (ecchymosis),
- Pain at the injection site (short-term), regional blood clotting (thrombosis) in the blood vessel. For this reason, varicose veins after sclerotherapy In patients where a clot is detected, this clot is removed through the holes created with a needle or a sharp scalpel.
Uncommon(rate of 1-10 in a thousand patients)
- Inflammation of the veins (superficial thrombophlebitis, phlebitis),
- Allergic inflammation of the skin (dermatitis), rash (urticaria), skin reaction, redness on the skin (erythema)
- Tissue hardening (induration), swelling, tissue death (necrosis) - occurs due to drug administration into the artery or injection into the vein in the foot or ankle area, reversing the pressure in the artery, temporary nerve damage
Rare as(1-10 in ten thousand)
- Vein occlusion (possibly due to the underlying disease)
- Pain in the arms and legs
Very rare (less than one in ten thousand)
- Sudden hypersensitivity reactions (anaphylactic shock); Symptoms such as sudden difficulty in breathing, dizziness, drop in blood pressure), Angio-edema, widespread rashes (urticaria), asthma attack.
- Stroke (apoplectic paralysis), headache, migraine, regional numbness (paraesthesia). ), loss of consciousness, confusion, dizziness, central speech disorder (aphasia), movement coordination disorder (ataxia), numbness of half the body (hemiparasia), mouth numbness (oral hypoesthesia),
- Temporary visual impairment ,
- Heart slowdown (vaso-vagal syncope), Palpitations, abnormal heart rate,
- Blood clot in the lungs, shortness of breath (dyspnea), feeling of pressure in the chest, cough,
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- Disturbance in the sense of taste, nausea, vomiting,
- Hair growth in the sclerotherapy area (hypertrichosis),
Alternatives to Slerotherapy Intervention:
Radiation treatments (laser, photoderm) have an important place in the treatment of small threadlike varicose veins, as in needle treatment. By sending light at certain wavelengths to capillary varicose veins that cannot be entered with a needle, damage is caused to the diseased vein and the dried vein is then dissolved and destroyed by the body. In this method, it is necessary to apply 2-4 sessions of treatment to the varicose area. However, your heirs are not suitable for the application of these methods.
Consequences of not intervening:
If not intervened, your disease will disappear. It may progress and the following conditions may occur.
Superficial phlebitis (Non-microbial or complicated vein inflammations) is superficial due to impingement, slowing of flow rate, inflammation on or near the vessel wall. Clots that form in the veins are called superficial phlebitis. It is quite painful and healing occurs in a long period of 7-10 days. Sometimes they occur as a result of diseases in other parts of the body.
Variceal bleeding: Spontaneous bleeding is observed in large varicose veins, sometimes as a result of impact and sometimes as a result of thinning and erosion-stripping of the skin layer over the varicose veins. Bleeding under the skin creates painful, purple images (ecchymosis) that spread over large areas. Open bleeding, on the other hand, is profuse, almost gushing, and often causes panic. This type of varicose bleeding, which can be stopped by simply stepping on it, can cause large amounts of blood loss and be life-threatening in cases of sleep or loss of consciousness (for example, a traffic accident). It is controlled and treated with elastic bandages applied by the physician or, if necessary, with surgical methods (stitching, etc.).
Wounds that do not close due to varicose veins(varicose ulcers)
Secondary varicose veins. Varicose ulcers, which occur with typical brown pigmentation at the ankle level, are difficult and time-consuming to treat and require full cooperation from the patient. Excessive pressure increase in the skin veins at the ankle level disrupts the nutrition of the skin by creating stasis in the capillary circulation. For this reason, long-term (up to 3 weeks) strict bed rest and medical observation are required to heal these wounds, which are also called stasis ulcers. Once the wounds are closed, they will not recur if the doctor's advice is followed.
Anesthesia:
You do not need to receive anesthesia during the sclerotherapy procedure. Creams and sprays can be used only on the areas to be treated and will reduce your feeling of pain.
Points that the patient should pay attention to before the procedure:
During the application. Bring shorts or tights to wear. Come wearing your compression socks. You can wear a pant to hide bandages and treatment scars after the application. Bring a shirt or a long skirt.
Please do not use body lotion, cream or bath oil derivatives on the day of treatment. Since such substances make your skin slippery, they prevent the bandages from sticking.
Please do not epilate or shave your legs on the morning of treatment. The alcohol-containing antiseptic solution to be applied during the treatment will cause burning and pain in small cuts.
You can continue light exercises after the injections during the treatment. But you should not do aerobics and jogging. Cycling or fast walking can be done.
Points that the patient should pay attention to after the intervention:
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Walking after sclerotherapy is very important. . You should walk at a fast pace for at least 30 minutes.
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After the procedure, compression socks will be worn day and night for a week. However, after the 3rd day, the bandages can be removed and a bath can be taken. After bathing, cream should be applied to the wound areas and socks should be worn again.
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Activities requiring heavy effort should be avoided for 24 hours after the treatment.
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You should definitely come for a check-up at the times recommended by your doctor.
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