Vascular Surgery – Sclerotherapy
Vascular surgery is a surgical subspecialty which deals with the treatment of vascular diseases, primarily arteries and veins. These are among others stenosis, varicose veins, vessel dilations, thrombosis and symptoms following deep vein thrombosis. Vascular surgery also deals with the vascular manifestations of diabetes and high blood pressure. Vascular problems affect both genders, but venous diseases are more frequent in women, while in men, atherosclerosis is the more common problem. Due to modern medical procedures treatment is available, which offers quick and remarkable improvement, eliminates varicose veins and diminishes the risk of their development, particularly if supported with a healthy diet and balanced lifestyle.
WHEN SHOULD I CONTACT A VASCULAR SURGEON?
- When a 60–70% stenosis of the cervical arteries is verified by cervical ultrasound examination
- When an aortic aneurysm (dilation) of 3–4 cm is visible on an ultrasound or CT scan
- If during walking, you experience increasing pain at the top back part of the thigh or at the calf, which decreases when you stop
- If nonhealing ulcers occur on your legs, with or without injury
- If you have dilated, twisted veins or if you have swollen legs or ankles in the evenings, or in case you have a “heavy” feeling in your legs
- If you have aesthetic problems on your leg due to capillary or dilated veins
- In case of any pain in the extremities during rest
- In case you have a tendency to have wounds on the extremities
- In case you experience weakness of the hand’s or leg’s muscle strength
WHAT SHOULD I EXPECT DURING THE SPECIALIST’S EXAMINATION?
- The specialist’s examination starts with a comprehensive medical history summary of the patient’s complaints
- Review all the available medical documentation and discuss them with the patient
- Physical examination
- CW doppler examination
- Preparation of a summary report of the visit and detailed consultation with the patient
- The examination is completely painless and causes no discomfort!
HOW DOES THE SCLEROTHERAPY TAKE PLACE?
- During sclerotherapy, the vascular surgeon pricks the dilated vein with a thin needle and injects a sclerotising agent (Aethoxysclerol) into the vein. The injected agent causes a vessel’s sterile inflammation, which triggers scarring of the vessel walls. The vein walls, therefore, adhere to each other and the branch is locked out from circulation and usually absorbed by the body. After the treatment, a compression roll bandage is applied on the extremity, which the patient has to wear constantly for two or three days, and then, during the next two weeks, it can be removed every day for 5–10 minutes. Immediately after the treatment, a 20 minute walk is recommended, but the patient should at least avoid sitting or standing still. If the treated area becomes tender or warm, it may be cooled off with icegel or with towel wrapped ice freezer blocks, but should avoid applying a wet compress. After sclerotherapy, hot bath, sauna, sunbath and solarium should be avoided for at least for four weeks. You may need more sclerotherapy treatments. In every session you may be injected 2–4 ml active substance into the vein, which is enough for the treatment of an area as big as both hands. After professional sclerotherapy, by appropriate lifestyle and wearing compression stockings, recurrence of the varicose veins can be prevented.
HOW TO PREPARE FOR THE EXAMINATION?
- Bring all your medical documents, including imaging scans on CD or in printed form. Before sclerotherapy, do not use any creams on your treatment area, and make sure to wear comfortable shoes and clothing, because a compression roll bandage will be applied on your leg. Sclerotherapy is not recommended in cases of fever, inflammatory disease of the affected area, a bedridden patient, severe arterial circulatory disorders, after local or multiple vein thrombosis, or in the presence of multiple risk factors such as, hormonal contraception, obesity, smoking, and sedentary lifestyle.