Ultrasound Guided Sclerotherapy

What is Ultrasound Guided Sclerotherapy?

Ultrasound-guided sclerotherapy is a minimally invasive procedure used to treat varicose veins and other vein-related conditions. During the procedure, a sclerosing agent (a solution that causes veins to collapse) is injected directly into the affected veins. The process is guided by ultrasound imaging, which allows your Viva Eve healthcare provider to visualize the veins in real-time, ensuring precise delivery of the sclerosing agent. 

How do you prepare for Ultrasound Guided Sclerotherapy?

Preparing for Ultrasound-Guided Sclerotherapy (UGS) involves several steps to ensure the procedure goes smoothly and to minimize any potential risks. Your Viva Eve provider will give you detailed instructions during your initial consultation. 

Here’s what patients typically need to do:

1. Consultation and Assessment 

• Medical History Review: Before the procedure, your Viva Eve healthcare provider will review your medical history, including any current medications, allergies, or underlying health conditions. 
• Ultrasound Examination: An initial ultrasound may be performed to assess the veins that will be treated. This helps the provider plan the procedure. 

2. Pre-Procedure Instructions 

• Medications: 
• Avoid Blood Thinners: If you’re taking blood thinners or medications that increase bleeding risk (like aspirin or nonsteroidal anti-inflammatory drugs), your provider may ask you to stop taking them for a few days before the procedure 
• No Lotion or Creams: Avoid applying lotions, creams, or oils to your legs on the day of the procedure, as they can interfere with the application of compression stockings and the procedure itself. 
• No Alcohol: Avoid alcohol consumption for at least 24 hours before the procedure, as it can increase bleeding risk and affect healing. 

3. Day of the Procedure 

• Comfortable Clothing: Wear loose, comfortable clothing, as your legs will be wrapped in compression stockings after the procedure.  
• Eat Lightly: Avoid heavy meals that may cause discomfort while lying down. 
• Hydration: Stay well-hydrated, but don’t overdo it. Proper hydration can help with venous access and make the procedure more comfortable. 

4. Bring Necessary Items 

• Compression Stockings: You’ll need to wear compression stockings after the procedure to help with healing and prevent complications. Your Viva Eve provider will give you some suggestions during your initial consultation. 

5. Post-Procedure Arrangements 

• Activity: Plan for a relatively easy day after the procedure. You should be able to walk and do light activities but avoid strenuous exercise or heavy lifting for a few days. 
• Time Off Work: Most patients can return to work the next day, but if your job requires significant physical activity, you might need to take a day or two off. 

6. Follow Specific Provider Instructions 

• Your Viva Eve healthcare provider may give you additional specific instructions based on your individual case, so it’s important to follow their guidance closely.

Why is Ultrasound Guided Sclerotherapy performed?

Ultrasound Guided Sclerotherapy (UGS) is performed for leg vein treatment to effectively target and close off varicose veins using a sclerosant, guided by ultrasound imaging to ensure precise delivery. Ultrasound-guided sclerotherapy offers several advantages, making it a preferred method for treating varicose veins and other vein-related conditions: 

1. Precision: The use of real-time ultrasound imaging allows for the accurate identification and targeting of veins, including those that are deeper and not visible on the skin’s surface.  
2. Minimally Invasive: UGS is a non-surgical procedure that involves only small injections. There are no incisions or stitches, the risk of complications is very low and the recovery is fast. 
3. Reduced Discomfort: Compared to other options, UGS typically results in less pain and discomfort during and after the procedure. Local anesthesia is often enough. 
4. Outpatient Procedure: Viva Eve providers perform this procedure at our in-office surgical suite. There is minimal downtime, and most patients are able to resume normal activities the same day. 
5. Effectiveness: UGS is highly effective in treating both surface-level and deeper varicose veins and alleviating associated symptoms. 
6. Cosmetic Benefits: By collapsing the problematic veins, UGS can significantly improve the appearance of the legs.  
7. Safety: The procedure is very safe with a low risk of complications. The use of ultrasound makes the technique extremely precise and minimizes the risk of damage to surrounding tissues. 
8. Versatility: UGS can be used to treat a variety of vein conditions, including small spider veins, larger varicose veins, and veins that have recurred after previous treatments. 
9. Repeatable: If necessary, the procedure can be repeated on the same vein or on different veins without significant risk, making it a flexible option for ongoing vein care.

What can you expect during Ultrasound Guided Sclerotherapy?

Ultrasound-Guided Sclerotherapy (UGS) is a relatively straightforward procedure. Here’s a step-by-step overview of what you can expect:

1. Preparation 

• Positioning: You will be asked to lie down on an examination table, usually with your legs slightly elevated. This position helps the veins become more visible and accessible for treatment. 
• Skin Preparation: The area to be treated will be cleaned with an antiseptic solution to reduce the risk of infection. 

2. Ultrasound Imaging 

• Initial Ultrasound: The provider will use an ultrasound probe to locate the affected veins, allowing the provider to see exactly where to place the injections. 
• Marking the Veins: In some cases, the provider may mark the location of the veins on your skin with a pen to guide the injections. 

3. Administration of the Sclerosing Agent 

• Local Anesthesia (Optional): Depending on your Viva Eve doctor’ 
• s preference and your comfort level, a local anesthetic may be applied to numb the area where the injections will be made. However, this is not always necessary. 
• Injection: The provider will inject the sclerosing agent (a special chemical solution) directly into the targeted veins using a fine needle. The ultrasound guidance ensures that the agent is delivered precisely to the affected veins. You may feel a mild sting or burning sensation during the injection, but this is usually brief. 
• Multiple Injections: Several injections may be required to treat all the affected veins, depending on the extent of the condition. 

4. Vein Closure 

• Vein Reaction: The sclerosing agent causes the vein walls to become irritated, leading to the collapse and closure of the veins. Over time, these closed veins will be reabsorbed by your body and gradually fade from view. 
• Monitoring: The provider will monitor the procedure on the ultrasound screen to ensure the agent is effectively treating the targeted veins. 

5. Post-Procedure Care 

• Compression: After the injections are complete, the treated area may be wrapped in compression bandages, or you may be asked to wear compression stockings. Compression helps to ensure that the veins remain collapsed and supports the healing process. 
• Observation: You may be asked to stay in our office for a short period of observation, especially if it’s your first time undergoing the procedure, to ensure there are no immediate adverse reactions. 

What is the followup and recovery like for Ultrasound Guided Sclerotherapy?

1. Aftercare Instructions 

• Walking: You will likely be encouraged to walk immediately after the procedure to promote circulation and reduce the risk of blood clots. 
• Activity Level: While normal daily activities can usually be resumed, you may be advised to avoid strenuous exercise, heavy lifting, or long periods of standing or sitting for a few days. 
• Compression Stockings: You’ll need to wear compression stockings for several days or weeks, depending on your Viva Eve provider’s instructions. This is crucial for a successful outcome. 
• Follow-Up: A follow-up appointment may be scheduled to monitor your progress and determine if further treatment is needed. 

2. Potential Discomfort 

• Mild Pain or Bruising: Some patients experience mild pain, tenderness, or bruising at the injection sites. This is usually temporary and can be managed with over-the-counter pain relievers if necessary. 
• Skin Discoloration: Some discoloration or redness in the treated area is common and typically fades over time. 

3. Results 

• Gradual Improvement: The treated veins will gradually fade over several weeks as they are reabsorbed by the body. It may take multiple sessions to achieve the desired results, especially for extensive varicose veins. 

What are the potential costs for Ultrasound Guided Sclerotherapy?

Insurance coverage for Ultrasound-Guided Sclerotherapy (UGS) and similar procedures largely depends on whether the treatment is deemed medically necessary or primarily cosmetic. UGS is often covered by insurance when treating varicose veins that cause significant symptoms, such as: 

• Pain or aching in the legs 
• Swelling (edema) 
• Skin changes, such as dermatitis or ulcers 
• Bleeding from varicose veins 
• Recurrent infections or thrombophlebitis (inflammation of a vein due to a blood clot) 

Your Viva Eve provider will discuss all the options and will provide you with a treatment plan and a potential estimate based on your individual circumstances. 

What are the potential risks and side effects for Ultrasound Guided Sclerotherapy?

Ultrasound-Guided Sclerotherapy (UGS) is generally considered safe, but it carries potential risks, including temporary side effects like bruising, swelling, or pain at the injection site. More serious, though rare, complications can include allergic reactions to the sclerosing agent, skin ulceration, blood clots (deep vein thrombosis), and, in very rare cases, an air embolism or nerve damage. Hyperpigmentation or darkening of the skin along the treated vein may also occur, and while it usually fades, it can sometimes be permanent.

What are the results of UGS? 

The results of Ultrasound-Guided Sclerotherapy (UGS) typically include the successful closure and gradual fading of treated veins, leading to an improvement in symptoms such as pain, swelling, and heaviness in the legs. Cosmetic results also include a reduction in the visibility of varicose or spider veins. While many Viva Eve patients see significant improvement after just one session, multiple treatments may be necessary for optimal results. The treated veins are usually reabsorbed by the body over weeks to months, though in some cases, new veins may develop and require additional treatment.