Ultrasound Guided Sclerotherapy (Echosclerotherapy)

Sclerotherapy is a technique for the treatment of varicose veins that involves the injection of various chemicals directly into veins. Echosclerotherapy (aka Ultrasound Guided Sclerotherapy) refers to the use of an ultrasound machine to make it possible to inject veins that are too deep to be seen or felt. These veins are otherwise undetectable and previously required surgical treatment.

This technique was developed in France, Canada, and the USA in the late 1980s.

There are several areas of the superficial venous system that are inaccessible to injections by touch or sight. These large veins are frequently the source of pressure that produces dilated varicose veins and even clusters of spider veins. These large veins must be treated before smaller vessels are treated, otherwise the small vessels will recur.

The most commonly injected vein is the largest superficial vein in the leg (greater saphenous vein). It starts on top of the foot and runs up the inside of the leg to the groin. In the thigh it is hidden under a fat pad. Ultrasound guidance is required to see it and inject it.

Even the largest of veins can be treated with echosclerotherapy (although the succes rate drops for larger and larger veins). Until about 2002, the only option for treating these veins was surgery. Now echosclerotherapy and endovenous laser make surgery an outdated procedure.

	Before and after foam sclerotherapy*

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	Before and three months after one session of foam sclerotherapy*

	Before and after foam sclerotherapy for a congenital venous malformation.*

	One foam session*

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