Ultrasound

ULTRASOUND GUIDED SCLEROTHERAPY

This approach to treating the bigger varicose veins is still the mainstay for more complex cases. The vascular technician uses an ultrasound machine to map out the veins deep in your thighs and legs. This is the same machine used to view an unborn fetus. The technician carefully checks the status of your deeper veins to make sure these veins are functioning well and free of any problems. Then the tech has you stand up and begins following the route of the great saphenous vein and its tributaries. This vein is often the cause of many vein problems. Using a gentle squeezing of the thigh or leg while the probe is held to the region of concern, a color flow study is projected onto the sonogram screen. This allows us to see if the veins are flowing blood back to the heart or if the flow goes back down towards the foot after the limb is compressed. This is the most important part of the testing in most vein clinics. A thorough map is formed of your veins and the areas of good and bad blood flow are documented for later use. The whole idea of this testing is to find out where you have veins that have bad valves that have caused dilation leading to enlarged varicose veins. The information is carefully reviewed by the doctor. All information is evaluated for treatment.

The next visit consists of your treatment for the bulging veins. The patient is lied down and the regions of concern are relocated on the sonogram machine. The tech will hold the probe over the region to be treated and display this on the screen. The doctor then uses the held probe to guide the needle into the vein. All this is visible on the screen. Precise targeting is therefore possible. The medication is then injected into the vein of concern. The idea is to shrink and destroy this bad vein. Remember, this vein is one of the veins that is causing the problem, you do not need this vein. When the veins are absorbed by the body, blood will find a healthier route to get back to the heart. Many people get concerned when the doctor says “we are going to destroy the bad vein”. There is little difference from a stripping of the bad vein or destroying it using ultra sound sclerotherapy. Either way the vein is removed. In this case it is done non- surgically . Many people want to know how this medication destroys the vein. It does so by irritating and destroying the inner lining of the vessel. A reaction is set up that causes the vessel to thicken and close down. The vein then slowly fades away. Many times, the smaller unwanted spider veins and larger unwanted vessels disappear too. This is because the main blood supply to the spiders and other visible vessels are shut off at the main source. Usually this main source was failing. The idea is to shut down the blood supply at the highest level possible and work our way down. Simply treating bulging vessel on the leg will do little good if the problem originated high up in the thigh. Hence the reason to start high up and “shut off the source of the problem”. Again , the blood will find healthy veins to travel through and get back to the heart.

The next part of the treatment consists of dispensing a pair of tight support stockings. These are placed on the limb that has been treated. The treatment is far more effective with compression around the treated thigh and leg. This approach keeps the veins compressed, hence smaller in diameter and therefore allows closure to occur with little complication. They also compress the calf and allow healthier blood flow immediately. The stockings are worn for 7-10 days all the time. We even ask our patients to shower with the stockings on. At first, they look at us somewhat surprised but later find that its not that difficult and become very compliant patients. They dry quickly since they are thigh high open toe stockings. Look at it this way, you have to come looking for a way to get your veins treated in a nonsurgical fashion. This way is the most successful form of treatment I have yet seen. We have a 95% success rate when the patient listens and follows all the doctors advices. Those that refuse to follow the use of compression hose, often find failure and regions of inflammation. Trust us, follow our advice and the results will be what you have hoped for. Better looking , healthier thighs and legs. What ever is left over after your treatment regime is complete, will be treated separately. These are usually the smaller spider veins and some smaller visible green veins called “reticular veins” that have not gone away. However, at this point these smaller vessels are much more successfully treated since all the pressure coming from areas above is shut down. Usually the use of simple saline will take care of what ever is left over.