SCLEROTHERAPY

Sclerotherapy involves venous injections of a detergent that acts as a chemical irritant to effct closure of a particular vein . The sclerosant can exhibit a wide range of concentrations . Foaming the liquid detergent with either room air or co2 enhaces the strength of the solution . A low concentration liquid detergent is normally utilized for telangiectasia and spider veins , with reticular veins requiring hiher strength liquid sclerosant or lower concentration foam , dependent upon diameter . Varicosities generally require foam , with co2 foam utilized by many experts at the mid thigh level or above , as the rare incidence of TIA events may be decreased further using co2 , but not necessarily prevented . Foam may wee be contrindicated in the presence of a documented patent foramen ovale . Migraines are sometimes associated with patent foramen ovale with some phlebologists seeing foam as a contraindication in these patients in the absence of a negative transesophageal echo. Recently groin and vulvar varicosities have been addressed utilizing co2 foam . The ability to image the renal veins and tributaries with ultrasound during the procedure is hepful .