Ultrasound-Guided Sclerotherapy vs. Visual Sclerotherapy

Written By Center for Vein Restoration
Sclerotherapy in ankle

Both versions of sclerotherapy are safe and effective in removing varicose veins and spider veins. But there are slight differences between the two that you should know.

If you’re considering varicose vein or spider vein treatment, you’ve probably heard the terms traditional sclerotherapy and ultrasound-guided sclerotherapy. Both procedures have been used for decades to treat varicose veins and spider veins safely and effectively. Either one will eliminate the pain and unsightly appearance of bulging, twisted varicose veins or itchy, irritating spider veins on your legs and feet in a brief in-office session.

Your Center for Vein Restoration vein specialist will explain each treatment option in detail and recommend which one is most suitable for your situation. To help you understand the procedures to make an informed decision, here’s a primer on visual sclerotherapy and ultrasound-guided sclerotherapy and how each works.

Ultrasound-Guided Sclerotherapy vs. Visual Sclerotherapy

Varicose veins develop when tiny valves in the leg veins weaken to the point where blood flows backward and pools within the vein. Though small, these one-way valves close up tightly so blood can return to the heart. When the valves fail to pump blood properly, the blood builds up within the vein wall. The vein eventually protrudes to form a visible varicose vein. Leg veins are particularly vulnerable to varicose veins because leg veins experience the greatest pressure from gravity when pumping blood back to the heart.

The goal of visual sclerotherapy and ultrasound-guided sclerotherapy is to close a damaged vein so blood is diverted to healthier veins and flows freely again. Once that’s achieved, the pain and swelling of the varicose vein diminish. Although both procedures use local anesthesia, visual and ultrasound-guided sclerotherapy uses slightly different methods.

Visual Sclerotherapy

In visual sclerotherapy, a vein specialist injects a sclerosant into the vein. The sclerosant typically is a saline-based liquid called sodium tetradecyl sulfate, which irritates the vein wall. The vein reacts by collapsing, which blocks blood from flowing through the diseased vein. Eventually, the vein is reabsorbed into the body, and blood reroutes to healthier veins. Over time, the swollen vein disappears. The procedure is brief and nearly painless.

One minor drawback to visual sclerotherapy is that the injection may not reach the entire vein. When blood interacts with the liquid sclerosant, it dilutes its concentration, which can alter its effectiveness.

Ultrasound-Guided Sclerotherapy

As its name implies, ultrasound-guided sclerotherapy uses duplex ultrasound to pinpoint exactly where to inject the solution. The ultrasound provides a picture for the doctor of which area of the vein needs the treatment.

The solution used for ultrasound-guided sclerotherapy is different from traditional sclerotherapy. In this procedure, a mixture of oxygen gas and a foam-based sclerosant is injected into the vein. The gas allows the doctor to get a clear image of the vein on the ultrasound, while the foam spreads out more evenly within the vein. Because the gas bubbles are tiny, the solution is able to interact more directly with the lining of the blood vessels by pushing the blood away.

Both procedures take about an hour or less. Afterward, your vein physician will instruct you to wear compression stockings for a specific amount of time. These stockings apply gentle pressure on the veins to promote smooth blood flow. Exercise is encouraged after the procedure as a brisk walk helps the calf muscles pump blood through the veins.

You may see some minor bruising after the procedure, but it quickly fades. If you experience any pain, you can take over-the-counter pain medications. Any usual bleeding or reaction should be reported to your doctor. A follow-up appointment is usually a week after the procedure.

Visual sclerotherapy and ultrasound-guided sclerotherapy aren’t the only treatments for varicose veins and spider veins. Thermal-heat based procedures such as laser ablation and radiofrequency ablation destroy varicose veins with the heat from a laser or radiofrequency waves. Ambulatory phlebectomy extracts larger varicose veins through two tiny incisions.

Newer innovative therapies, such as VenaSeal and ClariVein, are also available and widely used. VenaSeal closes a varicose with a medical adhesive. In a ClariVein procedure, a solution is sprayed into the vein as a rotating tip pushes through the diseased vein. All treatments are FDA-approved.

Know Your Treatment Options

Center for Vein Restoration offers a variety of treatment options for varicose veins. Our physicians and staff will recommend a therapy suitable for the size and location of your varicose veins. Each patient receives a customized treatment plan to eliminate the pain and appearance of swollen varicose veins. Contact us today for a consultation.

Find CVR Near You