Scleroterapi

Scleroterapi, also known as sclerotherapy, is a minimally invasive medical procedure used to treat abnormal veins by injecting a sclerosant into the vein lumen. The chemical irritates the endothelium, triggering inflammation and thrombosis that eventually leads to fibrosis and the closure of the treated vein. It is commonly used for varicose veins, reticular veins, and spider telangiectasias in the legs, and can also be employed for certain anorectal hemorrhoids or lymphatic malformations depending on the specialty.

Procedure and substances: The injections are usually performed in an outpatient setting with local anesthesia. The sclerosant may be used as a liquid or foamed solution; foamed sclerosants (for example polidocanol or sodium tetradecyl sulfate) displace blood and increase contact with the vein wall. Ultrasound guidance is used for larger or deeper veins. After treatment, compression stockings are typically worn for days to weeks, and patients are encouraged to walk and resume normal activities.

Outcomes and safety: Varied by vein size and anatomy, but many patients experience significant symptom relief and cosmetic improvement after one to several sessions. Results can last years, but recurrence is possible. Common side effects include local pain, bruising, and skin hyperpigmentation near the treated vein. More serious but rare complications include superficial thrombophlebitis, deep vein thrombosis, allergic reactions to the sclerosant, skin necrosis if extravasation occurs, or pulmonary embolism with foamed sclerosants if injected into a high-flow vein.

Contraindications include pregnancy, active infection, known allergy to sclerosants, extensive venous malformations, acute DVT, or uncontrolled bleeding disorders.

History note: Modern sclerosants and foam techniques have evolved since the mid-20th century, with ultrasound guidance expanding applications.