Venous Insufficiency Medication

  • Author: Robert Weiss, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: May 26, 2011
 

Medication Summary

No oral medication has yet been proven useful for the treatment of venous disease. Findings of prospective studies have not supported some manufacturers' claims about the effectiveness of their herbal products and nutritional supplements.

Sclerosing agents that are used to ablate refluxing veins and other anatomic structures can be grouped into several categories, including fatty alcohols (detergents), osmotic agents, and caustic agents. The safest and most widely used sclerosing agents are detergents.

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Sclerosing agents

Class Summary

These agents are used for the primary sclerosis of reflux pathways and for the ablation of friable thin-walled veins judged to be at high risk for rupture and hemorrhage.

View full drug information

Sodium tetradecyl sulfate (Sotradecol, STS, STD)

 

Primary sclerotherapy is the treatment of choice for ablation of refluxing superficial venous circuits in the absence of saphenofemoral junctional reflux. Also, treatment of choice for ablation of venous bleeding sites and friable thin-walled varices. In general, 1% most useful; may use 3% in larger varicosities as a liquid. Foam may be made using agitation and a solution-to-air ratio of 1:4. When using a foamed solution, 0.25-0.5% concentration is sufficient.

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Contributor Information and Disclosures
Author

Robert Weiss, MD  Associate Professor, Department of Dermatology, Johns Hopkins University School of Medicine

Robert Weiss, MD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American College of Phlebology, American Dermatological Association, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, and MedChi

Disclosure: Angiodynamics Honoraria Speaking and teaching; CoolTouch Corp Intellectual property rights Consulting; Cynosure Grant/research funds Independent contractor; Palomar Grant/research funds Independent contractor

Coauthor(s)

Craig F Feied, MD, FACEP, FAAEM, FACPh  Professor of Emergency Medicine, Georgetown University School of Medicine; General Manager, Microsoft Enterprise Health Solutions Group

Craig F Feied, MD, FACEP, FAAEM, FACPh is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Phlebology, American College of Physicians, American Medical Association, American Medical Informatics Association, American Venous Forum, Medical Society of the District of Columbia, Society for Academic Emergency Medicine, and Undersea and Hyperbaric Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

R Stan Taylor, MD  The JB Howell Professor in Melanoma Education and Detection, Departments of Dermatology and Plastic Surgery, Director, Skin Surgery and Oncology Clinic, University of Texas Southwestern Medical Center

R Stan Taylor, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Dermatological Association, American Medical Association, American Society for Dermatologic Surgery, Christian Medical & Dental Society, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Mary Farley, MD  Dermatologic Surgeon/Mohs Surgeon, Anne Arundel Surgery Center

Disclosure: Nothing to disclose.

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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  7. Tretbar LL. Treatment of small bleeding varicose veins with injection sclerotherapy. Bleeding blue blebs. Dermatol Surg. Jan 1996;22(1):78-80. [Medline].

  8. Nijsten T, van den Bos RR, Goldman MP, et al. Minimally invasive techniques in the treatment of saphenous varicose veins. J Am Acad Dermatol. Jan 2009;60(1):110-9. [Medline].

  9. Nael R, Rathbun S. Treatment of varicose veins. Curr Treat Options Cardiovasc Med. Apr 2009;11(2):91-103. [Medline].

  10. Leopardi D, Hoggan BL, Fitridge RA, Woodruff PW, Maddern GJ. Systematic review of treatments for varicose veins. Ann Vasc Surg. Mar 2009;23(2):264-76. [Medline].

  11. Abbade LP, Lastoria S, Rollo Hde A. Venous ulcer: clinical characteristics and risk factors. Int J Dermatol. Apr 2011;50(4):405-11. [Medline].

  12. Diehm C, Allenberg JR. Color Atlas of Vascular Diseases. New York, NY: Springer Publishing; 1999:1-396.

  13. Feied CF. Deep vein thrombosis: the risks of sclerotherapy in hypercoagulable states. Semin Dermatol. Jun 1993;12(2):135-49. [Medline].

  14. Feied CF. Peripheral venous disease. In: Rosen and Barkin, eds. Emergency Medicine Principles and Practice. Vol 3. 4th ed. St. Louis, Mo: Mosby-Year Book; 1998:Chapter 107.

  15. Goldman MP. Sclerotherapy: Treatment of Varicose and Telangiectatic Leg Veins. 2nd ed. St. Louis, Mo: Mosby-Year Book; 1995:1-519.

  16. Weiss RA, Feied CF, Weiss MA. Vein Diagnosis & Treatment: A Comprehensive Approach. New York, NY: McGraw-Hill; 2001:1-304.

 
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Superficial venous insufficiency with skin changes.
Ulcer due to venous insufficiency.
 
 
 
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