Sclerotherapy Workup

  • Author: Samer Alaiti, MD; Chief Editor: Jorge I de la Torre, MD, FACS   more...
 
Updated: May 16, 2011
 

Imaging Studies

Duplex ultrasonography is the diagnostic method of choice for diagnosing venous disease. A thorough workup is warranted in the presence of symptoms such as aching, cramps, fatigue and swelling of the lower limbs, along with a positive family history of varicose veins; in the presence of varicose veins, and in patients who have a cutaneous manifestation of an underlying venous disease (stasis dermatitis, stasis ulcers, lipodermatosclerosis, atrophie blanche).

Duplex ultrasonography is the most frequently used investigation for the diagnosis and management of chronic venous disease (both deep and superficial) in the lower extremities. It should demonstrate both the anatomical patterns of veins and abnormalities of venous blood flow in the limbs (functional impairment). Duplex ultrasonography has largely replaced handheld nonimaging (continuous wave [CW]) audible Doppler instruments to assess venous disease and confirm clinical impressions.[5] For more information, see Radiology article Deep Venous Thrombosis, Lower Extremity.

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Other Tests

Other available functional tests for venous disease include photoplethysmography and air plethysmography.

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Contributor Information and Disclosures
Author

Samer Alaiti, MD  Clinical Associate Professor, Department of Dermatology, University of Southern California; Medical Director, Miracle Mile Medical Center for Dermatology and Cosmetic Surgery, Inc

Samer Alaiti, MD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American College of Phlebology, American College of Physicians-American Society of Internal Medicine, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, and American Society of Lipo-Suction Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Shahin Javaheri, MD  Chief, Department of Plastic Surgery, Martinez Veterans Affairs Outpatient Clinic; Consulting Staff, Advanced Aesthetic Plastic & Reconstructive Surgery

Shahin Javaheri, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: eMedicine Salary Employment

Mark E Krugman, MD  Assistant Professor of Plastic Surgery and Clinical Professor of Otolaryngology-Head and Neck Surgery, University of California at Irvine School of Medicine

Mark E Krugman, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society for Laser Medicine and Surgery, and American Society of Plastic and Reconstructive Surgery

Disclosure: Nothing to disclose.

Nicolas (Nick) G Slenkovich, MD  Director, Colorado Plastic Surgery Center

Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS  Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

References

  1. Kahle B, Leng K. Efficacy of sclerotherapy in varicose veins-- prospective, blinded, placebo-controlled study. Dermatol Surg. May 2004;30(5):723-8; discussion 728. [Medline].

  2. Tisi PV, Beverley C, Rees A. Injection sclerotherapy for varicose veins. Cochrane Database of Systematic Reviews. 2006;Issue 4, Art. No.: CD001732. DOI: 10.1002/14651858.CD001732.pub2.:1372.

  3. Engel A, Johnson ML, Haynes SG. Health effects of sunlight exposure in the United States. Results from the first National Health and Nutrition Examination Survey, 1971-1974. Arch Dermatol. Jan 1988;124(1):72-9. [Medline].

  4. Parsons ME. Sclerotherapy basics. Dermatol Clin. Oct 2004;22(4):501-8, xi. [Medline].

  5. Raymond-Martimbeau P. The role of duplex ultrasound in the sclerotherapy of varicose veins. Phlebology Digest. 1994;1:4-10.

  6. Craig F. Feied, MD. Sclerosing Solutions. In: Helane Fronek MD. The Fundamentals of Phlebology, Venous Disease for Clinicians. 2nd. American College of Phlebology; 2007:P. 23, Ch.5.

  7. Philippe Kern, MD, Albert-Adrien Ramelet, MD, Robert Wutschert MD, Henri Bounameaux MD, et al. Single-Blind, Randomized Study Comparing Chromated Glycerin, Polidocanol Solution, and Polidocanol Foam for Treatment of Telangiectatic Leg Veins. Dermatologic Surgery. 2004;Volume 30 Issue 3,:367 - 372.

  8. Breu FX, Guggenbichler S. European consensus meeting on foam sclerotherapy. Dermatol Surg. 2004;30:709-717.

  9. Weiss RA, Sadick NS, Goldman MP, Weiss MA. Post-sclerotherapy compression: controlled comparative study of duration of compression and its effects on clinical outcome. Dermatol Surg. Feb 1999;25(2):105-8. [Medline].

  10. Zimmet SE. The prevention of cutaneous necrosis following extravasation of hypertonic saline and sodium tetradecyl sulfate. J Dermatol Surg Oncol. Jul 1993;19(7):641-6. [Medline].

  11. P . Kern , A . Ramelet , R . Wütschert , D . Hayoz. Compression after sclerotherapy for telangiectasias and reticular leg veins: A randomized controlled study. Journal of Vascular Surgery. June 2007;Volume 45, Issue 6:Pages 1212-1216.

  12. Mitchel P. Goldman, MD. Complications and Adverse Sequelae of Sclerotherapy. In: John J. Bergan, MD. The Vein Book. 1st. Elsevier; 2007:P.139, Ch.15.

  13. Guex J-J, Allaert F-A, Gillet, J-L, Chlier F. Immediate and midterm complications of sclerotherapy report of a prospective multi-center registry of 12,173 sclerotherapy sessions. Dermatol Surg. 2005;31:123-128.

  14. Sadick NS. Predisposing factors of varicose and telangiectatic leg veins. J Dermatol Surg Oncol. Oct 1992;18(10):883-6. [Medline].

 
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Telangiectasias.
Reticular veins.
Venulectasias.
Venulectasias after sclerotherapy treatment.
 
 
 
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