UGS TREATMENT OF VARICOSE VEINS
Presentation of treating veins can be seen here
What are varicose veins and spider veins?
Varicose veins are enlarged veins that can be flesh colored, dark purple or blue. They often look like cords and appear twisted and bulging. They are swollen and raised above the surface of the skin. Varicose veins are commonly found on the backs of the calves or on the inside of the leg. They can cause pain, heaviness, leg swelling, skin changes like redness or inflammation and even non healing leg ulcers.
What causes varicose veins?
The heart pumps blood filled with oxygen and nutrients to the whole body. Arteries carry blood from the heart towards the body parts. Veins carry oxygen-poor blood from the body back to the heart. The squeezing of leg muscles pumps blood back to the heart from the lower body. Veins have valves that act as one-way flaps. These valves prevent the blood from flowing backwards as it moves up the legs. If the one-way valves become weak, blood can leak back into the vein and collect there. This problem is called venous insufficiency. Pooled blood enlarges the vein and it becomes varicose. Inheritance is the main reason for this problem plus other factors like prolonged standing, many pregnancies and over weight.
How can varicose vein be treated?
In the past, people with large varicose veins had no option but to treat them with conventional surgery techniques. These techniques often involved hospitalization, pain, bleeding and anesthesia as the veins were stripped out of the body using surgical instruments. Smaller veins could be treated with sclerotherapy, a method of injecting a substance into veins that would cause them to shrink and disappear. Conventionally, sclerotherapy was only used on these smaller veins; that is, until the advent of new technology called ultrasound guided sclerotherapy.
What is Ultrasound Guided Sclerotherapy?
Ultrasound Guided Sclerotherapy (UGS) is used to treat the malfunction origin vein which is the cause of varicose veins deep under the skin without the need for surgery. It involves the precise injection of the diseased hidden vein with sclerosing solution under the guidance of the ultrasound image.
How are varicose and spider veins treated in Polyclinic K-centar? Following meticulous physical exam, dr. Yair Galili, our guest from Israel and one of the most experienced vein specialist in the world, will examine your legs with an advanced ultrasound to find the cause and severity of the problem. In the case of venous insufficiency, Dr Galili is able to solve the problem in the most efficient and convenient way by Ultrasound Guided Sclerotherpay (UGS) technique. This method when done by experience hands, is one of the most successful and efficient ways of treating varicose veins and most patients can expect a more than 95% improvement.
What is the difference between Ultrasound Sclerotherapy and Conventional Sclerotherapy?
The main difference between conventional Sclerotherapy and Ultrasound Guided Sclerotherapy is that the doctor uses the ultrasound image for guidance at the time of injection treats the diseased vein which is the origin of the problem. This provides the doctor with a precisely accurate image of the underlying incompetent veins, thus giving UGS its very high success rate.
Will the veins be gone immediately?
Usually the symptoms of varicose veins, such as aching and restless legs are gone almost immediately. Ultrasound guided Sclerotherapy leads to the collapse an absorption of the treated vein. It is no longer a varicose vein after successful treatment. There is about an 80% improvement in appearance in the first two weeks. However, it may take some time to completely disappear.
Does Ultrasound Guided Sclerotherapy permanently remove varicose veins?
The veins that have been treated effectively will not return. With UGS, varicose veins can be effectively treated without the need for surgery, but for some small percentage, varicose veins might reoccur, mostly in lesser degree. Our aim at The Varicose Vein clinic is to treat the veins that are present, help to prevent the occurrence of new veins and provide ongoing assistance in the treatment of any new problem veins should they emerge.
How long is the recovery period?
Most of the time, patients can return to normal activities immediately after treatment, including work or travel home, directly from the clinic. It is recommended to avoid lifting heavy weights and high impact activities for two weeks post-treatment.
How many treatments are needed?
Depending on the size of the vein usually 1-3 treatment sessions are required per leg for good results.
What can I expect following the treatment?
Discomfort from the injections is minimal for most patients. Treatment sessions take approximately few minutes to complete following which for some people, compression wraps are applied. These are worn continuously for 3 days hours after treatment. Our patients are instructed to walk for 15 minutes immediately after treatment and then 5-10 minutes 6 times per day for 7 days. Walking in the house or at work is perfectly acceptable.
Are there any complications?
When larger veins are injected, it is fairly common to develop a firm, tender cord or lumps along the vein. This is normal and simply indicates the vein has responded well to the injection. Occasionally, a brownish pigmentation may develop in the skin overlying a treated vein. This gradually fades over a period of several months and rarely, some vage discoloration may remains. There are several rare but potentially serious complications like blood clots can form in untreated deep veins of the legs. The chance for this is even smaller then in regular operation where it is not common. As with the use of any medication, there is remote chance of having immediate and treatable allergic reactions. Other non common and self resolved phenomena like transient visual disturbances, dizziness and skin sensations have been reported following injections of foam sclerosant. Overall, sclerotherapy is a safe procedure and serious complications are very rare.
What are the costs?
1000, 00 Euro is the cost for first treatment on the one leg. In the case that we treated the both legs, price for the first treatment is 1900, 00 Euros. Every next treatment, if it’s needed is half price of privies treatment.
Dr Yair Galili
Dr Galili who brings his extraordinary experience in this field to our clinic, is a highly skilled and very experienced vascular surgeon from Israel specialized in the UGS technique in North American Vein Clinic in Chicago USA 8 years ago and have done a phenomenal number of more than twenty thousand ( 20000! ) successful treatments and is a leading figure in this treatment in Israel and in the world.
The Benefits of Ultrasound Guided Sclerotherapy
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The procedure is so simple and straightforward for patients who are appreciative of relieving themselves of the pain associated with their leg veins.
The added bonus of the ultrasound guided sclerotherapy treatment is that it provides cosmetic improvement without having to take time off work. Patients are often amazed at the fact they can have 'gross' varicose veins treated by ultrasound guided sclerotherapy, and be back at work an hour later.
Advantages of the treatment include: -
No time off work
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No anaesthesia (the procedure is virtually painless)
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No surgery
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No scars or stitches
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Patients can continue normal daily activities
What to Expect During the Procedure
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Ultrasound Guided Sclerotherapy is a simple process that usually involves one to three injections into the diseased vein - most commonly from the groin to the knee. There may be more than one treatment session required.
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Vein Mapping
Using an ultrasound technique before provide us to obtain a precise picture of which veins need treatment, and which are best left alone.
Patients who have had their veins return after surgical treatment often have a very complicated pattern of veins in the groin. The advantage of using ultrasound mapping is that we can pinpoint the exact cause of the recurrent veins. The ultrasound is then used to guide injections to eliminate the source of the problem. -
Sclerosant Injection into the Vein
A solution (called a sclerosant) is injected directly into the veins using a very fine needle. This procedure has been used for decades on larger veins, and more recently refined for injecting tiny superficial spider veins (microsclerotherapy). The solution irritates the inside of the vein wall causing it to become inflamed. This triggers the bodies natural healing which results in the vein being closed off thus preventing any blood flow. Over a period of weeks the vessels fade, being barely or not visible.
Depending on its size, a single varicose vein may have to be injected more than once, a week or more apart. In any one treatment session many veins may be injected. -
How long does the treatment take?
Patients with very complicated veins (particularly the post surgical recurrences) may need three or four treatments. Other patients may only need one or two treatments. Each treatment takes less than half an hour. Patients then go for a walk for half an hour before returning to work.
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Post Treatment
A compression stocking is worn for one week continuously after treatment and a further two weeks during the day only.
Patients are reviewed one week and three months after the initial treatment.
Smaller veins including spider veins are treated once the ultrasound guided sclerotherapy is completed. -
Possible Side Effects
Like all medical procedures there may be side effects but generally Ultrasound Guided Sclerotherapy is a very safe technique. Because patients are mobile there is a markedly reduced risk of Deep Vein Thrombosis which is relatively common after surgical stripping of veins.
A full discussion about side effects and other types of procedures will be undertaken at the initial consultation. -
Sclerosants Polidocanol - used extensively since 1960 as the sclerosant of choice for spider veins but is also used at times for
Presentation of treating veins can be seen here