The circulatory system is made up of both veins and arteries. Arteries delivers fresh oxygen rich blood from the heart to all tissues and veins then collect the oxygen-depleted blood again and transport it back to the heart.
The heart will pump blood through the arteries, but not all the way through the veins.
In the lower limbs, blood requires a different transport system to return it, against gravity, back to the heart. This transport system is made up of a pump again, the “calf pump” and one way valves within the veins.
It is for this reason that walking is a great way to keep your legs healthy, since the calf pump is activated all the time.
Broken one-way valves in the legs will cause blood to flow back through the vein and pool in the lower legs, this is known as venous reflux, and often presents as varicose veins. Varicose veins are large blue tortuous vessels that buldge from the surface of the skin.
Sclerotherapy or injection of varicose veins is designed to improve the appearance of your varicose veins. The veins are injected with a solution called a sclerosant which damages the internal lining of the vein and causes blood to stop flowing through the vein. Over a period of time your own body will reabsorb the vein and it will disappear naturally. The chemical solution used is made specifically for the treatment of veins and is used in different concentrations. Foam sclerotherapy involves rapidly mixing volumes of the chemical solution with a small volume of air producing a white foam. Foam is able to fill even the most tortuous veins and it is for this reason that we use it, even large underlying abnormal veins can be treated. The procedure is performed under ultrasound guidance and control.
Ultrasound guided foam sclerotherapy is performed in the office. This treatment is especially suited for patients who require treatment after their veins returned after stripping surgery. Dr Blignaut prefers to use radio frequency ablation of the large veins and supplements this treatment with the use of foam sclerotherapy. The veins to be treated are identified using an ultrasound, they are sometimes marked on the skin. While lying on a treatment bed, a small needle is placed in the vein to be treated. The foam solution is mixed and injected into the vein. There is usually no pain associated with the injection of foam into larger veins. A compression bandage or stocking is immediately applied. This stocking or bandage is worn for severeal days following the injection.
Foam sclerotherapy is a suitable treatment for most patients with buldging varicose veins. It is a treatment of choice in our clinics and is often used. There are very few contra-indications for not performing the procedure, an important one is a patient with a "hole in the heart" or patent foramen ovale.
Sclerotherpay is poorly covered by medical schemes in South Africa. Fortunately it is a low cost and affordable treatment for most patients.