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Some varicose veins or veins that “feed” spider and varicose veins can’t be seen on the skin’s surface. Often times, these veins are the cause of venous ulcers, skin breakdown and wounds. For patients with these types of veins, echosclerotherapy may be a suitable treatment option. Contact us at the Vein Care Center, serving patients in Lima, Celina and the surrounding areas of Auglaize County, OH, to schedule your free screening or consultation with board-certified and aesthetic-laser-certified family physician D. Manu B. Aggarwal, MHSA, MD.

What Is Echosclerotherapy?

Echosclerotherapy is ultrasound-guided sclerotherapy. Using an ultrasound, veins are located below the skin’s surface. These veins can’t readily be seen on the surface of the skin. They are mapped out so they can be treated. The area will be visualized and a FDA-approved sclerosant will a into the vein. There are many medications that can be used, however, we only use FDA-approved medications. The sclerosant is either Polidocanol or Sotradecol. These two detergents work by denaturing (damaging) the proteins in the wall of the vessel. This causes the vein to collapse, causing the vein to close itself shut. Immediately following the injection, Dr. Aggarwal will then inject a numbing solution surrounding the area we treated to focus the medication to the area that needs treated. ***It is important for you to know that once these medications are mixed with air, to create a “foam”, it is off-label use. This means that the foam is not FDA-approved. In our office, we use foam several times a week in the treatment of large spider, varicose and perforator veins. Why is foam used? It is the same concept as foam soap; when you mix air with soap, you are using less soap, but still getting your hands clean. The same concept goes for foam echosclerotherapy or foam sclerotherapy (this is for larger spider veins). By using a foamed version, you use less medication and effectively treat the abnormal vein.

What Happens During Echosclerotherapy Treatment?

After Dr. Aggarwal uses ultrasound to determine which veins to target, she will inject a treatment solution into the abnormal vein. During the entire process, Dr. Aggarwal will monitor the procedure on an ultrasound screen to guide the needle into the vein. The solution used will destroy the inner lining of the vein, causing it to seal shut. You will be awake and lying comfortably throughout the procedure. You will be able to see the procedure on the monitor as well! Echosclerotherapy is often times used as treatment of choice for venous ulcers. One of the rare risk factors of foam sclerotherapy treatment is neurological symptoms (visual changes, headache, vomiting, numbness, tingling). These symptoms are very temporary and have never been shown to be permanent in the literature or in our practice. You will be monitored for these symptoms at your treatment. We have seen these side effects only a handful of times in the last 12 years of our practice.

What Is a Venous Ulcer?

Also called stasis leg ulcers, venous ulcers are shallow, hard-to-heal wounds most often located on the sides of the lower leg, above the ankle and below the calf. They form when veins fail to function properly – allowing blood to collect and pool in the lower extremities rather that flowing back to the heart. This creates a “bruise-like” effect to the skin from the inside of the skin to the outside. If you notice that your skin has turned dark red in a particular area and has become dry, thick and itchy, you may have the start of a venous ulcer that needs to be treated. Often times, the skin changes start with redness and many providers treat with steroids to lessen the redness without determining the underlying cause. Long-term use of steroids thin the skin and can actually make an open wound occur sooner. If left not diagnosed properly, ulcers form and create an open area(s) susceptible of infection.

Venous ulcers can be healed at times without echosclerotherapy. We have seen patients with ulcers that are over three years old. That is too long to have an ulcer. The work days lost and high rates of depression in people with venous ulcers need to be addressed as soon as possible; not to mention the effect on activities of daily living (cleaning, cooking, working, exercise, etc.). If you have an ulcer, early consultation is key to healing the ulcer quickly. The recurrence rate is very high if the underlying venous disease is not treated. Often times, wound care is prolonged and unnecessary if the underlying disease is quickly identified and treated. Ask your wound specialist for a referral. However, you do not need a referral to see us!

Am I a Good Candidate for Echosclerotherapy?

If you have larger veins that are not visible through the skin and/or are too twisted to be treated with some other vein treatment methods, or have skin changes seen early on in venous ulcers, Echosclerotherapy may be the right choice for you. Echosclerotherapy is sometimes used in conjunction with other treatments and is often an effective method of venous ulcer treatment. At your consultation, the Vein Care Center team will examine you and review your medical history. After your evaluation is complete, we will let you know whether you are a good candidate for Echosclerotherapy. ***Patients with a history of migraine headaches, COPD or asthma, or a condition called patent foramen ovale, may not be good candidates for this procedure and will be advised during their consultation. If it is contraindicated, there are other options for treatment and these will be discussed with you.

Why should you choose the Vein Care Center for Echosclerotherapy? We received our Vascular Testing Accreditation in 2007 and Vein Center Accreditation in 2015 and have been serving patients with venous disease in Lima, Celina and the surrounding areas of Auglaize County, OH, for more than a decade. Contact us today to book an appointment.

The information about echosclerotherapy was reviewed by Dr. Manu B. Aggarwal. If you have any questions, please don’t hesitate to contact us using our contact form below.

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