Twenty days ago I had sclerotherapy on my great saphenous vein. Unfortunately, the vein did not close, although I had one more sclerotherapy injection in the following days. Now, my doctor says that it is necessary to close the vein with thermo ablation. What's your position about that? Is this typical? It is possible to perform a thermo ablation after a sclerotherapy injection? Thanks a lot.
There are many ways to close (ablate) the saphenous vein, including sclerotherapy, RF ablation, Laser ablation, Clarivein, Varithena, and VenaSeal. Sclerotherapy closure is the least invasive but also has the highest rate of incomplete closure and recurrence. So, if the vein did not close, then it would be wise to close it with a form of thermal heat.
Published on Jul 11, 2012
I prefer to close the larger veins first (greater or lesser saphenous) prior to sclerotherapy.
Published on Jul 11, 2012
It is hard to comment without knowing more about your treatment, but yes, this is can be done. Usually, however, thermal ablation is performed first and sclerotherapy second.
Published on Jul 11, 2012
Typically, we would not do sclerotherapy on the GSV. We would do some form of endovenous ablation. Sclerotherapy is used in some countries but is not considered the standard of care in the US.
It may be difficult to do an ablation now because the partial sclerosis of the vein may make the passage of the the laser or RF catheter impossible. It would still be worth trying if the GSV still demonstrates reflux.
Published on Jul 11, 2012
Sclerotherapy would not be my first choice to treat a saphenous vein with reflux. Thermal ablation is the most appropriate and successful treatment due to the size of the vein. An ultrasound scan should be performed to establish an open vein to allow the catheter to pass all the way. Perhaps a second opinion with a board-certified vascular surgeon will help you make the decision
Published on Jul 11, 2012
That is unusual but depends upon what is the primary mode of treatment in that vein clinic. Mostly, thermal ablation (RFA or EVLT) is the first line of treatment. However, if sclerotherapy is being used as first line of treatment, then it is possible to have the scenario that you are describing. Thermal ablation will be used if scelrotherapy has failed. In our clinic, RFA is used as a first line of treatment for thermal ablation of large veins, such as the great saphenous vein.
Published on Jul 11, 2012