My doctor says it's okay but I thought veins had to clot in order for the sclerotheraphy to be successful.
Coumadin should be discontinued before procedures such as closure or
injection sclerotherapy. Sclerotherapy is essentially "scar therapy" and
achieves closure of the small veins by injuring the wall of the vein
chemically. If the patient cannot be taken off Coumadin due to a mechanical
heart valve then sclerotherapy can still performed but the chances of
failure are higher. Whether one mixes the sclerosant with a gas (foam) the
idea is that it will have more circumferential contact with the vein wall
and result in a more effective closure of the vein.
Published on Jul 11, 2012
Sclerotherapy with either straight solution or foam is unaffected by blood thinners. Blood clots that form after sclerotherapy can recanalize (open up) and often spell failure; vein closure is the goal of sclerotherapy, not clots.
Published on Jul 11, 2012
Yes, the sclerotherapy does make the veins clot, but it is a powerful drug and will override the warfarin in this case and the treatment will work just fine. It might take 2-3 sets of injections to make sure the veins are closed off completely, but this is normal even for those who are not on blood thinners. If the doctor said to keep taking the warfarin, it is important to do so.
Published on Jul 11, 2012
We treat many patients who are on Warfarin. The blood does clot as needed during sclerotherapy if the PT INR are within a range of 2-3 pending while the person is on Warfarin.
Published on Jul 11, 2012
Yes it works. As a cardiologist and phlebologist I treat patients taking warfarin all the time. I actually prefer it as there is less risk of DVT. In my experience, the results are about the same, although I use a higher concentration of sclerosant when the patient is on warfarin.
Published on Jul 11, 2012
Foam sclerotherapy will work while on coumadin (warfarin). Foam works by pushing the blood out of the veins and irritating the vein walls causing them to stick together to occlude. Certainly, larger veins such as the saphenous would have more of a problem closing while on coumadin then the smaller veins.
Published on Jul 11, 2012
Sclerotherapy does not clot veins. It creates an inflammatory reaction leading to fibrosis. Therefore sclerotherapy does work in patients on warfarin.
Published on Jul 11, 2012
Foam should work on or off coumadin
Foam works by damaging the inner wall of the vein.
Published on Jul 11, 2012
The foam sclerotherapy will still be effective even in the presence of warfarin. The mechanism by which this drug works is not affected by warfarin.
Published on Jul 11, 2012
Yes, it will work. This is an excellent question and I encourage you to
speak directly with your treating physician.
Published on Jul 11, 2012