Foam sclerotherapy treatment for varicose veins

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What is this information about?

This information is about what to expect when you come to Lewes Victoria Hospital for an outpatient procedure called foam sclerotherapy (pronounced s-klair-o-therapy). It tells you:

• what this procedure is
• what will happen before and after the procedure
• contact numbers to call should you need any further help.

Why have I been given this information?

You have been given this information because you, or a person you are looking after, will be having this procedure. Reading this advice will help you to prepare for what will happen. You will also know what to do to look after yourself once you get home.

Keep this information in a safe place so you can refer to it when you need to.

What is foam sclerotherapy?

Foam sclerotherapy is a treatment that uses an injection of foam to shrink the varicose veins being treated in your leg.

The foam is made by mixing a clear fluid (called a sclerosant) with air to form a mixture of tiny bubbles. This mixture is then injected into the vein, or veins, needing treatment. When the foam contacts the inner vein wall, the vein collapses and sticks together, sealing off the vein and eventually shrinking down.

The foam does not stay in the vein. Once it reacts with the inner vein wall, it breaks up into the blood stream.

Why foam sclerotherapy?

There are different ways to treat varicose veins, but the results of your diagnostic ultrasound (scan) show that foam sclerotherapy is the best treatment for you.

Wat does the treatment involve?

Foam sclerotherapy involves one or two small injections being given into the surface vein, or veins, of your leg. There is no need for anaesthetic.

These injections are guided by ultrasound imaging (a scan that looks inside your body). This makes sure that the needle is in the right place inside the vein and that the foam only spreads through the areas it is needed.

What happens after I have the injections?

After your injections you will be fitted with a compression stocking to the treated leg or legs. You may also need to have a tight bandage over the treated area.

We will ask you to stay with us in the department for 10 to15 minutes after your procedure. This is to make sure you are feeling well before being taken home.

How long should I wear the compression stockings?

These stockings are important because they:

• are part of the treatment for your varicose veins
• help to reduce the risk of a blood clot after your procedure.

You will need to wear the stockings night and day for the first 48 hours.

After the 48 hours you can take the stockings off to shower any time.

Replace the stockings and wear for 1 week, day and night.

You then wear the stockings for another week, in the day only.

At the end of the second week, you no longer need to wear stockings.

How should I look after myself once I return home?

You should not drive yourself home after the procedure.

You may begin to drive once you feel able to do so, and you are not restricted by the stocking or bandages.

It is important to keep moving and walk regularly. For the first 3 to 4 days after the procedure, avoid strenuous (hard or tiring) exercise, kneeling for long periods.

Avoid sitting with your legs down for too long. Try to move around often, and when sitting, keep your legs raised if possible.

You can return to work the next day.

Can I travel after this operation?

You should not:

• travel by airplane for 4 weeks after treatment.
• travel in confined circumstances (where you cannot get up and move around) for long periods without a break.

What if I have pain or discomfort after the procedure?

You may feel mild pain and tenderness in your leg at any point, up to several weeks after treatment. Taking paracetamol, or the usual medicine you would take for a headache, can help. Topical anti-inflammatory gel can also be useful for tenderness in the area.

It is usual for the treated veins to become lumpy and hard under the skin. The skin may look bruised or faintly discoloured over the treatment area. This is normal and will go away with time. Any hard lumps where the veins were is a sign that the treatment has worked.

Are there any risks or complications that I need to be aware of?

Your consultant will talk to you about these unlikely complications before treating you.

• Visual disturbances (problems with your eyesight) can happen after the injection. This usually only lasts for a few minutes. It has no long-term effects. It may be more common in migraine sufferers.
• Ulceration (a small sore) can form at the injection site, but this is rare.
• 1 in 200 people can develop a thrombosis (also called a DVT) within the deep veins after these injections.
• 1 in 50,000 people can have a severe allergic reaction to the foam.

Will I need more treatment sessions?

Sometimes you may need more than one treatment session for lots of varicose veins. We will usually review the treatment after about 6 weeks to decide if more injections are needed.

Who can I contact for further help or advice?

In usual working hours of 8am-5pm Monday to Friday