Sclerotherapy of varicose leg veins. Technique, indications and complications

The aim of treatment by sclerotherapy is the fibrous occlusion of varicose veins and the absence of recanalization of an intravascular thrombus. Modern sclerotherapy started at the beginning of the 20(th) century in Europe. Tournay in France, Sigg in Switzerland and Fegan in Ireland developed different schools of practice. Recently ultrasound-guided sclerotherapy has appeared, mainly for the treatment of saphenous trunks and incompetent perforating veins. The precise diagnosis of varicose vein disease and the recognition of the most proximal point of reflux dictates the choice of optimal treatment and reduces the risk of recurrence and complications such as pigmentation or matting. The risk of complications depends on the agent used, its concentration and the quantity injected. Sclerotherapy is the treatment of choice for spider veins and is indicated in the treatment of reticular and short saphenous varicose veins. There is currently no consensus on the place of sclerotherapy in the treatment of the long saphenous vein and incompetent perforating veins. Neither is there a consensus on the type and duration of the compression to be applied after sclerotherapy. Sclerotherapy is safe and in the hands of experts the risk and secondary side effects of the treatment are minimal.