[The limits of effective sclerotherapy in the obese]

The sclerosant treatment of varices in the obese patient is generally approached with apprehension, and regarded as ineffectual. In its clinical reality, however, despite some particular problems, sclerosis of distended saphenous veins in their terminal section does not pose a problem in a patient whose overweight is less than 50% of the ideal weight per height. Between 50% and 100%, the realisation of effective sclerotherapy demands particular and rigorous examination, treatment and control techniques, as are described. Over 100% of excess weight, an effective sclerosis is only very rarely possible, and will prove to be uncertain in both execution and follow-up. This mode of treatment no longer occupies the forefront of therapeutic problems.