Advances in sclerotherapy

Although venous systems are inherently variable, the treatment of varicose and telangiectatic leg veins can be approached in a logical, systematic fashion (Table 4). Instead of randomly injecting as many veins as possible in a given period of time, venous regions or entire abnormal superficial venous networks related to incompetent perforators should be injected in a single session. Although each patient requires differing amounts of time with this systematic approach, with experience, accurate estimations can be made, ensuring optimal productivity. Understanding the interconnected character of the venous system, it is senseless for physicians to limit treatment to telangiectatic veins. Dermatologists with an interest in phlebology should strive to perceive veins as a complete system, with the dermal telangiectatic component not as a separate skin disorder but as a manifestation of venous hypertension. An awareness of this will allow us to render optimal care for our patients.