Sclerosing treatment has proven to be the most effective treatment to eliminate venules and variculas in the lower extremities.
This treatment consists of the injection of a substance inside the vein that produces an inflammatory reaction with obliteration and fibrosis of the vein, producing a local reaction that makes the vein disappear. The greater the reaction produced at the vein level, the lower the recanalization rate and, therefore, the lower the chances of the vein coming out again.
Sclerosants
Sclerosing agents are basically divided into three types:
Detergents, reduce the surface tension at the level of the vessel wall, producing cell lysis, this type of sclerosants are the ones that allow foaming.
Osmotic agents are indicated for very small vessels, produce vasospasm in their introduction and some lesions at the injection sites. These agents are usually hyperosmolar solutions and present a risk of post-treatment pigmentation.
Chemical agents are the most frequently used for cryosclerosis. They are highly viscous and require prolonged contact with the vessel to be treated. They can be painful to inject.
Cryosclerosis
Cryosclerosis is a variant of traditional sclerosis, in which cold is associated with this process by cooling the sclerosing substance with the help of carbon dioxide.
Thus, when the sclerosant is introduced, a vasospasm (contraction of the vessel) is produced so that the sclerosing liquid remains longer in the area to be sclerosed, thus increasing its effectiveness. At the same time it regulates the amount of sclerosant to be injected.
Cryosclerosis, therefore, optimizes the sclerosing treatment of small vessels. On the one hand, it regulates the amount of sclerosant we use, and on the other hand, it makes it more effective as the sclerosant remains longer in the area to be treated.
Technique and care
Every medical treatment has its advantages and disadvantages, one of the main complications of sclerosing treatment is the skin pigmentation of the area to be treated. This pigmentation is secondary to the thrombotic process inside the vessel, when the hemoglobin of the blood mixes with the sclerosant, a localized thrombus is produced, and this is what causes the pigmentation to appear. Cryosclerosis limits the formation of this thrombus, thus reducing the amount of thrombus, and pigmentation is reduced.
Precisely because of pigmentation, it is preferable to sclerotize an area more than once instead of pigmenting this area, since pigmentations secondary to the sclerosing treatment are difficult to eliminate.
After treatment, the only thing to do is to wear a Class I / II elastic compression. This will reduce the inflammatory reaction of the treated vein and make the sclerosant more effective in the area.