Alaska Vein Clinic



Ultrasound Guided Sclerotherapy, or USGS, is another treatment available to the vein specialist to treat causes of varicose vein disease. It is one of the most common venous procedures performed in the United States and Europe. A chemical irritant, called a sclerosant, is injected into the vein located by ultrasound.   

Dr. Artwohl observes the injection process on the ultrasound screen. The sclerosant damages the lining of the vein wall. This causes the vein to scar down, and eventually leads to the body reabsorbing the destroyed vein.

Some patients can suffer reflux in the saphenous veins as well as reflux in perforator veins and sometimes a combined treatment approach of endovenous thermal ablation and USGS is needed.

Additionally, other patients have venous problems are caused solely by incompetent perforator veins.

Perforator veins are veins that run in a cross-wise direction in the leg and are supposed to carry blood from the superficial veins to the deep veins. When a patient suffers perforator vein incompetence, the blood runs the wrong way, from the deep to the superficial. This reverse blood flow can cause all the signs of venous reflux disease: varicose veins, leg pain, swelling, pigmentation, and ulceration.  These veins can be treated quickly and easily by ultrasound guided sclerotherapy.

After USGS, patients and can return to normal activity that same day. Following treatment, patients will be asked to walk immediately and wear prescription-strength compression stockings for a period of time, as prescribed by the doctor. No pain medication is required after the procedure.

This video shows Dr. Artwohl performing ultrasound guided sclerotherapy of an incompetent perforator vein at the Alaska Vein Clinic. The incompetent perforator vein appears as a dark “channel” running somewhat diagonally downward from left to right in the screen.  Under ultrasound guidance, a needle is placed into the incompetent perforator vein and a foamed sclerosant is injected. As the scleroscant goes in, it will appears white and the the vein goes into venospasm. The vein will scar down and the reflux in this vein will be eliminated.  There is no downtime after this procedure.
Dr Artwohl performing ultrasound guided sclerotherapy at the Alaska Vein Clinic.  The patient will resume normal activities right after the procedure.
Perforator veins normally carry blood from the superficial venous system.  Many people have refluxing perforator veins in which the blood flows from the deep to the superficial system.  We always check for this problem in our vein patients.

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