Sclerotherapy

Introduction
Varicose veins and the subset of small varicosities referred to as telangiectatic and reticular veins are the most common vascular disorders of the lower extremities. Up to 60% of American adults are affected with varicose veins, and the incidence increases with age [1]. Many of these patients are affected not only by their appearance, but also by the quality of life that can accompany varicose veins. Varicosities can be associated with varying degrees of discomfort and pain, lipodermatosclerosis, venous ulcerations, thrombophlebitis, and deep vein thrombosis.

Sclerotherapy involves the introduction of a sterile foreign chemical by injection into an intracutaneous, subcutaneous, transfascial or subfascial abnormal venous lumen, resulting in transmural denaturation of the vessel wall and subsequent panvascular fibrosis and destruction of the vessel. Controversy concerning the precise mechanism of action of sclerotherapy persists. The term sclerotherapy was first introduced in 1936. However, intravascular sclerotherapy of varicose veins was initially performed in 1840, shortly after the development of the hypodermic needle, utilizing a solution of absolute alcohol [2]. Increasing sophistication in the discipline of sclerotherapy over the years has led to continued refinement of sclerotherapy techniques. Advances in the development of sclerosing solutions, prolonged postsclerotherapy compression, accurate methods of detecting valvular incompetence and venous hypertension, and the refinement of foam sclerotherapy techniques for the closure of incompetent saphenous trunks and perforating veins have resulted in the practice of sclerotherapy flourishing in the United States and abroad.