Does Asclera, Polidocanol work on varicose veins?
Asclera (Polidocanol) for Varicose Veins?
Doctor Answers 14
Asclera for Sclerothrapy
Asclera (Polidochanol) is FDA approved. It has advantages because it is painless on injection, has low likelihood of skin necrosis and is effective.
It is commonly used for feeder veins, reticular veins and some individuals use it for varicose veins. Its concentration when used is 0.5% to 1 %.
Asclera is a wonderful product for cosmetic sclerotherapy.
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Asclera for Varicose Veins
The majority of individuals who receive sclerotherapy treatment will have good visual improvement of their spider or reticular veins. However, there is no guarantee that sclerotherapy will be effective in every case.
Unfortunately, Asclera is not typically used for varicose veins, which are significantly larger. Instead of an injection, the veins need to be broken down/collapsed with heat or ultrasound, removed via stripping or via a brand new method, glue. I believe this is the future of varicose vein treatments. Venaseal©, is a cyanoacrylate, like super glue. It was recently approved by the FDA and will be available for widespread use in the US in 2015.
Asclera for varicose veins.
Large varicosities (> 3-4mm in diameter) may still be effictively treated with sclerotherapy, but as the abnormally dilated vessels get larger, the amount of sclerosant gets correspondingly larger as well as less effective, since the sclerosant works by irritating the lining of the vein, stimulating spasm and clotting within the vein. The larger the vein, the more blood that is present to dilute the sclerosant, making it less potentially effective. Asclera works great for small spider veins, but the smaller they are, the more technique-dependent effective sclerotherapy is dependent upon.
For large(r) varicosities, better options exist, including endovenous laser ablation all the way to old-style surgical vein stripping. A dedicated vein clinic or a specialist in vascular surgery would be the people to see. Best wishes! Dr. Tholen
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Asclera for Varicose Veins
Asclera and leg veins
Asclera (Polidocanol) Sclerotherapy for Varicose Veins & Spider Veins of the Legs
Yes, Asclera (also known as Polidocanol) does work well for varicose veins, as long as any deeper venous problem is addressed at the same time. Most patients with varicose veins also have a deeper circulation condition known as venous reflux disease. This deeper disease results in the varicose veins forming at the surface. If the underlying vein disease is not treated, the surface branches will not response properly or will occur. Usually this disease affects the deeper saphenous veins of the legs and can usually be addressed by a laser treatment or radiofrequency treatment prior to or in conjuction with the sclerotherapy. A good analogy is that the diseased saphenous vein is the trunk of a tree and the varicose veins at the surface are the branches of the tree. If you only treat the branches, the trunk will just grow new branches (new varicose veins). If the trunk problem (which is usually present) is successfully identified by ultrasound and treated, then the branches can often be treated with Polidocanol or Asclera sclerotherapy. Very large surface branches are usually best treated with phlebectomy (they tend not to respond well to sclerotherapy), but small to moderate sized varicose veins or reticular veins tend to respond very well to sclerotherapy with Polidocanol. Asclera / Polidocanol is an FDA approved medication for both small varicose veins as well as spider veins.
Since you should always have an ultrasound done to check for the deeper vein problem and since this deeper problem should always be addressed before treating the surface branches, I would suggest that you see a board-certified vein specialist for a detailed evaluation before you have any treatments on your varicose veins done.
Painless Vein Treatment
Ascelra is now FDA approved for the treatment of varicose veins. I have found it is most effective for spider and reticular veins, but can also be used for larger caliber vessels. For larger vessels ultrasound guidance often improves outcomes.
Polidocanol is effective against larger veins
Yes! Polidocanol can be used to successfully treat larger caliber veins including varicose veins. Although these veins can be visualized easily and treated with sclerotherapy, ultrasound-guided sclerotherapy can be more effective in treating affected vessels, by identifying potential feeder vessels called accessory or perforating vessels. If you have varicose veins, it would be wise to first obtain an ultrasound study of the legs--quick, easy, painless, and informative--to determine if upstream vessels such as the great saphenous veins require treatment first before proceeding with polidocanol sclerotherapy treatment.
Spider Vein therapy
It works best on spider veins and reticular veins. i have never used it on varicose veins and am happy with performing microphlebectomy are larger varicose veins if ablation of tributaries dont work to shut the varicose vein down. i have seen a number of complications from other physicians injecting a wide range of agents into larger veins including matting and skin staining with dark brown spots.
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