Sclerotherapy or microphlebectomy for calf veins?

How significant is the risk of brown staining of skin from foam sclerotherapy on theses superficial vessels? The deep veins are fine by ultrasound. I have several small areas across my tibia. Is it better to remove these varicose veins ?the veins are moderate size and wind around my calf. They are about 2-3 inches long

Doctor Answers (3)

Either microphlebectomy or sclerotherapy or both

+1
I prefer microphlebectomy for sizable varicose tributaries in the calf (posterior leg) and foam sclerotheapy for veins crossing the tibia - as vein across the tibia are painful to remove because it is a sensitive area, especially in thin people. Most of the time, I do both, inject under ultrasound guidance and do microphlebectomy on the large veins. Unlike once of the comments made, I disagree with the physician who states there is  high risk for DVT with sclerotherapy - this is not borne out busy clinical practices. 


Buffalo General Surgeon
4.5 out of 5 stars 7 reviews

Should have Venous Evaluation first.

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If you have larger veins in your legs then you should first have a venous evaluation to look for the source of the veins.  A venous reflux ultrasound could reveal malfunctioning (refluxing) valves which could be the source of the varicose veins and which should be treated before the varicose veins.  If there is no reflux then sclerotherapy is possible for smaller veins and microphlebectomies for larger veins. Staining is always a possibility from sclerotherapy but the risk is minimum if polidocanol is used.

John Landi, MD
Naples General Surgeon
5.0 out of 5 stars 2 reviews

Foam Sclerotherapy for Varicosities

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The risk of temporary pigmentation is insiginificant if injections are done with no extravasation. Yet, foam sclerotherapy is ill-advised in your situation, since there is no control of the agent flow after injection. It can, therefore, leak through the perforators into your deep system leading to deep vein thrombosis. If by "removal" you meant "phlebectomy", it is effective and safe, but temporary. The best would be to identify the cause of your varicosities with appropriately performed ultrasound and address the root of the problem, rather its sequences. You must have either saphenous or perforator incompetence. Deep veins have nothing to do with it. Hope it helps.

Lev Khitin, MD, FACS
New York General Surgeon
5.0 out of 5 stars 4 reviews

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.