Should I Get Venous Doppler Studies Before Sclerotherapy?

Important considerations in sclerotherapy include the proper use of sclerosant solutions, but more importantly, the technique used for injection. Larger veins should be addressed prior to smaller end branches. As a fellow of the American College of Phlebology and a double board certified surgeon who is a Diplomate of the American Board of Phlebology and the American Board of Plastic Surgery, it is important for me to evaluate these venous patterns in a logical and comprehensive fashion prior to having treatment. Do not focus on the sclerosant as much as the surgical planning and knowledge of the treating physician.

The experienced vein specialist should be able to detect during the first consultation if you need additional study before proceeding with the sclerotherapy. In some cases it might be necessary to get an ultrasound to make sure there is not a problem with a blood flow in the main vein. If such occurs it must get resolved first for the sclerotherapy to be effective.

My recommendation to do a venous reflux doppler exam prior to sclerotherapy depends on several factors including amount of spider veins, location of spiders, family history, pregnancy history and response to prior sclerotherapy treatments.  If I am suspicious of reflux then I would recommend a pre treatment full venous evaluation.  This exam gives a lot of useful information as far as ability to respond to treatment and risk of future vein formation.