How I started doing this procedure?
Till 1990, I used to do the
conventional Trendelenburg’s Operation and Stripping in most of
my patients. Later I changed to Subfascial ligation and
excision. From 1995 onwards I started doing the Sclerotherapy.
This was reserved exclusively for very aged patients with
nonhealing varicose ulcers, who were otherwise misfit for
surgery. Finding the procedure excellent I started doing on more
patients. Cases are well studied, documented and followed up
from 1997. Patients started coming by hearing from those
patients who previously underwent the procedure and slowly the
technique became accepted. Patients started coming in large
numbers demanding Sclerotherapy to be done for them. Slowly we
started getting patients from nearby districts. The patients’
acceptance and satisfaction helped us to get more and more
patients from all over Kerala, all over India, from Lakshadweep,
Gulf Countries, Europe, Africa and United States.
How I do it?
I do the FOAM SCLEROTHERAPY and the solution used is Polidocanol
(POL) or Sodium Tertradecyl Sulfate (STS) in varying dilutions
at multiple sites and varying postures. The whole procedure
takes hardly 10 minutes. No anesthesia is required. Patients
come usually in the morning and go back home in the evening.
My Experience with Sclerotherapy
Out of more than 2400 patients who underwent this minimally invasive procedure, my observations are as follows:
i. Most of the patients (60%) belong to Class VI (CEAP) Group (with non healing extensive Ulceration of foot). About 20% with Class V (recurrent or healed ulceration); 10% with Class IV (Eczema, Extensive leg Hperpigmentation, Lipodermatosclerosis); 7% with Class III disease (Lower limb edema) 3% with Class II & I (Classical Varicose Veins & Spider/ reticular veins).
ii. Out of 500 patients, one patient develops allergy to the drug.
iii. Only one incidence of Deep Vein Thrombosis is reported so far.
iv. About 20 % of patients have some dryness of mouth and mild heaviness of head during the procedure.
v. Dark staining along the length of vein is observed in some cases
vi. 5% patients develop hypotension and hence the procedure should be done in the operating room with monitoring facility.
vii. Recurrence after the procedure is less than10%, which can be corrected easily by Sclero at those sites.
viii. Two cases of local Hirsutism have been reported.
ix. Blister formation, ulceration and cellulitis occur rarely when given for spider veins of the foot.
x. Foam Sclerotherapy is excellent especially in the sense; the quantity of drug can be remarkably reduced and side effects very little.
xi. Sclerotherapy is equally effective in very large sized, midsized and in Spider/Reticular veins.
xii. Selection of Surgeon is the most important factor in the final outcome of success rate and not the choice of method of treatment.
Cost of treatment
Unimaginably low cost of
Incomparable low cost of treatment for varicose veins, anywhere
in the world compared to any other technique
Photo gallery …….
Procedure Acceptance Graph
The following graph is self
explanatory as to the acceptance and patient's satisfaction :