Treatment of varicose veins. An update.

The modern injection-compression sclerotherapy, as described by Fegan of Ireland and Sigg of Switzerland, bears little resemblance to the injection treatment of varicose veins as used in the United States in the 1940s. Sotredecol (sodium tetradecyl sulfate) is the agent injected, and no more than 0.5 ml is used at any one site. The sites picked are those of the incompetent perforator veins which are found by careful physical examination. The injection is made into the emptied vein with the leg raised, and a firm compression dressing is applied as the injections are made from below cephalad. The compression bandage is worn for 3 weeks. Randomized studies that compared surgery and injection-compression sclerotherapy in the treatment of varicose veins have shown little difference in the end results. The overall cost, including hospitalization, work days lost, and complications, are greater with surgery. A series of 66 patients has been analyzed.