Chapter 14 - Sclerotherapy treatment of telangiectasias

Abstract

Telangiectasias or angioectasias are small dilated-blood vessels near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter. They can develop anywhere on the body, but are commonly seen on the face around the nose, cheeks, and chin. They can also develop on the legs, specifically on the upper thigh, below the knee joint, and around the ankles. High-pressure reflux through failed valves is at the root of nearly all telangiectatic webs, although there are some exceptions due to A–V malformations or shunts. The first treatment session is usually limited to a small number of sites in order to observe the patient for any allergic reactions, and the ability to tolerate the burning or cramping of a hypertonic solution, to judge the effectiveness of a particular concentration and class of sclerosing agent, and to observe the ability to comply with compression. Concentrations of sclerosants used for telangiectasias are less than those used for reticular veins. Typically, the solutions are not foamed. When sclerosing solutions are injected into telangiectasia, blood is usually flushed out of the vessel ahead of the solution, thus the sclerosant is usually not diluted at all. When based upon a correct diagnosis and an appropriate treatment plan, sclerotherapy is a highly effective method of treatment for telangiectasias.