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What is Asclera used for in vein removal?

My friends have mentioned Asclera for varicose vein removal. What is it? Is it safe?


Doctors Answers (4)

Asclera is a brand name for an aqueous solution of polidocanol, which is a medical grade non-toxic detergent (soap) used to treat small veins with sclerotherapy treatment. It is injected in many locations along the vein to be treated and works locally to remove the thin inside lining of that segment of vein. This allows the vein to close and will be reabsorbed by the body and disappear usually in about 4-6 weeks. Sclerotherapy injections help remove small reticular (blue) veins and (red/purple) spider veins primarily on the legs. Compression hose are worn to help keep the veins closed for 2-3 weeks (you do not need to sleep with them) following the sclerotherapy. Baths, Jacuzzis, saunas, and hot water are avoided for the first month to help keep the treated veins permanently closed. You have the ability to grow new veins easily your entire life, but damaged veins are not reabsorbed without treatment and accumulate over time, especially following pregnancies. The treatments are FDA-approved and are both safe and effective. Mild temporary bruising is the most common side effect. Normal activities may be resumed immediately following sclerotherapy.

Asclera is approved by the FDA for treatment of spider veins and reticular veins up to 3 mm in diameter. It works by injuring the cells lining the treated veins so the veins will seal shut and the sealed veins eventually are absorbed by the body. Asclera is one of the two sclerosants commonly used to make endovenous foam for injection into larger varicose veins. Significant allergic reactions to Asclera are very rare. To put this in perspective, an injection of Asclera is safer than an injection of most antibiotics. The risks of sclerotherapy or endovenous chemical ablation include allergic reactions, deep vein thrombosis (clotting), skin ulceration, skin pigmentation, and, rarely, stroke. Any of these can happen, though serious complications of treatment are uncommon. In our experience, the risks of driving to the office appointment are greater than the risks of the procedures.

Asclera is one of two FDA-approved solutions for treating spider veins. Larger varicose veins are better removed by microphlebectomy. This is done in the office under local anesthetic with no down time. Larger veins injected with a foamed solution (either of the two above) can lead to isolated "trapped blood," which needs to be drained between treatments. It can also lead to more pigmentation over the treated veins. It usually takes multiple visits. As a vascular-trained surgeon and wanting to most effective treatment for my patients, removal is more efficient and effective for the patients and often covered by insurance if medically necessary. For smaller "feeder" veins and to the spider veins, sclerotherapy with either solution is effective. The action of each solution is similar and mostly it is personal preference of the injector. Microphlebectomy is done through tiny punctures that leave little or no marks when healed.

Asclera is an FDA-approved medication that is used in sclerotherapy to cause a vein to go into spasm and close off. It is a detergent that injures the inner lining of the vein, so the vein is destroyed from the inside out, and gradually gets re-absorbed by the body. It does not technically remove any vein - it injures it enough to become non-functioning and small so that it no longer carries blood. The body then eventually gets rid of it naturally.

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