Sclerotherapy Course

Lesson 1 • Sclerosant Pharmacology Basics

Introduces detergent, osmotic, and chemical sclerosant categories with mechanisms of action. Builds pharmacological literacy needed for agent selection in later chapters.

Lesson 2 • Venous Anatomy and Physiology

Covers superficial and deep venous systems, valvular function, and hemodynamic principles. Provides the anatomical map essential for safe injection targeting.

Lesson 3 • Pathophysiology of Venous Disease

Explains chronic venous insufficiency, varicose vein formation, and telangiectasia development. Links disease mechanisms to sclerotherapy's therapeutic rationale.

Lesson 4 • History and Evolution of Sclerotherapy

Traces sclerotherapy from 19th-century origins to modern evidence-based protocols. Contextualizes current techniques within a century of clinical refinement.

Lesson 1 • Treatment Planning and Goal Setting

Translates assessment findings into a sequenced, vessel-specific treatment plan. Aligns clinical goals with patient expectations to support adherence.

Lesson 2 • Comprehensive Medical History Intake

Structures the history-taking process to uncover cardiovascular, hematologic, and allergic risk factors. Directly informs contraindication screening covered in the next section.

Lesson 3 • Duplex Ultrasound Screening Principles

Introduces B-mode imaging and color Doppler for reflux detection before treatment. Establishes the diagnostic baseline required for ultrasound-guided procedures.

Lesson 4 • Physical Examination Techniques

Teaches inspection, palpation, and percussion of the lower extremity venous system. Findings guide vessel mapping and treatment prioritization.

Lesson 1 • Sterile Preparation and Aseptic Technique

Establishes aseptic preparation protocols for drawing, mixing, and labeling sclerosant syringes. Prevents infection and medication errors at the point of preparation.

Lesson 2 • Concentration Selection by Vessel Type

Maps sclerosant concentration to vessel diameter, type, and location using evidence-based guidelines. Prevents under- or over-treatment errors in clinical practice.

Lesson 3 • Detergent Sclerosants in Depth

Examines polidocanol and sodium tetradecyl sulfate: concentrations, foam conversion, and clinical profiles. Provides the agent knowledge base for all subsequent technique chapters.

Lesson 4 • Foam Sclerosant Preparation

Teaches the Tessari and double-syringe techniques for producing stable, consistent foam. Foam quality directly affects efficacy and safety in larger vessel treatment.

Lesson 1 • Treating Small Varicose Veins

Extends injection skills to larger, palpable varicosities using higher concentrations and foam. Introduces the concept of treating proximal sources before distal branches.

Lesson 2 • Treating Telangiectasia and Reticular Veins

Applies injection fundamentals to fine vessels using magnification and low-concentration agents. Addresses the unique challenges of small-caliber vessel targeting.

Lesson 3 • Needle Insertion and Vessel Entry

Teaches bevel orientation, insertion angle, and tactile feedback for reliable vessel cannulation. Correct entry technique minimizes extravasation and patient discomfort.

Lesson 4 • Workspace and Equipment Setup

Defines the optimal treatment room layout, lighting, magnification, and emergency equipment placement. A properly configured workspace reduces procedural errors and response time.

Lesson 1 • Ultrasound Equipment and Image Optimization

Covers transducer selection, gain settings, depth adjustment, and Doppler modes for vascular imaging. Optimized imaging is the prerequisite for safe needle visualization.

Lesson 2 • Real-Time Monitoring and Endpoint Recognition

Uses ultrasound to confirm sclerosant distribution, detect spasm, and identify foam migration. Teaches procedural endpoints that signal successful vessel obliteration.

Lesson 3 • Needle Visualization Techniques

Teaches in-plane and out-of-plane needle approaches with real-time tip tracking. Reliable needle visualization prevents inadvertent arterial or deep vein injection.

Lesson 4 • Small Saphenous and Perforator Veins

Extends ultrasound-guided skills to the small saphenous vein and incompetent perforators. Highlights proximity risks to the sural nerve and deep system.

Lesson 1 • Patient Self-Care Instructions

Equips patients with written and verbal guidance on activity, hygiene, and warning signs. Clear self-care education reduces preventable complications and unplanned contacts.

Lesson 2 • Immediate Post-Procedure Monitoring

Defines the observation period, vital sign checks, and ambulation protocol following injection. Early detection of adverse reactions depends on structured post-procedure surveillance.

Lesson 3 • Compression Garment Selection and Application

Covers stocking classes, bandage types, and correct application technique for different vessel treatments. Proper application prevents pressure ulcers and ensures therapeutic pressure delivery.

Lesson 4 • Follow-Up Assessment and Retreatment Planning

Structures the follow-up visit to evaluate vessel response, residual disease, and retreatment need. Connects outcome assessment to the treatment planning skills from Chapter 2.

Lesson 1 • Extravasation and Tissue Injury

Manages inadvertent perivascular injection with immediate dilution, hyaluronidase use, and wound care. Timely intervention limits the extent of tissue damage.

Lesson 2 • Allergic and Anaphylactic Reactions

Distinguishes mild allergic responses from anaphylaxis and outlines the emergency response protocol. Preparedness for anaphylaxis is a non-negotiable clinical competency.

Lesson 3 • Minor Cutaneous Complications

Addresses hyperpigmentation, matting, urticaria, and localized skin reactions with prevention and treatment strategies. These are the most frequent adverse outcomes in clinical practice.

Lesson 4 • Thrombotic Complications

Covers superficial thrombophlebitis, deep vein thrombosis, and pulmonary embolism risk, detection, and response. Builds on DVT risk knowledge from the patient assessment chapter.

Lesson 1 • Recurrent and Residual Varicose Veins

Addresses neovascularization, anatomical variation, and prior surgical scarring that complicate retreatment. Requires integration of all prior assessment and technique skills.

Lesson 2 • Pelvic and Vulvar Varicosities

Extends sclerotherapy to pelvic origin veins and vulvar varicosities using specialized imaging and access. Addresses the unique anatomical and patient-comfort challenges of this region.

Lesson 3 • Venous Malformations

Introduces direct puncture sclerotherapy for low-flow venous malformations using ethanol and foam agents. Requires advanced imaging interpretation and multidisciplinary coordination.

Lesson 4 • Combining Sclerotherapy with Other Modalities

Integrates sclerotherapy with laser, radiofrequency ablation, and phlebectomy in a staged treatment plan. Optimizes outcomes by selecting the right modality for each vessel type.