MICROSCLEROTHERAPY MASTERCLASS

This MICROSCLEROTHERAPY MASTERCLASS WEBINAR, hosted by Haroun Gajraj, brings together leading UK experts and board members of the British Association of Sclerotherapists (BAS). The panel, featuring aesthetic nurse Emma Kelliher, consultant vascular surgeon Zola Mzimba, and technical expert Richard Oliver, discusses the clinical treatment of leg spider veins.

The discussion covers a broad range of professional topics, from patient selection and the necessity of duplex ultrasound scans to the management of common complications like hyperpigmentation and matting.

Video Timestamps

00:00 – Introduction and meet the experts

01:40 – Patient selection: Clinical examination vs. Duplex ultrasound

09:52 – Does treating proximal reflux improve microsclerotherapy outcomes?

15:39 – The consent process: Discussing rare risks like stroke and TIA

20:06 – Safety data and neurological adverse events

26:09 – Selecting sclerosants: Liquid vs. Foam

29:19 – Off-label use and the importance of correct dilution

33:31 – Evidence review: Cochrane results on foam vs. liquid for telangiectasia

48:38 – Post-treatment care: Are compression stockings necessary?

52:20 – Managing hyperpigmentation and staining

01:02:40 – Understanding and treating telangiectatic matting

01:05:38 – Rare complications: Skin ulceration and healing

01:13:28 – Managing veno-arteriolar reflex (spasm)

01:14:38 – Technical pearls: Syringe size and needle bending

01:23:43 – Visualization tools: Veinlite, Syris, and near-infrared imaging

01:36:15 – Q&A: Addressing resistant veins and patient-specific contraindications

01:46:25 – BAS membership benefits and closing remarks

Key Discussion Points

• Duplex Ultrasound Usage: Experts debate whether a full duplex scan is required for every patient or if a thorough history and clinical examination are sufficient for purely cosmetic vessels.

• Liquid vs. Foam for Spider Veins: A review of current literature suggests no significant difference in efficacy between liquid and foam, although some evidence indicates a higher risk of matting with foam.

• Informed Consent: Why practitioners are increasingly discussing extremely rare but serious risks, such as stroke, to ensure patients are fully informed according to modern legal standards.

• Visualization Aids: The use of adjuncts like cross-polarized light (Syris headlamp) and transilluminators to improve injection accuracy and identify hidden feeder veins.