Sclerotherapy – from historical research to the modern and efficient method of phlebological treatment

Venous insufficiency most likely accompanied humanity from the moment that man adopted an upright posture. The beginnings of sclerotherapy go back many years – it was in the Classical Era that Hippocrates recommended puncturing varicose veins. In fact, minimally invasive treatment became available only in the mid-nineteenth century, when Francis Rynd invented the hypodermic needle, and Charles-Gabriel Pravaz in 1851 introduced a hypodermic syringe. It was already more than 100 years ago that chemicals were injected into veins to get rid of varicose veins. The pioneer of phlebology is considered to be Professor Paul Linser. In the 1920s, he used 1–2% mercury perchloride injection in over 6000 patients. In the 1960s, George Fegan presented modern compression sclerotherapy in the journal The Lancet, which again popularized this method. In 1963 Doctor Peter Lunkenheimer used polidocanol for the first time in his patient. The era of foam sclerotherapy began when, in 1939, Stuart McAusland performed and described obliteration with foam. The introduction of ultrasound to sclerotherapy was a milestone along with the discovery that foam is visible on ultrasound. The precision of the method has reached an unprecedented level. Contemporary guidelines for sclerotherapy were presented in a document during a Guideline Conference held by the German Society of Phlebology in 2012. In the 21st century, along with the development of minimally invasive medicine, sclerotherapy has once again gained an important position in the treatment of veins.