Spider and reticular veins around the ankle always have a source that must be identified. In this patient the GSV and Cockett’s perforator were normal. Her etiology is incompetent reticular veins, secondary to a small perforator from the anterior tibial vein. Four modalities of treatment were done as is common in all of our treatments. […]
Ankle spider veins can be hard to clear. Reasons include higher venous pressure at the ankle, numerous venous inflow paths, and due to lack of subcutaneous tissue the greater propensity to ulceration. This is before and after at 20 minutes post sclerotherapy with Sotradecol 0.15% 1/2 N S followed by bacteriostatic water flush.
Treating ankle veins can be a challenge. You can get excellent results using appropriate techniques.