Sclerotherapy Complications

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16 feb 2017

Quite often, our patients ask a question: are there any complications after sclerotherapy procedures and how often? - Yes, there are quite often, but most of the complications are not serious and disappear in a short time. Next, we will tell you about the most common complications after sclerotherapy:

 

Pain (found in 50% of cases) and pain in venous sclerosis, a fairly common complication, most often manifested in the evening and night after the procedure. This is due to slight perifocal inflammation around the sclerotic vein. The pain syndrome is easily stopped by walking or taking NSAIDs (paracetamol). Extremely rare is a prolonged pain syndrome, more than 1-2 days.

 

Bruises, ecchymoses and hematomas (occur in 30%-40% of patients) are formed at the sites of sclerosant injections as a result of blood entering outside the vein, either due to a violation of the compression regime, or as a result of the individual characteristics of the skin and the homorheological properties of the patient’s blood. These manifestations disappear within 7-20 days without any specific treatment; using heparin-based ointments it is possible to speed up the process of “resorption of bruises” up to 7-10 days.

 

Edema (occurs in 30% of cases) often occurs with sclerosis of large veins below the knee joint and / or inadequate compression therapy. Edema syndrome resolves on its own within 1-2 days, subject to all recommendations.

 

Hyperpigmentation (found in 30-50% of cases) is the appearance of dark traces along the sclerotized veins and at the injection sites of sclerosant. This is due to the impregnation of the skin with hemosiderin, a dark yellow pigment that is formed as a result of the dissolution of the coagula formed inside the vein after the procedure. In most patients, hyperpigmentation disappears completely in the period from 3 weeks to 6 months. However, in 5% of cases, hyperpigmentation can persist up to 1-2 years.

 

Matting (skin matting) or “vascular haze” (noted in 20-30% of cases) is the appearance of a dark gray “halo” around sclerotic veins or the formation of small telangiectasias. Skin matting occurs as a result of a significant increase in regional venous pressure in places of sclerotic veins. In most cases, the "vascular haze" disappears in the period from 1 to 12 months. In 0.5% of cases, matting remains forever.

 

Transient blindness (from 0.01 to 0.2% of cases) is a transient violation of the visual analyzer lasting less than 2 hours. The development mechanism is not well understood and is unlikely to cause serious concern; it goes away on its own.

 

 

Skin necrosis and ulceration (found in 0.2% of cases) is an extremely rare complication that occurs with individual intolerance to the drug, or after the introduction of a sclerosant under the skin (past a vein). In rare cases, skin necrosis and ulceration can occur if the compression regimen is not observed.

 

Allergic reactions (from 0.01 to 0.2%) - a reaction of the body's hypersensitivity to the introduction of sclerosant, is extremely rare. In most cases, it is asymptomatic, in rare cases it requires the use of resuscitation measures.

 

Paresthesia (from 0.1 to 0.2%) is numbness or decreased sensitivity in places of sclerotherapy, the cause of which is the effect of sclerosant on the sensory nerves. Treatment does not require passes independently in the period up to 2-3 months.

 

Deep vein thrombosis (less than 0.01%) the formation of blood clots in the deep veins of the lower extremities. An extremely rare complication after sclerotherapy, the literature describes isolated cases of DVT after scleroobliteration of the trunks of the large and small saphenous veins.

 

In conclusion, I would like to note that it is not possible to predict 100% how the patient's skin will respond to sclerotherapy. As a rule, after the first session of sclerotherapy, it is possible to predict local changes in the skin and the timing of obtaining the desired, cosmetic treatment result. Sclerotherapy is an effective, non-surgical method for treating varicose veins, but only in “experienced hands”.

 

You can find the results of sclerotherapy in the AngioLife vascular center here.

 

 

 

 

Author: Alexandr Voloshyn MD ©