Side Effects and Complications of Ultrasound-Guided Foam Sclerotherapy

The idea of treating varicose veins in outpatient clinic conditions, at low cost, has made sclerotherapy an attractive option that is becoming more and more popular. Foam sclerotherapy method has made it possible to reduce the concentration and amount of a sclerosing agent injected into the vein with improved safety and better results compared to classical sclerotherapy.

So far, foam sclerotherapy has proven effective in the treatment of varicose veins of the main tree, diseased perforant veins, other varicose veins as well as reticular veins and telangiectasias (spider veins).

The most common complications of sclerotherapy are "matting", hyperpigmentation, necrosis, allergic reactions and thrombophlebitis. These complications are less complicated from the medical point of view, but they can be very disturbing for the patient. Rare, but more serious complications are deep vein thrombosis, thromboembolic complications, sclerosing drug injection in the arterial blood vessel, peripheral nerve injury.

Skin necrosis most often occurs when the sclerosing agent exits the blood vessel into the surrounding tissue. This complication is relatively rare with experienced physicians. Skin necrosis can also occur in certain cases when there is so-called arteriovenous malformation and when there is excessive local compression at the injection site of the sclerosing agent. The most important prevention of these complications is a careful and precise technique. Fortunately, the wounds that occur are usually very small, up to 4 mm in diameter. These wounds spontaneously heal with an acceptable aesthetic effect.

"Matting" is the appearance of small red new veins in patients who have undergone sclerosis or venous surgery. These changes are particularly noticeable on the thigh, the inner part of the ankle and the lower leg. The percentage of occurrence is 15-24%. "Matting" usually disappears after 3-12 months, and sometimes it can remain permanently. If these changes occur, clinical follow-up is advised and, if changes are not withdrawn, it is necessary to repeat the sclerotherapy.

Hyperpigmentation is the pigmentation of the blood vessel treated with sclerotherapy, most often with often brown colour. In 70% of cases hyperpigmentation is withdrawn after 6 months, and in 10% of cases it permanently remains, but in the further plan of treatment can be treated with a laser.

Allergic reactions can be local and systemic and are treated in the classic way of treating allergies.

Thromboembolic complications are very serious, but also very rare. In large studies, about 1% of deep vein thrombosis was recorded, while embolic complications are very rare.

Superficial thrombophlebitis is a relatively harmless complication that occurs most commonly on the second day after intervention and after 4 days it passes spontaneously.