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Possible Complications of Non-Surgical vein Treatment
There are a number of possible complications that can occur with sclerotherapy and EVLTTM, even when the greatest of care is taken(12,13,14,15):
- Pigmentation(5,16,17,18,19,27) is the appearance
(1:10)(1) of brown marks on the skin located over or near the treated veins. This is a common consequence of therapy, particularly when treating spider vein clusters with injection microsclerotherapy. Pigmented areas are composed of haemosiderin (a form of iron) that can become trapped in the skin. In most patients the pigmentation gradually fades, disappearing completely within 3-12 months although pigmentation lasting greater than 12 months has been reported in 5% of cases. Close attention to wearing the compression stocking and having trapped blood removed at your follow-up appointments will minimize pigmentation. It is advisable to stop iron supplements before your treatment. Recently, topical laser therapy has proved promising in reducing areas of pigmentation.
- Matting(18) is the development of extremely fine networks of spider veins likely to occur on the outer and inner thighs. Matting usually resolves spontaneously though some will resolve with further injection treatment. Some may persist despite further treatment. Matting is more common in people with extensive surface veins and in overweight people with poor muscle tone. Matting can also follow the surgical removal of varicose veins 18. Matting is not seen with EVLTTM.
- Hair growth at sclerotherapy injection sites can occur but is mild, quite localized, temporary and rare. It resolves spontaneously over several weeks.
- Swelling of the leg or ankle occurs occasionally
(2:100)(1) and will settle with time. It is due to inflammation of the skin. Wearing the compression stocking, elevating the leg when sitting and regular walking will help.
- Numbness of the skin(14,20) is rare and temporary
(3:1000)(1) but can last up to three months. It is usually located down the inner aspect or back of the calf. It is due to irritation of nerves that lie in close proximity to an injected vein. Numbness can be expected for a few hours with EVLT™ procedures as local anaesthetic is used to anaesthetize the vein to be treated.
- Migraine sufferers may experience visual disturbances (1:1000)(1) lasting a few minutes and can occur in patients treated with injection sclerotherapy. This may be followed by the onset of a headache (2:1000)(1). Taking a mild analgesic such as Panadol or Panadeine or anti-migraine medication can provide relief. Should you suffer with migraines then it is best to attend with a friend to assist with driving home.
* Ulcers 16,18,21 of the skin are rare and usually appear as small, painful sores within two weeks of injection scleotherapy treatment (9:1000)(1). They heal slowly and leave a scar, which can be excised if unsightly. They occur due to sclerosant passing from the injected veins into the small associated skin arteries 4. Ulcers are more common in people who smoke cigarettes or who have certain associated skin conditions. Ulcers are not seen with EVLT.
- Allergic reactions(22,23,24,25) to either the sclerosant used or to the local anaesthetic are rare (3:10,000)(1) but may be serious and life threatening. Some reactions require immediate treatment. Should you feel any abnormal sensations during treatment such as generalized itchiness, nausea or shortness of breath, don’t hesitate to tell Dr Loizou who will then provide the appropriate treatment.
- Deep Vein Thrombosis is a clot in the deep venous system – not in the treated varicose veins. This potentially serious problem is extremely rare if the compression stocking is worn as directed and regular daily walking is maintained. The approximate risk is less than 1:2000 patients for sclerotherapy and even less in EVLT™ cases. If your relative risk of DVT is considered increased then prophylactic treatment will be advised. Deep vein thrombosis may lead to clots in the lung (pulmonary embolism), which can be a life threatening condition requiring hospitalization. It is advisable to avoid long distance travel (greater than 4 hours duration) for at least 4 weeks following the treatment of varicose veins. Symptoms of deep venous thrombosis and pulmonary embolism include a painful swollen calf or leg unrelieved by walking, unusual shortness of breath, cough with or without blood stained sputum and stabbing chest pain. Should you experience any of the above symptoms please contact Dr Loizou immediately.
- Intra-arterial injection(21,16,18,25) is an extremely rare (1:10,000)(1) complication that can result in significant muscle and skin damage. This now rarely occurs due to the use of ultrasound guidance of the needle, which allows for a more accurate placement during the injection procedure.
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