Varicosclerotherapy complications

General definition
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Complications of a properly performed and extravasated or intra-arterial injection of the sclerosing agent:
Phlebitic irritation with local pain
Risk of local necrosis (to be assessed as low) with parainjection of the sclerosing agent. The following procedure is recommended for accidental extravasation: fan-shaped injection of 5 ml isotonic saline solution to dilute the local concentration of the sclerosing agent.
Local (injection-related) haematoma formation
Allergic reactions; also iodine allergy when using sclerosing agents containing iodine
Vasospasm
Matting (occurrence of telangiectasia in the area of the sclerosed veins); migraine-like symptoms
Flicker scotomas
Thromboembolism
Arterial injection with tissue necrotizing: in case of accidental intra-arterial injection (risk is extremely low with a practiced technique), 5000-10,000IE of heparin should be injected immediately through the remaining cannula. If this is not possible, 5000-10,000IE heparin is injected together with 250mg prednisolone i.v. To be able to perform an immediate thrombolysis attempt, an i.m. injection should be strictly avoided.
generalized medicinal exanthema (rare)
Late complications:
Hyperpigmentations
Nerve damage during extravasation
Recurrences after sclerotherapy: the tendency to recur when using non-foamed sclerosing agents is high. It is between 40 and 70% over a period of 5 years. Control of the sclerosing result.