2015;30(5)357-364. Does this look like "staining" and should I consult my Physician to have the blood removed that is sitting there making the vein more puffy, than it was prior to the injection? J Dermatol Surg Oncol. 22. It generally takes an hour or less to complete. Alternately, the doctor may administer an anesthetic and insert a catheter into the affected blood vessel, then use a solution of 90% alcohol to block the vein. If this is due to "trapped blood" the best treatment would be to remove the trapped blood for fast healing and to avoid hyperpigmentation. Complications observed in a prospective French Registryof 12 173 sclerotherapy sessions.From reference 1: Guex JJ et al. It is important to discuss the benefits and risks of sclerotherapy with a doctor, and possible coverage with an insurer, before making a decision. Goldman MP, Sadick NS, Weiss RA. 1" wide area of tons of tiny new vessels just distal to injection sites. Early administration of systemic steroids may help reduce the subsequent inflammation that causes tissue damage (grade 1C).3-5 Aspiration of blood with any remaining sclerosant followed by local intraarterial administration of heparin has not been identified in a single case report.24, Bergan et al16 recommended 6 days of therapeutic heparin to treat arterial injury following sclerotherapy. Possible risks and complications of sclerotherapy include: Also, if tiny air bubbles from foam sclerotherapy get into the bloodstream, it may cause chest tightness, a dry cough, dizziness, and nausea. Figure 1. If there is trapped blood then evacuating this does help significantly. Gillet JL. Skin necrosis from extravasation of intravenous fluids in children. Leslie-Mazwi TM, Avery LL, Sims JR. Intraarterial air thromnogenesis after cerebral air embolism complicating lower extremity sclerotherapy. (2021). Dermatol Surg. 73. Thromb Haemost. 2009;35(1):53-57. Such coagulum, which is trapped between the two ends of a treated vein, tends to remain liquefied. Local or generalized skin reactions, such as urticaria, are much more frequent (around 0.6%) than systemic involvement, and true anaphylaxis is an extremely rare complication constituting an emergency.6-10 These reactions are unpredictable. This is usually seen as a darkened area or can be felt as a hard area. Sclerotherapy usually produces some temporary discomfort. 2011;26(5):203-208. Sclerotherapy is usually an outpatient procedure that lasts 3045 minutes. Urticaria is easily treated with an oral antihistamine, but may be a sign of a systemic allergy. Recent illnesses or medical conditions, such as a heart condition or a history of blood clots. The provider examines your veins and checks for blood vessel disease. Learn how we can help 55. Would that defeat the purpose? 18. Although spontaneous resolution occurs in 70% of cases at 6 months, pigmentation may persist longer than 1 year in up to 10% of patients.2,6,63 Hyperpigmentation is usually due to a combination of both melanin and hemosiderin pigment deposits secondary to either direct hemosiderin deposition, post-inflammatory processes, or a combination of the two. Patients with superficial venous thrombosis have a 5% to 40% chance of developing deep venous thrombosis.56, Deep venous thrombosis can be ruled out in patients with superficial phlebitis using an ultrasound evaluation.56 Most patients have minimal phlebitis and require no treatment or a simple drainage of an associated coagulum with a 22-gauge needle.6 In symptomatic patients, drainage of the thrombi after liquefaction, approximately 2 weeks after sclerotherapy, hastens resolution of the otherwise slow and painful resorption process.6 Adequate compression and frequent ambulation should be maintained until the pain and inflammation resolve.