Superficial thrombophlebitis of the venous dorsal arch of the foot and deep venous thrombosis after foam sclerotherapy

Abstract

Four days after foamsclerotherapy of an incompetent great saphenous vein of the left lower leg a 49-year-old woman developed a superficial thrombophlebitis of the venous dorsal arch. In the course of follow-up repeated color duplex sonography initially did not show involvement of the deep venous system and, hence, she was treated with non-steroidal anti-inflammatory drugs and compression hosiery. However, six weeks after foam treatment we diagnosed a deep venous thrombosis (DVT) of the popliteal vein and started an oral anticoagulant therapy. Although rarely observed, DVT is among the most serious complications of foamsclerotherapy Therefore, we suggest that the occurrence of a superficial thrombophlebitis that is not located in close vicinity of the vein treated should be an indication for regular follow-up examinations to prevent missing the occurrence of disease progression and a possible involvement of the deep venous system.

Safety Concerns for Sclerotherapy of Telangiectases, Reticular and Varicose Veins

“…It occurs primarily after treatment of larger varicose veins and is manifested by an area of erythema, heat, and tenderness over an indurated venous segment. This usually develops within a few weeks of treatment and involves the treated area or a venous segment proximal or distal to the injection site [21] . In case of post sclerotherapy superficial thrombophlebitis, assessment should be made to understand the involvement of the proximal saphenous veins and concomitant deep vein thrombosis.…”