Acute Massive Pulmonary Embolism Following High Ligation Combined with Compression Sclerotherapy for Varicose Veins

Abstract

A case of acute pulmonary embolism following high ligation and compression sclerotherapy for varicose veins is reported. A 54-year-old women developed superficial varicosities and stasis pigmentation on her left leg 1 year prior to her first visit to hospital. No deep vein thrombosis was detected by ascending phlebography performed 3 months prior to operation. High ligation combined with compression sclerotherapy was performed for the varicose veins. One day after treatment, the patient complained of chest pain and discomfort, and then collapsed. Perfusion scintigraphy revealed multiple embolisms in the bilateral lungs. The patient recovered after aggressive anticoagulant and thrombolytic therapy. Although pulmonary embolism is a rare complication of sclerotherapy, it is potentially one of the most serious.

Controlled Radiofrequency Endovenous Occlusion Using a Unique Radiofrequency Catheter Under Duplex Guidance to Eliminate Saphenous Varicose Vein Reflux: A 2-Year Follow-Up

“…Although it is not routine to scan patients for deep vein thrombosis (DVT) detection after vein stripping or ligation surgery, published reports suggest some thrombotic and embolic risks exist with traditional vein surgery. 13,14 DVT after vein surgery has been cited as absent in one report or occurring at a rate of 0.3% and 1.1%. 5,15,16 By comparison, the rate of pulmonary embolus and DVT with catheter-based obliteration of saphenous vein reflux at our center was 0%.…”

Safety Concerns for Sclerotherapy of Telangiectases, Reticular and Varicose Veins

“…Several cases of pulmonary embolism with or without DVT have been reported after sclerotherapy including intradermal venectasies [50,51] . There is not much clarity on the true incidence of pulmonary embolism following sclerotherapy.…”

Complications of Sclerotherapy

“…Although better than liquid, foam has proven to be equally safe 26 . Several cases of pulmonary emboli have been reported, 27 with or without evidence of DVT in the limbs (rare).…”