Reasons for Ulceration After Injection Treatment of Telangiectasia

Abstract

Understanding the mechanism of this complication can lead to its prevention. No more than 0.2 ml of sclerosant should be administered to a single site. The warning sign of backwash of sclerosant into arterials is the temporary blanching of the skin from the arterial spasm.

Laser-Doppler Examination Shows High Flow in Some Common Telangiectasias of the Lower Limb

“…[11][12][13] We agree with Goldman that the necrosis of the skin in some cases after sclerotherapy is because of the occlusion of the afferent arteriole. 1,13 Our study revealed that functioning AV shunts are present only in some cases; in other cases, one can find only perforator vein reflux, as already published by some authors. [3][4][5][6][7][8][9] It is necessary to note that studies searching for perforator vein insufficiency could not find them in every case.…”

“…According to these results, a complete AV malformation circuit could be found in some cases with afferent artery, glomus of the shunt body, and efferent, dilated, varicose veins, which drain the blood through a dilated perforator vein to the deep venous system. 13,17 These results support the opinion that the blanching of the skin during sclerotherapy is the consequence of the spasm of the afferent arteriole. [11][12][13] We agree with Goldman that the necrosis of the skin in some cases after sclerotherapy is because of the occlusion of the afferent arteriole.…”

“…13,17 These results support the opinion that the blanching of the skin during sclerotherapy is the consequence of the spasm of the afferent arteriole. [11][12][13] We agree with Goldman that the necrosis of the skin in some cases after sclerotherapy is because of the occlusion of the afferent arteriole. 1,13 Our study revealed that functioning AV shunts are present only in some cases; in other cases, one can find only perforator vein reflux, as already published by some authors.…”

“…11 • During therapy of spider veins, very diluted sclerosing solution can cause skin necrosis because the sclerosing agent thrombotises the feeding artery. 1,13 These signs drew our attention to the possibility of AV shunts behind spider veins. We wanted to find answers to the following questions: Are spider veins caused by perforator vein insufficiency or AV shunts?…”

Laser-Doppler Examination Shows High Flow in Some Common Telangiectasias of the Lower Limb

“…11 • During injection sclerotherapy, a small area of the skin around the needle sometimes whitens because of spasm of the feeding arteriole. 1,13 These signs drew our attention to the possibility of AV shunts behind spider veins. 11 • During therapy of spider veins, very diluted sclerosing solution can cause skin necrosis because the sclerosing agent thrombotises the feeding artery.…”