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Venous thromboembolism after ultrasound guided sclerotherapy

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    By Katherine Kozlowski, medicsl author and contributor to Vein News and VeinsVeinsVeins.com 

    Ultrasound guided sclerotherapy is done regularly in patients with chronic venous disease using a variety of FDA approved sclerosant solutions.

    Is venous thromboembolism possible after ultrasound guided sclerotehrapy ?  This questions was asked by researchesrs at Spaco Vascular, Sao Paulo Brazil;   Brazilian Association of Phlebology and Lymphology, São Paulo, Brazil and the University of São Paulo, São Paulo, Brazil.

    The article was published in Phlebology;  2021 Apr;36(3):233-239 (see below for full reference). 

    The objective of the study was to analyze the prevalence of venous thromboembolism (VTE) after ultrasound guided foam sclerotherapy.

    Study Method:  Cliniccal retrospective study with patients treated from 2004 to 2014.

    Charts with incomplete data and follow-up less than 60 days were excluded.

    Tessari method was used to prepare foam sclerosant.

    Polidocanol foam was used in all patients.

    What was the primary outcome of this study ?   The primary outcome was the prevalence of venous thromboembolism.

    What was the secondary outcome of this tudy ?   To determine possible risk factors.

    What statistical methods were used to analyze this data ?  Chi-square test and Marascuillo prodecure were applied at a significance level of 5%.

    What are the results of this study ?

    2,616 patients were included with 4,712 lower limbs treated.

    The mean age of patients who received US guided sclerotherapy was 50.7 ± 0.86.    83.7% were female.

    Venous thromboembolism occurred in 0.49%  and pulmonary embolism 0.3% in a mean time of occurence of 44.0 ± 42.2 days.

    Male gender, personal or family history of phlebitis or DVT and high caliber varicose veins were significantly associated with the development of venous thromboembolism (p< 0.05%). 

    What are the conclusions of this study:  The incidence of venous thromboembolism is low after ultrasound guided sclerotherapy. 

    Male gender, personal or family history of venous thromboembolsima nd caliber or dimension of the injected veins larger than 7 mm increases the risk of venous thromboembolism. 

    Reference:  de Aguilar Eduardo T, Dos Santos Jorgete B, Carvalho DD.  Venous thromboembolism after ultrasound guided sclerotheray.  Phl;ebology 2021; 36(3): 233-239. 

    • Dr Karamanoukian's note:  Ambulation in the office, immediately following ultrasound guided sclerotherapy significantly reduces the likelihood of developing venous thromboembolism.  We do this procedure regularly and safely in our practice at the Vein Treatment Center. 
    Vein Treatment Center
    Williamsville, NY 
    Orchard Park, NY