Consent: Foam Sclerotherapy

This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines, and the applicable and appropriate law in your jurisdiction governing patient consent.

Overview of Procedure

Foam sclerotherapy is the injection of a sclerosant agent via a needle into unwanted veins, typically as a treatment for varicose veins. This results in irritation and scarring inside the vein, thus closing them off.

By Dr K. Fattahi [Creative Commons Attribution license (reuse allowed)]

Figure 1 – Foam sclerotherapy, performed under ultrasound guidance

Complications

Intra-Operative

Complication Description of Complication Potential Ways to Reduce Risk
Extravasation of sclerosant Occasionally the medication will be injected outside of the vein which can cause pain and ulceration. Use of ultrasound guidance to ensure correct identification of the venous structures.
Injury to surrounding structures Small superficial nerves can be damaged during cannulation. Injection into an artery is extremely rare but could cause ischaemia or scarring to the leg.
Allergic reaction Allergy to the sclerosing agent is rare but can result in an anaphylactic reaction.

Early

Complication Description of Complication Potential Ways to Reduce Risk
Pain The sclerotherapy can cause painful lumpy veins in the leg.
Bleeding/bruising There is a small chance of bleeding or bruising around the puncture sites.
Infection This is very rare.
Brown discolouration This is a relatively common side effect due to haemosiderin deposition within the skin post-operatively and can last for several months.
Spider veins These are small veins that often resolve spontaneously.
Blood clots DVTs and PEs are a possibility in any operation. The risk is increased in patients with a raised BMI, on the pill, recent flights, previous DVT, pregnancy, smokers, cancer and prolonged bed rest. The patient will be given anti-embolism stocking and low molecular weight heparin peri-operatively to minimise this risk as deemed appropriate.

Late

Complication Description of Complication Potential Ways to Reduce Risk
Reintervention Varicose veins have a tendency to reoccur later in life, requiring further intervention. Multiple treatments may also be required with extensive varicosities.

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