I had foam scleotherapy 16 days ago on a very superficial varicose vein behind my left knee. The surgeon injected the vein with foam; however, at that moment, I felt pain along the vein in my inner thigh. I had severe bruising along this vein even though it was far from the site of injection. I now still have bruising and there are palpable tender lumps along the length of the vein on my inner thigh for about 4-5 inches. Is this normal? What do I do?
It sounds as if the vein has become clotted as a result of the foam sclerotherapy. This can happen and is a normal reaction to foam in a varicose vein. Moist heat to the hard areas and ibuprofen should help. Try this for one week and if no improvement, then follow up with your treating physician for possible drainage of the clotted area.
Published on Jul 11, 2012
This is the reason we do not inject larger varicose veins on the surface. As a board-certified, vascular-trained surgeon, I remove these through tiny punctures under local anesthetic. Injections cause areas of trapped blood, and your doctor should drain these. These areas of trapped blood typically appear around 10-14 days.
Have you had an ultrasound evaluation for underlying saphenous reflux? If present, it should be treated also or you will continue to develop varicose veins.
Published on Jul 11, 2012
This is the common presentation of blood trapped within the treated vein. This causes a great degree of tenderness when pressed on. Trapped blood is easily and nearly painlessly removed by the doctor that treated that leg. We do not charge for the removal of trapped blood and I would not expect anyone to charge. One would want to have this checked and removed as soon as possible to make the extraction complete.
Published on Jul 11, 2012
You had a vein treated in the popliteal crease. I have to assume that this vein was a tributary of the great saphenous vein because after injection, you have developed thrombophlebitis in the inner thigh where the saphenous tributaries or the great saphenous vein courses. The distribution of the "palpable cords" in the inner thigh highly suggests that either the great saphenous segment in the lower leg itself or its tributaries have also undergone "successful sclerotherapy" in that they have closed. The fact that they are felt through the skin indicates that they are superficial and not deep veins. As long as a deep vein clot has been excluded by venous Doppler ultrasound scanning (Duplex scan), then the way you treat superficial vein thrombophlebitis is topical (dry) heat, ibuprofen and leg exercise. The inflammation will eventually subside. Ambulation on a regular basis is also recommended to prevent development of deep vein clots. Once the inflammation subsides, your vein doctor can decide if you need additional microphlebectomy to remove any of these thrombo-obliterated superficial veins.
Published on Jul 11, 2012
You may require a phlebectomy after careful assessment and a prior ultrasound before that.
Published on Jul 11, 2012
It is not uncommon to have hard lumps at the site of clotted veins where you've had foam sclerothearapy. You shouldn't have too much pain during the treatment, as long as tiny needles are used and the foam is injected into the vein. Depending on how much foam is injected, you can get clots along the length of the vein treated and a fair distance from the injection site. These clots start to get tender 5-7 days after treatment. If this is what's going on, your provider might consider puncturing the clotted vein and expressing the trapped blood. A follow-up ultrasound should help to clear this matter up as well.
Published on Jul 11, 2012