Case report: Inadvertent intra-arterial injection during sclerotherapy may not be the disaster you think

Abstract

Inadvertent intra-arterial injection is a rare and serious complication of sclerotherapy. Multiple treatments have been used in reported cases, with varying levels of success. We report a rare case of intra-arterial injection being treated with steroids and pulsed dye laser therapy and present a plan for future incidences. A 52-year-old woman presented to the clinic looking for aesthetic improvement to telangiectatic veins on the anterior aspect of the right leg. She developed cutaneous necrosis after sclerotherapy injection with 4 mL of 0.5% liquid polidocanol. After 23 months of pulsed dye laser therapy and a course of oral prednisolone, the patient made a good recovery and is left with minimal lasting tissue damage. More research is needed into the area of treating cutaneous necrosis with a pulsed dye laser, but this case report indicates a possible future therapeutic use after a successful outcome.