Complications of sclerotherapy: methods of treatment and prevention

Abstract

Objective — to study the frequency of complications of sclerotherapy (ST), their spectrum, to determine the effectiveness of the proposed methods of treatment and their prevention. Materials and methods. The study involved 128 patients aged 18 to 65 years. The patients were divided into groups, depending on the concentration of polidocanol (0.5 and 1 %) used for sclerotherapy. Outcomes were assessed on the 2nd day, in 1 week, 1 month, 6 months, and 1 year after the procedure. The purpose of the assessment was to identify early and long-term post-procedural complications. Results and discussion. In the group of patients in whom we used 1 % polidocanol, early complications such as edema and erythema and hemorrhages occurred statistically significantly more often (p < 0.05). The most frequent long-term complication of sclerotherapy was hyperpigmentation (32.8 % of cases), which occurred more often in patients in whom we used a higher concentration of sclerosant (p = 0.024). Hypopigmentation and scarring were extremely rare. During re-examination of patients with hypopigmentation 1 year after the procedure, 61.3 % of patients showed a significant decrease in hyperpigmentation, and in the remaining 38.7 % of patients, hyperpigmentation disappeared completely. Conclusions. Local complications such as edema, erythema, hemorrhages, and hyperpigmentation occur more often when using 1 % polidocanol as a sclerosant compared to 0.5 % polidocanol (p < 0.05). Such early local negative manifestations as edema and erythema in the area of drug injection are transient and disappear without a trace in 100 % of patients within the first week after the procedure. The use of cosmetic cream with arbutin in the composition does not affect the reduction of hyperpigmentation in patients (p > 0.05).