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I had the VENUS procedure done 4 weeks ago along with foam sclerotherapy into a perforator vein about 3" above my ankle. Ultrasound shows a thrombosis in this area. It is still hardened, tender, and has not improved. What should I expect my surgeon to do?
You need to have the thrombus drained with a simple needle puncture during
your next office visit. Clot formation happens often in the veins treated by
Foam Sclerotherapy and draining the clot in 2-3 weeks helps the healing
process and relieves the symptoms. Waiting too long makes it more difficult
extract the trapped blood
Only depends on how far did the clot in the deep veins extended. If remains in the calf only, nothing to be done. If the leg is not swollen, nothing to be done. The indurated vein is expected since that is the effect of the sclerotherapy. Compression stockings everyday are very important as well as walking exercises.
Thrombosis of veins following foam sclerotherapy is common. If it is tender and palpable then is can be drained by inserting a needle into it and evacuating it.. If it is deeper and localized then local care with heat and time will usually resolve it.
There is no question that foam injected into a perforator vein can, and almost always will leak into the deep veins. That is why so much care is taken and your surgeon followed all the necessary precautions. Does the ultrasound show a thrombosis in the deep system of veins or a superficial branch varicosity? The treatment and level of concern may differ. It sounds like you have a hardened, tender area known as superficial phlebitis, which is of minor concern as long as there are no clots in the deep veins. This can occur quite commonly and will resolve in 4-6 weeks with compression (stockings) and patience. If cleared to do so, a small dose of aspirin will help.