Complications of varicose vein treatment
Complications of injection sclerotherapy
On the whole this is a safe technique and can give good results if used in appropriate cases. Complications may include:
 | Anaphylaxis - a major allergic reaction to the substance used. This requires emergency treatment. |
| Allergic rash - this may be to the substance injected or to the bandages or dressings used. |
| Ulceration - if the substance is injected under the skin by mistake. |
| Arterial injection - rare but can be a catastrophy if this is into a major artery. |
| Superficial thrombophlebitis - this happens if the vein is not fully emptied before the injection and then not properly compressed. |
| DVT - deep vein thrombosis. This will need treatment with blood thinning tablets (warfarin) for 3 months at least. |
| Nerve damage - if the injection is into a nerve. |
| Pigmentation - if the substance leaks out of the vein into the fat beneath the skin. |
Complications of long saphenous surgery
Minor complications may arise in up to 20% of patients. They include:
| Scars and spiders - thread veins may appear at the sites of vein removal but this is very variable. |
| Haematoma - blood may accumulate in the groin. Rarely it may need a second operation to drain it. |
| Recurrence - varicose veins may come back after perfectly adequate surgery. This is due to leakage at another junction or due to neovascularity in the groin (this is the growth of new little veins). |
| Numbness and pain - this may be patches on the leg or, if the saphenous nerve is damaged, around the inner ankle. This may affect up to 10% of patients. |
| Wound infection - primarily in the groin in up to 5% of patients. Rarely an abscess may form requiring a second operation to drain the pus. |
| Lymphatic leak - rarely a problem in the groin. |
| Blistering - at avulsion sites or as a reaction to the bandages. These blisters are usually superficial and heal without scarring. |
| Leg swelling - usually not a problem for first time surgery. More of a problem for redo groin surgery. |
Major complications occur in under 1% of patients. They include:
| Deep vein thrombosis and pulmonary embolus (when the clot dislodges and moves to the lungs). |
| Major deep venous damage - usually when the junctions are tied off. |
| Arterial damage - rare. |
VNUS Closure has similar complications except groin infection as there is no incision here. The main advantages of this procedure are less pain and faster recovery.
Complications of short saphenous surgery
Essentially the same as long saphenous surgery except that damage to major nerves at the back of the knee can affect the muscles of the calf and shin. Ankle movements may thus be affected ('foot-drop'). This is a very rare complication and usually due to lack of experience operating in this area.
The sensory nerve that may be affected is the sural nerve. This runs down the back of the calf and supplies the skin of the lower calf, back of ankle and into the sole of the foot.
Complications of SEPS
The complications are essentially the same as long saphenous surgery with the addition of haematoma formation along the track of dissection and subsequent infection of this.