Varicose vein treatment aftercare – rare complications

Complications after varicose vein treatment are uncommon. However, I believe it is important that you know about them, what signs to look out for, and what I do to reduce the risk.

Deep vein thrombosis (DVT)

What is a DVT?

Your leg has two sets of veins. The superficial veins lie just under the skin, and these are the ones that become varicose. The deep veins run through the muscles and carry most of the blood back up to your heart. The aim of treatment is to close the faulty superficial veins while keeping your deep veins working normally.

A deep vein thrombosis is a blood clot that forms in one of the deep veins and partly or fully blocks it.

How likely is it?

DVT used to happen in around 1 in 100 patients (1%) after traditional open surgery for varicose veins. With modern endovenous treatments, which treat the vein from the inside, the risk is much lower at around 4 in 1,000 patients (0.4%).

How I reduce the risk

The best way to prevent a DVT is to get moving soon after your treatment. This is why I encourage you to return to your normal activities as soon as possible. All of my aftercare advice is designed to keep blood flowing well through your deep veins, and regular walking is one of the most helpful things you can do.

Some people have a higher risk of DVT, including those who:

• have a high body mass index (BMI)
• smoke
• have had a DVT in the past
• take hormone replacement therapy (HRT) or the oral contraceptive pill
• are having chemotherapy

If any of these apply to you, I will recommend a course of blood-thinning injections for seven days after your procedure. These are small injections given just under the skin, which you can usually give yourself at home.

Signs to look out for

A DVT usually causes marked swelling of the whole leg and makes it difficult to walk normally.

How a DVT is treated

A DVT is treated with blood-thinning medication (anticoagulants), usually for three months. During this time, the blocked vein gradually reopens, and in the vast majority of cases the symptoms settle completely.

More serious problems are very rare after minimally invasive varicose vein treatment. One example is a blood clot travelling to the lungs (a pulmonary embolism), and only a very small number of such cases have been reported in the medical literature.

Other rare side effects of foam sclerotherapy

During foam sclerotherapy, a relatively large area of vein lining is broken down very quickly. As this happens, certain natural substances are released into the bloodstream. These are closely related to chemicals that occur naturally in the brain and nervous system.

This is the likely explanation for a small number of very rare, short-lived effects that have been reported during or shortly after treatment:

• brief changes to your vision
• a migraine-type headache
• brief weakness in an arm or leg
• a dry cough

Although these may sound alarming, they are effects that have been reported in the medical literature rather than effects I have seen in my own patients. No long-lasting damage to the nervous system has ever been described.

Allergic reaction

A true allergic reaction to the sclerosant (the medicine used to close the vein) is rare. Severe whole-body allergic reactions (anaphylaxis) after sclerotherapy are even rarer, and only a handful of individual cases have been reported.