Diagnostic et traitement des varices des membres inférieurs - KCE

34 Varicose Veins KCE Reports 164
6.3 SCLEROTHERAPY
Adverse events reported from included studies in section 5.3 were:
• tissue necrosis
• skin staining/ pigmentation
• matting (formation of microtelangiectasias)
• induration
• risk of deep venous thrombosis
A large prospective, multicentre, controlled study enrolled 1025 patients undergoing
foam sclerotherapy. This study reported one case of septicaemia, one transient ischemic
attack and 11 venous thromboembolic events (including one pulmonary embolism) 124 .
A RCT compared sclerotherapy foam concentrations (1% versus 3% polidocanol
sclerosant foam) in 143 patients. At 3 years the incidence of local side effects
(pigmentation and matting) did not significantly differ between groups (6% and 9%
respectively) 79 .
A review by Guex et al. summarised the complications of sclerotherapy, based on the
literature and on a French registry 125 . The estimates of the incidence of complications
were higher for foam sclerotherapy (0.58%) than for liquid sclerotherapy (0.55%).
Matting and residual pigmentations are common (1% to 10%) for foam sclerotherapy
and uncommon (0.1% to 1%) for liquid sclerotherapy. Among the most serious
complications, deep venous complications after foam sclerotherapy is the most frequent
one with an estimated range between 0.09% and 0.2% in the French Registry (n=12173
sessions) 125 . Deep venous complications and large skin and muscular necrosis are also
mentioned for liquid sclerotherapy but less frequently reported (