Undesirable effects of foam sclerotherapy.

Adverse effects of foam sclerotherapy.

Foam sclerotherapy is one of the treatments for symptomatic venous disease and has been widely used for over 25 years due to its efficacy and safety. The annual number of sclerotherapy procedures performed in France is estimated at 1.3 million. Our review of the literature identifies and analyses the adverse effects of foam sclerotherapy, which have led the health authorities to take new measures to limit the indications, concentrations and volumes of foam sclerotherapy due to serious adverse events that have recently occurred. The most frequent adverse events are «minor» events represented by superficial venous thrombosis, inflammatory scleritis, skin pigmentation, pain caused by an injection or persistent pain in the sclerosed area. Serious adverse events associated with foam sclerotherapy, including cardiac arrest, arterial thromboembolic events, pulmonary embolism, deep vein thrombosis, skin necrosis or anaphylactic shock are rare. – The incidence of pulmonary embolism and deep vein thrombosis is estimated to be less than 1 % each. – The incidence of systemic allergic reactions is estimated at 0.3 %. – A review of the literature revealed 6 deaths since the use of foam in 1995, two of which occurred after 2008. 3 mechanisms of action have been suggested to explain these serious adverse reactions : massive embolism, severe vasoconstriction and polidocanol cardiotoxicity.