Extensive tissue necrosis following high-concentration sclerotherapy for varicose veins.

BACKGROUND

Tissue necrosis after sclerotherapy has been observed, but is unexplained.

OBJECTIVE

To present the complication of extensive tissue necrosis following high-concentration sclerotherapy for varicose veins.

METHODS

Cases coming to the attention of the authors are presented briefly with commentary and discussion to explain the mechanisms of tissue destruction.

RESULTS

Although the complication of extensive tissue necrosis has been ascribed to intra-arterial injection, in fact, careful study of the cases described here shows that intravenous injection was present in each case. A theory of distribution of the sclerosant into the arterial arborization is proposed. This theory would explain the distribution of sclerosant into the arterial tree and would also explain the causation of extensive tissue necrosis. Mention is made of experimental work in which intra-arterial injection was not the mechanism of causation of tissue necrosis.

CONCLUSION

Extensive tissue necrosis following high-concentration sclerotherapy may be rare, but its occurrence is serious and its treatment may be incomplete.