Deep vein thrombosis: the risks of sclerotherapy in hypercoagulable states

There have been many case reports of deep vein thrombosis and pulmonary thromboembolism in patients undergoing sclerotherapy for the treatment of varicose veins, but the true incidence of venous thromboembolism in this patient population is unknown. Patients who develop deep vein thrombosis while being treated for varicose veins do so either because of an error in treatment or because the patient suffers from some underlying hypercoagulable state. It is possible to identify prospectively many patients who are at especially high risk for venous thromboembolism by virtue of genetic predisposition, past or recent medical problems, or environmental factors. When sclerotherapy is used in such patients, special efforts must be made to protect against the development of venous thrombosis during treatment.