Treatment of small bleeding varicose veins with injection sclerotherapy. Bleeding blue blebs

Bleeding is a well-recognized but seemingly uncommon complication of varicose vein disease. Some deaths have occurred in which bleeding developed from vessels in the base of chronic venous ulcers.

To elucidate a more common type of venous bleeding that can be identified and treated by an experienced sclerotherapist.

The records of a group of patients with bleeding superficial phlebectasias, primarily on the feet and ankles, are reviewed. All patients received injection sclerotherapy after the initial bleeding episode. A comparison was made between those patients whose bleeding points were sutured in the emergency department and those who were treated only with compression.

Suture-ligation of the bleeding site delayed healing when compared with simple compression. Concomitant injection sclerotherapy proved to be a successful and permanent method of treating these veins. No recurrent bleeding developed in any of the patients, even in those with previous episodes of bleeding.

Initial treatment of the bleeding blue bleb requires only compression of the tiny open vessel. Later injection sclerotherapy provides a permanent method of obliterating the thin-walled veins and prevents future bleeding. It is essential to treat the entire incompetent venous system as well as the bleeding site itself.