Skin necrosis following extravasation during peripheral phlebography

Area of Science:

• Vascular Surgery
• Radiology

Background:

• Venography is a diagnostic imaging procedure used to visualize veins.
• Complications, though rare, can occur during venography.
• Skin necrosis is an infrequently reported adverse event.

Observation:

• Two cases of skin necrosis following leg venography are presented.
• These cases resulted from extravasation of the contrast medium.
• Literature review identified only four prior English-language reports.

Findings:

• Extravasation of contrast medium during venography can lead to severe skin necrosis.
• The pathogenesis involves direct toxicity and potential vascular compromise.
• Clinical presentation, course, and treatment strategies are detailed.

Implications:

• Understanding the risk factors and mechanisms of skin necrosis is crucial for prevention.
• Careful technique during contrast injection may minimize extravasation.
• Prompt recognition and management are essential for optimal patient outcomes.