1.SYSTEMIC ALLERGIC REACTION AND ANAPHLAXIA
Drug-related skin reactions in Foam Treatment, as in every drug use; Rash (urticaria) may occur.
It is difficult to detect drug allergies in advance.
Severe ones such as anphalaxis are very rare.
In some patients; The chances of this are higher in people with a history of allergic reactions, asthma and chronic urticaria.
Direct liquid use is more common; It is known that the use of foam reduces the risk.
For those who receive more than one session of foam treatment, it is better to reduce the dose over time.
2. TISSUE NECROSIS
Necrosis is tissue death. Here, there is a wound (ulcer) caused by both tissue death and tissue loss. Although rare, it may also involve the subcutaneous tissues.
Excessive dose or large amounts leaking into the subcutaneous tissue and or affecting the arterioles are also among the reasons. It would not be right to attribute this to medicine or doctors alone.
Osmotic substances, when the arteriovenous shunt is open and passes into the arteriolar circulation, also contribute to the vasospasm that occurs in the arterioles.
Tissue necrosis can also be seen weeks after the procedure. First, it starts like an inflammatory reaction. Pain, localized swelling, followed by crusting begin within 24-72 hours and the healing process begins immediately. Most of them mature and disappear within 2-3 weeks. The body has a powerful repair mechanism.
Direct arteriole or small artery injection is very rare. A total of 70 cases have been reported in the last 20 years. It usually occurs in injections made in large veins and arterioles. It has been reported that the chance of this is higher in injections made in the medial malleolar (ankle) area.
3.NEUROLOGICAL COMPLICATIONS
It is seen at a rate of 0-2%. The main cause can be either gas embolism, clot embolism or Patent Foramen Ovale (unclosed hole in the heart, these small holes are found in 30% of the population).
Temporary visual disturbances and major ischemia are seen in varying degrees, ranging from simple headache to major ischemia.
Visual impairments are 1.4%, all of them are temporary.
The risk of stroke was seen in two people out of 4059 cases. 0.01%.
What to do to prevent:
- � Foam treatment should not be applied to very large veins.
- The foam should be prepared with low liquid and consumed within 60 seconds.
- The foam should be prepared separately for each session.
- More than 10 ml of foam should not be used in each session.
- You should rest for 5-10 minutes after the procedure.
- Straining should be avoided.
- Rest period. A bandage should be applied afterwards.
OTHER PROBLEMS AFTER FOAM TREATMENT
- CLOTS IN THE VESSEL
Apart from the superficial large-diameter veins, the most feared is the superficial one. It is a clot in a deep vein, not a vein. We call this Deep Vein Thrombosis (DVT).
Let's clarify one point here; This rate is even lower in superficial capillaries and small diameter vessels. Since most of the patients are in this group, you do not need to worry about this.
The gastrocnemius middle vein, called the posterior calf muscle below the knee, is seen. In foam treatments applied to the back area below the knee, thrombosis may occur in the vein called the Small Saphenous Vein.
What we all fear is the formation of a clot in these veins followed by a clot in the lung, called "pulmonary embolism". This is a very serious situation. Life-threatening is the prevalence of clots going to the lungs. Pulmonary Embolism was observed in only 1 case in 1025 cases.
What should be done to prevent such a troublesome situation?
- Too much foam treatment should not be done: As the volume increases, the risk increases. . I will share other figures regarding this later. Less decision, more harm. Roughly, the risk increases when more than 10 ml is given.
- The risk increases in foam treatment of veins larger than 5 mm. The general recommendation should be 1.5 – 2.0 ml.
- Injecting large diameter veins in the groin area also increases the risk.
- After the treatment, 5-10 minutes. After resting and wrapping the elastic bandage Return to normal movements is recommended. Simple walking along with movement, especially movements of the foot such as pressing the pedal, are effective.
- There are researchers who draw attention to the importance of night bandage.
- Routine coagulation tests are not recommended in the treatment of foam.
- Low Molecular Weight Heparin is recommended for protection only in high risk cases.
Other rare complications:
- Nerve Damage-
- Temporary leg edema and lymphedema.
- Matting: New vessel formation (recurrence) is more common in men. It occurs within 4-6 weeks. It is most common in the knee and calf area. These pass within 3-12 months. In this case, it is necessary to wait patiently.
- Staining: It is seen at a rate of 10-30%. It occurs within 3-4 weeks. It does not occur immediately. It takes about 6-12 weeks. 10% of it is permanent. It is likely to be permanent after 1 year.
- Fainting: Vasovagal reflex. It is a benign condition that develops after any surgical procedure. It can develop even while receiving an injection. It is seen as a simple fainting. Patients also develop nausea, vomiting and sudden loss of consciousness. Additional symptoms such as dizziness and hot flashes may occur. The point to be considered is; Injuries caused by sudden falls. In this respect, resting for 5-10 minutes after the procedure becomes even more important.
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