Is it safe to get non-foam sclerotherapy if I have a PFO?

Question

I had a TERRIBLE reaction while still on the table after ultrasound guided foam sclerotherapy. Had a brief seizure and what appeared to be a TIA or embolism this June. Still having issues with my right leg I went to a different doctor who said she thinks it was the air that caused problems so this time it will just be the solution. I have always been pretty fearless about procedures in the past, but I don't know if I can keep calm for the next treatment. If not, what would be safer?

Hratch Karamanoukian, MD, FACS · Answer

There are many patients who have PFO's who get foam sclerotherapy without incident. Most PFO's remain undiagnosed and asymptomatic.It is not just having a PFO, but a right to left shunt that is key. This is done with a bubble test which I assume you have already had.If there is no shunt, the likelihood of air going through is unlikely.I would, however, stick with traditional sclerotherapy to avoid potential problems or limit the amount of foam sclerotherapy to less than 5 cc at a time and keep the legs elevated above the level of the heart.Discuss with your treating doctor.H KaramanoukianCardiovascular surgeon and vein specialist

John Landi, MD · Answer

Liquid sclerotherapy is safe to use with a PFO.  However. I would recommend that you have a cardiac evaluation before preceding with any further treatment. I had a patient about 2 years ago that developed severe headaches after foam sclerotherapy and further evaluation revealed a similar experience following her colonoscopy.  Cardiac eval revealed a large PFO which was corrected. Why take any risks?  Have a cardiac evaluation.

Alix J. Charles, MD · Answer

Thank you for your question.  I am so sorry to hear about the complication you suffered, and I hope you make a full recovery.  I personally perform quite a bit of injection sclerotherapy in my practice.  The issue of having an air embolism following sclerotherapy in a patient with a PFO was never an issue prior to the use of foam.  If you have regular liquid sclerotherapy without any air mixed with the sclerosant your will have a low air embolism risk. Hope this helps!

Is it safe to get non-foam sclerotherapy if I have a PFO?

Answers (3)

Recommended reading

Everything you need to know about Sclerotherapy

Our mission is to create a world where every investment in modern beauty is Worth It.

Is it safe to get non-foam sclerotherapy if I have a PFO?

Answers (3)

Browse related questions

Recommended reading

Everything you need to know about Sclerotherapy

Our mission is to create a world where every investment in modern beauty is Worth It.