I Had Schlerotherapy on my Legs 2 Months Ago, I Now Look Worse and Have A Blood Clot. Normal?

Question

I have a large hardened and painful vein with a clot. I can follow it with my finger all the way up to my inner thigh. I had an ultrasound that revealed a blood clot in my groin. The doctor drained the leg clot on my last visit, I never wish to repeat that horrible experience, it was very painful and didn't do me much good. I don't want to go back to that guy,he told me I will look great in 4 to 6 wks, it's been 8 wks and I still swell up nightly. Is it normal? will the clot go away on its own?

Victoria Karlinsky-Bellini, MD · Answer

one of the most important things to determine is the location of the clot. As long as it is superficial (clearly visible to the naked eye) draining the clot is appropriate. If the clot is in the deeper venous system it must be addressed with US and possible surgical intervention. If you do not feel comfortable going back to the doctor who treated you initially, please go to see a vascular surgeon for a second opinion to ensure that there is not a bigger issue that needs to be dealt with urgently. Clots in the superficial veins post Sclerotherapy is a fairly common occurrence and it is correct to drain them if they do not seem to be going away on their own after about 6-8 weeks of treatment.

Hratch Karamanoukian, MD, FACS · Answer

Superficial vein thrombophlebitis can occur following sclerotherapy if the patient does not wear compression stockings or if the sclerosed veins are not adequately compressed using stockings. If this occurs, it is important to recognize it early and in some cases to place a tiny puncture wound and to drain the coagulum (old blood) in order to reduce the likelihood of hyperpigmentation and to alleviate unnecessary pain and discomfort.

John Landi, MD · Answer

Sclerotherapy is a process and it may take more than one treatment to clear the veins.  Following sclerotherapy veins tend to look worse before looking better. Clots can occur after sclerotherapy and can be either in the superficial or deep veins.  Fortunately, this happens infrequently.  Clots do occur commonly in spider veins after treatment and usually resolve with local care such as heat, NDAIDS and time.  You had the appropriate treatment with ultrasound followed by evacuation (drainage). Sometimes this drainage may need to be repeated as seems to be your case.  It can be done with local anesthesia  or even local anesthesia and oral sedation if necessary.  You should see a vein specialist for a second opinion.

Mark Taylor, MD · Answer

If you doctor has lots of experience he will know how to care for you. It is not uncommon to remove coagulated blood from a vein after sclerotherapy. If you are not improving after a month or so, get a second opinion.

Timothy Mountcastle, MD · Answer

the treatment for superficial vein clots after sclero is drainage. exactly what the other doctor did. there are ways to control the pain during that procedure with local anesthesia and marking the vein prior to administering the local anesthesia.

	 

	if the blood clot is in your deep vein that is a concern and would have been treated already.

	 

	if the clot is in your gsv and migrating then treatment may be neccessary.

	 

	more information is really needed from your ultrasound report for me to give you any info.

	 

	a follow up ultrasound showing no migration of the clot in the superficial vein would also be helpful as no signs of movement after two weeks is indicative of stability.

	 

	it is also difficult to tell the difference between a clot and a  treated vein with sclero by ultrasound. both show stiffening of the vein and noncompressability and thus making it difficult to tell by ultrasound wheter its a clot or a treated vein.

	 

	in summary you should go to a vein surgeon or vascular surgeon with experience in vein surgery.

	i really dont have enough info to answer your question completely.

Samir Shureih, MD · Answer

having a blood clot in the groin can be serious depending on where the clot is.

	You should see a vascular surgeon ASAP, for a venous Duplex and a decision whether to ligate the sapheno-femoral junction. and proceed with removal of the saphenous vein with the clot. Also depending on where the clot  whether you need to be on blood thinners.

I Had Schlerotherapy on my Legs 2 Months Ago, I Now Look Worse and Have A Blood Clot. Normal?

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