Phlebological Review
eISSN: 1509-5738
ISSN: 1232-7174
Phlebological Review
Current issue Archive About the journal Supplements Editorial board Abstracting and indexing Contact Instructions for authors Ethical standards and procedures
Editorial System
Submit your Manuscript
Search
Editorial Policies
Sarajevo Declaration on Integrity and Visibility of Scholarly Publications

Without publication fees

without publication fees

Open access

without publication fees
1/2024
vol. 32
 
Share:
Send email
Share:
abstract:
Case report

A rare case of leg ulceration after hybrid ablation (EVLA + UGFS) in the treatment of varicose veins: case report and literature review

Jan Szczepański
1, 2
,
Maciej Jaworski
1, 3
,
Christian Baraldi
4
,
Andrzej Przewięźlikowski
2
,
Kinga Gradzik-Minecka
5
,
Mariagrazia Sionne
6

  1. Melius Clinic, Toruń, Poland
  2. Hospital Eskulap, Centre for the Treatment of Heart and Vascular Diseases, Bydgoszcz-Osielsko, Poland
  3. Clinical Department of Angiology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Poland
  4. Vascular Clinic Dr. Baraldi, Catanzaro, Italy
  5. MegaMed, LuxMed Group, Bełchatów, Poland
  6. Tirrenia Hospital, Belvedere Marittimo, Italy
Phlebological Review 2024; 32, 1: 32–36
DOI: https://doi.org/10.5114/pr.2024.152008
Online publish date: 2025/08/21
View full text Get citation
 
PlumX metrics:
Skin and subcutaneous tissue necrosis is a rare but significant complication of hybrid varicose vein ablation procedures combining endovenous laser ablation (EVLA) with ultrasound-guided foam sclerotherapy (UGFS). We present the case of a 54-year-old patient who developed rapidly progressing localized skin and subcutaneous tissue necrosis in the anteromedial half of the calf following a scheduled varicose vein ablation of the right lower limb. The procedure included laser ablation of the great saphenous vein and precise spot ablation of incompetent perforators, complemented by UGFS with the application of approximately 10 cm³ of 1.5% Aethoxysklerol foam. The early postoperative period was uneventful; however, four days later, pain and inflammatory symptoms appeared, which were exacerbated by the development of necrosis. Further treatment involved multiple mechanical debridement procedures, the use of specialized dressings, as well as vacuum-assisted closure (VAC) therapy, ultimately leading to complete ulcer healing. The case analysis suggests that the complication may have been caused by unintended penetration of the sclerosing foam into the arterial system or damage to adjacent structures due to laser ablation. Despite the rarity of this complication (only the second case among more than 7,000 procedures performed), its potentially severe consequences highlight the necessity of thorough patient education and meticulous postoperative monitoring.
keywords:

chronic venous insufficiency, foam sclerotherapy, varicose veins, perforators, thermal ablation, EVLA, skin and tissue necrosis
Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2025 Termedia Sp. z o.o.
Developed by Bentus.