@Article{Szczepański2024,
journal="Phlebological Review",
issn="1232-7174",
volume="32",
number="1",
year="2024",
title="A rare case of leg ulceration after hybrid ablation (EVLA + UGFS) in the treatment of varicose veins: case report and literature review",
abstract="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.",
author="Szczepański, Jan
and Jaworski, Maciej
and Baraldi, Christian
and Przewięźlikowski, Andrzej
and Gradzik-Minecka, Kinga
and Sionne, Mariagrazia",
pages="32--36",
doi="10.5114/pr.2024.152008",
url="http://dx.doi.org/10.5114/pr.2024.152008"
}