Arterial Injection

Intraarterial injection of a sclerosant is a very rare complication. The most commonly reported location for intraarterial injection is into the posterior tibial artery in the area of the posterior or medial malleolar regions of the ankle [2]. Immediate pain, cutaneous blanching in an arterial pattern, loss of pulse, and progressive cyanosis usually occur.

Another area where arterial and venous circulation are in close proximity is at the junction of the femoral and long saphenous veins [2, 3]. The external pudendal artery bifurcates and may surround the long saphenous vein just after its connection with the femoral vein. Because of anatomical variations of these collateral arteries, duplex scanning is important before injection of sclerosants in this area.