A Systematic Review and Meta-analysis of Thrombotic Events Following Endovenous Thermal Ablation of the Great Saphenous Vein

Healy, Donagh; Kimura, Shiori; Power, David; Elhaj, Abubaker; Abdeldaim, Yasser; Cross, K.S.; McGreal, Gerard T.; Burke, P.; Moloney, Tony; Manning, Brian J.; Kavanagh, Eamon G.

doi:10.1016/j.ejvs.2018.05.008

Cited by 101 publications

(42 citation statements)

References 56 publications

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“…Moreover, they may be performed without or with local anesthesia only. Hence, the minimally/less invasive methods allow early mobilization and fast patient return to daily and working activity; thus, their use is associated with a reduced risk of post-operative thrombosis [30,32,33]. Regrettably, despite the aforementioned benefits for the patient, when assessed in regards to the rate of disease recurrence, all these methods have substantially similar effectiveness in long-term assessment [14,[16][17][18]34].…”

Section: Discussionmentioning

confidence: 99%

The Analysis of Selected Morphological and Hemodynamic Parameters of the Venous System and Their Presumable Impact on the Risk of Recurrence after Varicose Vein Treatment

Szary

Wilczko²,

Plucińska³

et al. 2021

JCM

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Introduction: The current treatment of venous disease is focused on reflux elimination in main venous trunks, especially in the saphenous vein. However, a high recurrence rate, independent of the method of treatment, suggests that the reason of low effectiveness may be due to a strategy focused on symptoms, without considering their origin. Method: The aim of study was the comparison of retrospective data from 535 women with venous disease, either after treatment (n = 183) or not treated before (n = 352). The analysis concerned clinical symptoms and the results of the extended diagnostics, including the examination of the lower limb, pelvic and abdominal veins either using duplex-doppler ultrasound as well as venography with computed tomography or magnetic resonance. Results: The comparison of selected venous system parameters revealed more advanced disease progression in previously treated patients, compared to non-treated individuals (e.g., ipsi- or bilateral incompetence of sapheno-phemoral junction—29.5% vs. 20.4%, at P < 0.05 and 13.6% vs. 7.7% at P < 0.05, respectively). This difference could be explained by post-treatment alterations in the venous system, an older age and the higher number of pregnancies in the recurrence group. However, both groups did not differ in regards to the symptoms of pelvic venous insufficiency or the frequency of relevant variants/abnormalities in venous system. Conclusions: Based on the aforementioned findings, we postulate the revision of treatment strategy, which should consider abdominal and pelvic veins as the source of reflux in many female subjects.

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Section: Discussionmentioning

confidence: 99%

The Analysis of Selected Morphological and Hemodynamic Parameters of the Venous System and Their Presumable Impact on the Risk of Recurrence after Varicose Vein Treatment

Szary

Wilczko²,

Plucińska³

et al. 2021

JCM

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“…ETA is recommended as the first-choice procedure for symptomatic varicose veins. 9) Since the therapeutic goal of ETA is the obliteration of incompetent saphenous veins by thermal injury to the venous wall, ETA could be associated with concerns regarding the potential risks for VTE. Japanese nationwide survey found that venous thrombotic events, including VTE (deep vein thrombosis (DVT), pulmonary thromboembolism (PTE), and EHIT class 3-4), occurred in 0.194% of 43,203 cases.…”

Section: Discussionmentioning

confidence: 99%

Endovenous Thermal Ablation for a Varicose Vein Patient with Factor XII Deficiency: A Case Report

Shirasugi

Horiguchi²,

Tanaka

et al. 2020

Annals of Vascular Diseases

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Factor XII (FXII) deficiency is a rare coagulation disorder, and its potential relationship with venous thrombosis was reported. Here we present a case of a 67-year-old woman with FXII deficiency who successfully underwent endovenous thermal ablation (ETA) for primary varicose vein due to the incompetent great saphenous vein (GSV). The FXII deficiency was revealed through preoperative examinations, and the patient underwent ETA as a day surgery. For prophylaxis of thrombosis, she received compression therapy alone. Her postoperative course was uneventful, without any kind of thrombosis. In the presence of FXII deficiency, ETA could be safely performed.

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“…If a thrombus forms postoperatively at the proximal junction of the treated vein, it is called endovenous heat-induced thrombosis (EHIT) in the international literature; if it extends into the deep vein system, it is called postablation superficial thrombus extension (PASTE) [407][408][409]. Schäffer et al indicate that this clinical constellation is independent of the procedure used and can appear even after nonthermal procedures; furthermore, it refers to a thrombus extension in the deep and not the superficial vein system.…”

Section: Recommendation 114mentioning

confidence: 99%

“…Sect. 6.2.2.2.2.1 PATE after EVLA -Burns [454] -Deep leg vein thrombosis [409,454,455] -Lung embolism [409,455] -In individual cases: lymphocele, wound infection, arteriovenous fistula [349,386] The incidence of paraesthesia after sRFA in the European cohort study was 3.4% in the first postoperative week, and then it fell to 0.4% and remained at that value throughout the 5-year observation period [451,456]. This represents a clear improvement over previous treatment procedures [351].…”

Section: Radio Frequency-induced Segmental Thermal Ablation/segmental...mentioning

confidence: 99%

S2k guidelines: diagnosis and treatment of varicose veins

Pannier¹,

Noppeney²,

Alm³

et al. 2022

Hautarzt

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Table 1 Clinical classification (C) according to CEAP Class Clinical signs C0 No visible or palpable signs of venous incompetence C1 Spider veins and/or reticular varices C2 Varicose veins C3 Oedema C4a Pigmentation, eczema C4b Atrophie blanche, dermatoliposclerosis C5 Cured venous leg ulcer C6 Active venous leg ulcer in CEAP stage C2, developed progression to CVI [13]. Recommendation 13 An imaging technique shall be used in the context of standardised phlebological diagnosis. The first-choice method shall be duplex ultrasound. If necessary, vein function shall also be measured (e.g., PPG/LRR or VOP). Recommendation 15 Complete, traceable documentation of the findings shall be kept. Recommendation 16 Pathological findings from technical examinations should be tested for clinical significance. Recommendation 139 Invasive treatment of varicose veins during pregnancy should be indicated only in exceptional cases.

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A Systematic Review and Meta-analysis of Thrombotic Events Following Endovenous Thermal Ablation of the Great Saphenous Vein

Abstract: Thrombotic events occur infrequently following GSV EVTA. Given the large numbers of procedures worldwide and the potential for serious consequences, further research is needed on the burden of these complications and their management.

Cited by 101 publications

References 56 publications

The Analysis of Selected Morphological and Hemodynamic Parameters of the Venous System and Their Presumable Impact on the Risk of Recurrence after Varicose Vein Treatment

The Analysis of Selected Morphological and Hemodynamic Parameters of the Venous System and Their Presumable Impact on the Risk of Recurrence after Varicose Vein Treatment

Endovenous Thermal Ablation for a Varicose Vein Patient with Factor XII Deficiency: A Case Report

S2k guidelines: diagnosis and treatment of varicose veins

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