Outcomes of a single-center experience with classification and treatment of endothermal heat-induced thrombosis after endovenous ablation

Korepta, Lindsey; Watson, Jennifer; Mansour, M. Ashraf; Chambers, Christopher M.; Cuff, Robert; Slaikeu, Jason D.; Wong, Peter Y.

doi:10.1016/j.jvsv.2016.12.010

Cited by 23 publications

(14 citation statements)

References 17 publications

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“…In class II EHIT, the administration of LMWH with ultrasound control until the thrombus resolves to class I EHIT (usually 10-14 days) is suggested. When class 3 or 4 EHIT is identified, therapeutic anticoagulation is recommended [38,[42][43][44]. Short-term LMWH anticoagulation with repeated ultrasound scans and follow-up until thrombus regression to class I are proposed in certain centres and in class III EHIT (for class IV EHIT, a therapeutic DVT regimen is suggested) due to the possibility of thrombus retraction and regression.…”

Section: Specific Thrombotic Complications After Minimally Invasive Tmentioning

confidence: 99%

“…The above-mentioned management guidelines adapted for the Lawrence classification are as follows: for classes 1 and 2 only observation and US follow-up are suggested; for class 3 (thrombus up to the level of the femoral venous wall) a decision should be made according to the surgeon's judgement, including the selection of anticoagulant (LMWH) treatment; for classes 4 and 5 anticoagulation with LMWH is proposed; and for class 6 a full therapeutic DVT treatment regimen is recommended [38]. According to the published outcomes of the clinical implementation of the above-mentioned EHIT management protocol, the stable nature of a thrombus, and low progression and embolisation rates allow safe treatment of most patients [38,[42][43][44][45]. Korepta et al identified 70 patients with EHIT in a study of 4799 ablation procedures.…”

Section: Specific Thrombotic Complications After Minimally Invasive Tmentioning

confidence: 99%

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A review of the risk of deep vein thrombosis in surgical and minimally invasive treatment of varicose veins

Wołkowski¹,

Urbanek²

2018

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Deep vein thrombosis (DVT) remains one of the most important clinical complications of varicose vein surgery. Despite the fact that procedures employed in the treatment of varicose veins are commonly classified as carrying a low risk of thromboembolism, this risk may vary significantly across different patients due to the presence of individual risk factors. This is a review of the risk of DVT in surgical and minimally invasive treatment of varicose veins. In retrospective studies addressing open varicose vein surgery, the rate of symptomatic DVT has been estimated at approximately 1%, but in prospective imaging-based studies, the risk of DVT in clinical settings seems to be much higher. The role of risk factors for DVT as well as their proper evaluation and individual risk stratification are significant. Because of population aging, a higher incidence of thromboembolic complications can be expected, suggesting the need for an individualised approach to risk stratification and appropriate risk-adjusted prophylaxis in patients who are candidates for varicose vein treatment. The implementation of new treatment modalities, in particular thermal and non-thermal ablation, does not eliminate the risk of DVT completely despite their relatively minimally invasive nature. Moreover, these methods can be related to the occurrence of new types of thrombotic complications, such as endovenous heat-induced thrombosis. The limited number of prospective studies regarding thromboembolism prophylaxis in modern phlebological treatment warrants further research on the importance of patient assessment and evaluation of procedure-related risk factors for venous thromboembolism.

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Section: Specific Thrombotic Complications After Minimally Invasive Tmentioning

confidence: 99%

Section: Specific Thrombotic Complications After Minimally Invasive Tmentioning

confidence: 99%

A review of the risk of deep vein thrombosis in surgical and minimally invasive treatment of varicose veins

Wołkowski¹,

Urbanek²

2018

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“…However, if postoperative ultrasound were reserved for only those with symptoms, a considerable number of DVT would be missed. 9,16 Jones et al also questioned the clinical significance of most forms of EHIT; however, progression to PE has occurred in multiple studies. 9,21,23,24 These occurrences are rare but in the setting of what is generally thought to be an elective procedure are unacceptable.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Deep Vein Thrombosis after Radiofrequency and Laser Ablation of the Lower Extremity Veins

Itoga

Rothenberg

Deslarzes-Dubuis

et al. 2020

Annals of Vascular Surgery

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“…0.2% of those treated by radiofrequency ablation. PASTE is characterised by the appositional growth of a thrombus into the deep vein (2,3,5,6). Unfortunately, the terms in international use are misleading, because the thrombus extends into the deep vein system and is not a superficial extension.…”

mentioning

confidence: 99%

“…4). According to the literature, the risk can be reduced through the use of laser systems in the wavelength region of 1470 nm, which have a high absorption spectrum in the range of water (2,5).…”

mentioning

confidence: 99%

Appositionsthrombus als Komplikation endovenöser Katheterverfahren (Post ablation thrombus extension [PATE])

Schäffer¹,

Weingard²,

Kiderlen³

et al. 2018

Phlebologie

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ZusammenfassungAppositionsthromben sind mit einer Prävalenz von 0,2–6% eine nicht seltene Komplikation nach endovenösen Katheterverfahren. Mögliche Risikofaktoren wurden bislang noch nicht ausreichend untersucht, außerdem fehlen Standards für eine angemessene Prophylaxe und ein einheitliches Therapieschema. Wir haben eine retrospektive Analyse von 2015–2017 bezüglich der Prävalenz sowie möglicher Risikofaktoren für das Auftreten eines Appositionsthrombus nach endovenösen Verfahren im Venenzentrum Freiburg durchgeführt. Die in der Literatur beschriebenen Risikofaktoren wie, Gefäßdurchmesser> 7,5mm, simultane Miniphlebektomien sowie ein erhöhter BMI konnten nicht verifiziert werden. Die Stadieneinteilung und die Bezeichnungen des Appositionsthrombus im internationalen Gebrauch wie EHIT (endovenöse hitzeinduzierte Thrombose) und PASTE (post ablation superficial thrombus extension) sind irreführend, da diese Komplikation auch bei nicht-thermischen Verfahren auftreten kann und es sich um eine Thrombusextension ins tiefe Venensystem handelt. Daher empfehlen wir die modifizierte Bezeichnung PATE (post ablation thrombus extension). Ein PATE 0 entspricht einem planen Verschluss und ist somit ein Therapieerfolg. PATE I beschreibt eine Thrombusextension mit Einengung des Lumens der tiefen Vene bis zu 25%, PATE II bis 50% und PATE III >50%. Eine therapeutische Antikoagulation empfehlen die Autoren ab PATE II mit einer Dauer bis zum Verschwinden des Appositionsthrombus.

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Outcomes of a single-center experience with classification and treatment of endothermal heat-induced thrombosis after endovenous ablation

Cited by 23 publications

References 17 publications

A review of the risk of deep vein thrombosis in surgical and minimally invasive treatment of varicose veins

A review of the risk of deep vein thrombosis in surgical and minimally invasive treatment of varicose veins

Incidence and Risk Factors for Deep Vein Thrombosis after Radiofrequency and Laser Ablation of the Lower Extremity Veins

Appositionsthrombus als Komplikation endovenöser Katheterverfahren (Post ablation thrombus extension [PATE])

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