Postoperative prophylaxis of venous thromboembolism (VTE) in patients undergoing high ligation and stripping of the great saphenous vein (GSV)

Wang, Haitao; Sun, Zhongyi; Jiang, Weiliang; Zhang, Yingnan; Li, Xianwei; Wu, Yongjian

doi:10.1177/1358863x14564592

Cited by 23 publications

(6 citation statements)

References 10 publications

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“…The incidence of haemorrhagic complications was gener-ally low in each group but was higher in group B (0.75%) compared to the other groups. The authors concluded that postoperative VTE thromboprophylaxis following high ligation and GSV stripping effectively reduces venous thrombosis complications [60]. In another prospective randomised study, 48 women received LMWH prophylaxis two days after surgery and 45 women received LMWH within seven days of surgery [61].…”

Section: Venous Thromboembolism Prophylaxis After Varicose Vein Surgementioning

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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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: Venous Thromboembolism Prophylaxis After Varicose Vein Surgementioning

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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“…Wang et al, in a study on DVT prophylaxis in venous surgery reported a 5.17% of DVT and 1.48% of pulmonary embolism, a non-negligible percentage for benign disease. 27 Chen et al found an incidence of postoperative DVT in stripping of 7.7%, higher than expected. 28 Bukina and Golovlev, in stripping with “miniflebectomy” on local anesthesia, detected a crural DVT in 3.5% of cases.…”

Section: Discussionmentioning

confidence: 81%

Deep Venous Thrombosis and Ulcers of Lower Limbs: Ultrasound Findings in 156 Patients

Gilardi

Fiamma

et al. 2022

Int J Angiol

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Venous ulcers (VUs) of lower limbs affect 1% of Western population. In most cases, ultrasounds show only superficial venous insufficiency (SVI), but a deep venous insufficiency (DVI) may also be present without a history of deep vein thrombosis (DVT). To assess SVI and DVI in DVT-positive and DVT-negative patients with VU, a retrospective cohort of 123 patients entered the study (50 male and 73 female, minimum age 29 years and maximum age 90 years, and mean 70.6 years). In 56 patients (45.5%), ulcer was on the right leg, in 52 (42.3%) on the left leg, and in 15 patients (12.2%), ulcer was bilateral, resulting in a total number of 138 limbs in the study. Sixty-six patients suffered DVT, while in 72 anamnesis was negative. Color duplex ultrasound was performed on both limbs, which revealed insufficiencies of superficial and/or deep veins in 18 limbs which had not been affected by an ulcer or a previous DVT. So the study was on 156 limbs. SVI were substantially overlapping in two groups (p-value = 0.593), while combined SVI and DVI was 72.5% in DVT positive limbs (p-value = 0.001). In 70% of cases with a femoral vein insufficiency (p-value = 0.036) or popliteal vein insufficiency (PVI) (p-value 0,003), a DVT history was present. Of 18 limbs, although not affected by ulcer or previous DVT, eight were positive for DVI (two femoral veins and six popliteal veins). In the patient with VU, the history of DVT is a strong predictor of DVI insufficiency. In DVT-positive patients with ulcer, the number of “combined superficial and deep insufficiencies” appears to be particularly significant and surgical treatment must take this into account. A previous DVT has a low impact on great and small saphenous insufficiencies in ulcer patients; these were substantially overlapping in DVT-positive and DVT-negative patients. The 18 limbs with DVI and SVI without ulcer and DVT history were unexpected result. We think these patients must have a close follow-up to avoid the onset of a VU.

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“…23 ) In addition, Wang et al also reported that postoperative DVT occurred in 20 cases (5.17%) among 542 cases of stripping surgery in patients with GSV incompetence, and that 67.9% of the DVT cases were found within 2 weeks after the surgery. 24 ) These results highlight that it may not be possible to detect worsening of IDDVT if it happens 1–2 weeks after VV surgery. Therefore, this study did not completely clarify whether or not the IDDVT changed (or worsened) postoperatively.…”

Section: Discussionmentioning

confidence: 90%

Asymptomatic Isolated Calf Deep Vein Thrombosis: Does It Worsen after Varicose Vein Surgery?

Horiguchi¹,

Ono²,

Shirato³

et al. 2017

Annals of Vascular Diseases

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In our varicose vein center, on a trial basis, among the patients with asymptomatic calf deep vein thrombosis (CDVT) we carefully selected the patients for varicose vein surgery using the requirements as follows; 1) the patients had varicose veins with incompetent saphenous veins, 2) sequential examination including DUS confirmed stability and clinical insignificance of asymptomatic CDVT, 3) the patients do not have any risk factors for DVT such as a coagulation profile disorder (antithrombin deficiency, protein C deficiency, protein S deficiency, or antiphospholipid syndrome) or malignancies, 4) surgery is possible under local anesthesia alone, and 5) the patients can understand the concept of asymptomatic CDVT and undergo the surgery on their own will and informed consent. The patients who fulfilled these conditions underwent the varicose vein surgery. Twenty-eight patients with 30 limbs with varicose veins had asymptomatic CDVT, found by preoperative duplex ultrasonography (DUS). Among CDVT, 91% of CDVT existed in the soleal veins. After the diagnosis of the asymptomatic CDVT, serial DUS was performed and showed no changes in the status of the thrombus. Then varicose vein surgery (high ligation of the saphenous junctions either with or without stripping of the saphenous veins) was performed. After the surgery, the CDVT was re-evaluated by DUS. In 27 limbs, CDVT did not show any changes in the status of the thrombus, and in 3 limbs the CDVT was partially resolved. These data suggest that, at least, as far as the patients fulfilled these conditions, varicose vein surgery did not worsen the asymptomatic CDVT. (This is a translation of Jpn J Phlebol 2016; 27: 405–412.)

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Postoperative prophylaxis of venous thromboembolism (VTE) in patients undergoing high ligation and stripping of the great saphenous vein (GSV)

Cited by 23 publications

References 10 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

Deep Venous Thrombosis and Ulcers of Lower Limbs: Ultrasound Findings in 156 Patients

Asymptomatic Isolated Calf Deep Vein Thrombosis: Does It Worsen after Varicose Vein Surgery?

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