Pulsatile Varicose Veins Secondary to Severe Tricuspid Regurgitation: Report of a Case Successfully Managed by Endovenous Laser Treatment

Varizes pulsáteis simulando aneurisma de artéria femoral: relato de caso

“…In patients with VI and associated complications, such as recurrent bleeding and chronic ulcerations, more invasive treatment may be needed. 2 , 6 , 7 Casian et al 7 achieved complete ulcer closure and absence of relapses for 1 year after combined treatment of a patient with PVV. After failure of compressive clinical treatment, the patient underwent saphenous ligation at the saphenofemoral junction under local anesthesia, followed by retrograde catheterization of the great saphenous vein and infusion of 20 mL of thick foam, produced with the Tessari technique using 3% sodium tetradecyl sulfate solution.…”

“…Although uncommon, varicorrhagia can cause voluminous bleeding because of the high venous pressure in these cases, which can be aggravated by anticoagulants taken by these patients, who often have comorbid atrial fibrillation. 2 Considering the rarity and the associated high cardiac risk, definitive treatment of PVV remains controversial. 7 Cases of venous insufficiency (VI) with mild symptoms appear to be adequately treatable with elastic compression and systematic elevation of the limbs.…”

“…Chihara et al 2 reported their experience with treatment of PVV (CEAP 6) with recurrent bleeding in a patient with atrial fibrillation maintained on full anticoagulation with factor Xa inhibitor. The patient underwent endovascular laser treatment of the great saphenous below the knee while on anticoagulation.…”

“…There were no hemorrhagic complications and the wound had healed by the 45th postoperative day without relapses over 6 months of follow-up. 2 In turn, Badger et al, 6 decided to treat a patient with PVV (CEAP 4) with saphenectomy, 1 year after annuloplasty of the tricuspid valve. 6 …”

“… 1 Severe tricuspid regurgitation (TR) is cited as a factor that is associated with development or relapse of lower limb varicose veins, which can exhibit pulsating, retrograde flow. 2 …”