Radiofrequency ablation with concomitant stab phlebectomy increases risk of endovenous heat-induced thrombosis

Hicks, Caitlin W.; DiBrito, Sandra R.; Magruder, J. Trent; Weaver, M. Libby; Barenski, Cathy; Heller, Jennifer

doi:10.1016/j.jvsv.2016.10.081

Cited by 31 publications

(24 citation statements)

References 10 publications

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“…They noted no case of thrombus progression among patients with Type 1 EHIT that were managed with observation or anticoagulation. Sadek et al, 35 Hicks et al, 32 and Jones et al 65 proposed observation for Type 1 EHIT and anticoagulation for the other subtypes with early discontinuation of anticoagulation for those with Type 2 EHIT with DUS confirmed thrombus regression. Knipp et al 6 treated patients with thrombus extension with 1 week of anticoagulation and a repeat DUS and they described that in almost all cases, the thrombus regressed so that no further treatment was required.…”

Section: Discussionmentioning

confidence: 95%

“…Regarding the prediction of EHIT, some potential risk factors may have emerged but these require further research: concomitant phlebectomy, 32 prior VTE, 31,32 prior superficial thrombophlebitis, 33 larger GSV diameter, 31,33,66 higher CEAP clinical class, 66 and elevated d-dimer with normal C reactive protein 27 have been proposed to be associated with EHIT.…”

Section: Discussionmentioning

confidence: 99%

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

Healy

Kimura

Power

et al. 2018

European Journal of Vascular and Endovascular Surgery

101

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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

Healy

Kimura

Power

et al. 2018

European Journal of Vascular and Endovascular Surgery

101

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“…When considering factors affecting the rate of DVT after varicose vein surgery, not only the study methodology but also the type (phlebectomy, truncal ablation + phlebectomy) and nature (unilateral or bilateral operations) of surgical procedures are significant [5,13,22,23]. In a study based on Hospital Episode statistics, Sutton retrospectively analysed VTE episodes occurring within 12 months of varicose vein surgery.…”

Section: Deep Vein Thrombosis and Venous Thromboembolism Incidence Inmentioning

confidence: 99%

“…However, several VTE risk factors identified in patients undergoing this type of procedure can significantly influence the thrombotic event rate. Several other coexisting factors related to the patient's clinical condition and history (including age, a previous DVT episode, or other clinically important factors) can result in an increased procedure risk [21,23,25].…”

Section: Deep Vein Thrombosis and Venous Thromboembolism Incidence Inmentioning

confidence: 99%

“…Other potential EHIT risk factors have been identified in the literature as well. Some of the most commonly suggested are the size (diameter) of the treated vein, proper procedure execution with an appropriate distance between the device tip and the SFJ, and preservation of the vein washing mechanism (related to the preservation of the patency in the superficial epigastric vein and the restoration of blood inflow into the saphenous vein) [23,29,37,46,47].…”

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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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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Radiofrequency ablation with concomitant stab phlebectomy increases risk of endovenous heat-induced thrombosis

Cited by 31 publications

References 10 publications

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

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

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

S2k guidelines: diagnosis and treatment of varicose veins

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