The trends in venous thromboembolism occurrence and prevention after minimally invasive varicose vein surgery

Lobastov, Kirill; Shaldina, Maria; Matveeva, Athena; Kovalchuk, Anna; Borsuk, Denis; Schastlivtsev, Ilya; Laberko, Leonid; Fokin, Alexey

doi:10.1177/02683555231217364

Phlebology

2023

DOI: 10.1177/02683555231217364

|View full text |Cite

The trends in venous thromboembolism occurrence and prevention after minimally invasive varicose vein surgery

Kirill Lobastov,

Maria Shaldina,

Athena Matveeva

et al.

Abstract: Objectives To assess the trends of VTE occurrence and prevention in varicose vein surgery. Method The registry-based CAPSIVS trial (NCT03041805) analysis includes results in 1878 lower limbs. The primary outcome is a 28-day symptomatic or asymptomatic DVT revealed with duplex ultrasound. Results Any DVT, including EHIT, was observed in 3.4%, while symptomatic in 0.5%. Prophylactic anticoagulation was administrated in 20.4% with LMWH (13.2%) or DOAC (7.1%) for patients with higher VTE risk but did not reduce th… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2024

Publication Types

Select...

Article3

Relationship

Self Cite0

Independent3

Authors

Journals

Cited by 3 publications

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Endovenous Microwave Ablation Versus Laser Ablation for Small Saphenous Vein Varicosis

Lu,

Jiang,

et al. 2024

Adv Ther

View full text Add to dashboard Cite

Endovenous Microwave Ablation Versus Laser Ablation for Small Saphenous Vein Varicosis

Lu,

Jiang,

et al. 2024

Adv Ther

View full text Add to dashboard Cite

Is it safe to discontinue anticoagulant after surgical treatment of varicose vein disease, which caused pulmonary embolism?

Kipiani,

Kozlova,

Lobastov

2024

Ambulatornaya khirurgiya

View full text Add to dashboard Cite

Superficial vein thrombosis, which is mostly caused by lower extremity varicose vein disease, can be complicated by pulmonary embolism. At the same time, the optimal duration of anticoagulant therapy for pulmonary embolism originated from varicose vein thrombosis is still under debate. On the one hand, the presence of varicose veins is considered a small risk factor for the development of venous thromboembolic events, which persistence determines an increased risk of relapse and requires prolonged anticoagulant therapy. On the other hand, elimination of varicose veins is associated with reduced risk of subsequent venous thromboembolic events. The article describes a clinical case of recurrent pulmonary embolism after surgical treatment of varicose vein disease, which caused primary pulmonary embolism. A 45-year-old patient suffering from left lower extremity varicose vein disease for 5 years was admitted to the intensive care unit with suspected pulmonary embolism. The further examination revealed signs of thrombotic occlusion of the segmental and subsegmental branches of the pulmonary arteries bilaterally and the middle lobe branch of the right pulmonary artery, as well as signs of the right-sided heart overload. In this case, pulmonary embolism was found to originate from thrombosis of the trunk of the great saphenous vein ofthe left lower extremity with a proximal border at the level of the lower leg. No signs of deep vein involvement were detected. The parenteral anticoagulant therapy initiated in the hospital was followed by switching to therapeutic doses of rivaroxaban. The signs of recanalization of involved veins were identified after 6 months of treatment, and it was decided to perform endovenous laser coagulation of the trunk of the great saphenous vein combined with mini-phlebectomy of varicose tributaries on continuous oral anticoagulant therapy. The rivaroxaban therapy was completed a month after intervention. However, 7 days later the patient was diagnosed with repeated symptomatic pulmonary embolism, which originated from thrombosis of the left popliteal vein. It was recommended to resume anticoagulant therapy of indefinite duration. The article discusses the issues of optimal duration of treatment for pulmonary embolism originated from thrombosis of superficial varicose veins, as well as the possible timing of completion of anticoagulant therapy after the intervention.

show abstract

An updated approach to the risk assessment and prevention of postoperative venous thromboembolism in varicose vein surgery

Lobastov,

Shaldina,

Borsuk

et al. 2024

Ambulatornaya khirurgiya

View full text Add to dashboard Cite

This narrative literature review is dedicated to the issue of individual risk assessment and prevention of postoperative VTE in patients undergoing lower limb varicose vein surgery. The registry-based CAPSIVS trial showed that the detection frequency of any forms of VTE after modern minimally invasive superficial vein surgery reaches 3.4%, of which only 0.5% are symptomatic. The current clinical guidelines regulate the individual risk assessment of postoperative thrombosis using the Caprini Risk Score (CRS). The first validation study resulted in a proposal of evidence-based approach to the phlebological patient stratification into risk groups according to the Caprini scores with 0–6 scores indicating the low risk, 7–10 scores – the moderate risk and 11 scores or more –the high risk, which differs significantly from approaches in other medical specialties. At the same time, the pharmacoprophylaxis may be appropriate in the groups of moderate and high risk, especially when simultaneous varicose tributary ablation and perforating vein interventions increasing the risk of VTEC 6–11 times are performed. The duration of pharmacoprophylaxis of postoperative venous thrombosis is essential to its efficiency, which should not be less than 7 days for the moderate VTE risk group and reach 30 days for the high VTE risk group. A single injection of parenteral anticoagulants on the day of surgery has been shown to be associated with an 8.8% incidence of postoperative thrombosis. The risk of postoperative thrombosis in patients with VTE in their past medical history, including prior varicothrombophlebitis is increased by 4.2 times, which requires that secondary pharmacoprophylaxis be prescribed for at least 30 days, and in some cases up to 3-6 months. At this stage, there is sufficient evidence to support the use of the Caprini Risk Score to assess the risk of postoperative VTE and prescribe adequate pharmacological prophylaxis in varicose vein surgery treatment.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

The trends in venous thromboembolism occurrence and prevention after minimally invasive varicose vein surgery

Cited by 3 publications

References 41 publications

Endovenous Microwave Ablation Versus Laser Ablation for Small Saphenous Vein Varicosis

Endovenous Microwave Ablation Versus Laser Ablation for Small Saphenous Vein Varicosis

Is it safe to discontinue anticoagulant after surgical treatment of varicose vein disease, which caused pulmonary embolism?

An updated approach to the risk assessment and prevention of postoperative venous thromboembolism in varicose vein surgery

Contact Info

Product

Resources

About