Disappearance of Heat-Induced Thrombosis on the Third Day After the Endovenous Laser Treatment: A Case Report

Фокин, А. А.; Борсук, Д. А.; Vladimirskii, V. V.

doi:10.17116/flebo20161031141-145

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…The full-text reading and application of the inclusion and exclusion criteria resulted in the inclusion of 16 studies in the present systematic review. We excluded 65 studies for the following reasons (Appendix 2): reviews with overlapping data, 7,8 primary outcome not reported, [9][10][11][12][13][14][15][16][17][18] not written in English, [19][20][21][22][23][24][25][26][27][28][29][30][31] conference abstracts, overlapping data with an already included report by same author, 56 data not yet available, 57 full text not available, 58 no distinction between primary and secondary AASV incompetence, 59 no distinction in outcome between GSVand AASV, 60-62 and other outcome. [63][64][65][66][67][68][69][70][71] A flow chart of the selection procedure is shown in Figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency

et al. 2021

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Objective To investigate and compare the outcomes of the available treatment modalities for anterior accessory saphenous vein (AASV) incompetence. Methods A systematic literature search was performed in MEDLINE, Embase, and the Cochrane Library. Studies reporting the outcomes of patients who were treated for primary AASV incompetence were included. The methodologic quality of the articles was assessed using the Methodological Index for Non-Randomized Studies (MINORS). A random-effects model was used to estimate anatomic success, defined as AASV occlusion. The secondary outcomes were pain during and after treatment, venous clinical severity score, quality of life, esthetic result, time to return to daily activities, and complications. Results The search identified 860 articles, of which 16 met the inclusion criteria. A total of 609 AASVs were reported. The included studies were of poor or moderate quality according to MINORS score. The pooled anatomic success rates were 91.8% after endovenous laser ablation and radiofrequency ablation (EVLA, RFA, 11 studies), 93.6% after cyanoacrylate closure (3 studies), and 79.8% after sclerotherapy (2 studies). The non-pooled anatomic success rate was 97.9% after phlebectomy and 82% after CHIVA. Paresthesia was seen after EVLA in 0.7% of patients (6 studies). Phlebitis was seen in 2.6% of patients after RFA (2 studies), 27% after sclerotherapy (1 study), and 12% after the phlebectomy (1 study). Deep venous thrombosis and skin burn did not occur. Conclusion Treatment of AASV incompetence is safe and effective. Despite limited evidence, occlusion of the AASV can be achieved with endovenous thermal ablation and cyanoacrylate. There does not appear to be a benefit of EVLA compared to RFA regarding treatment efficacy. Phlebectomy shows promising results if the saphenofemoral junction is competent. Lower results are seen after sclerotherapy and CHIVA. However, studies with sufficient sample sizes of solely treatment of AASV incompetence are needed to draw firm conclusions.

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Section: Study Selectionmentioning

confidence: 99%

A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency

et al. 2021

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“…Studien und Publikationen zu dem Risiko postoperativer tiefer Beinvenenthrombosen nach endovenösen thermischen Ablationen, beschreiben ein Thromboserisiko von ca. 1-1,8 % [11][12][13]. Das ist ein deutlich höheres Thromboserisiko als nach der klassischen operativen Sanierung der Varikosis.…”

Section: Postoperative Thromboseunclassified

Varizenchirurgie: Belastender als andere Verfahren?

Brunig¹,

Buhr²

2019

Phlebologie

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ZusammenfassungSämtliche in der Varizenchirurgie angewandten Verfahren beherbergen Risiken. Die Risiken der klassischen operativen Sanierung der Varikosis mittels Stripping sind in der Literatur sehr ausführlich beschrieben.Bei den neueren therapeutischen Optionen, wie z. B. den endovenösen Therapien oder der Schaumsklerosierung werden die möglichen Komplikationen erst in jüngerer Zeit systematisch ausgewertet. Dementsprechend liegen derzeit im Vergleich wenige Daten hierzu vor.Betrachtet man die Lebensqualität des Patienten in den neuesten Vergleichsstudien und Metaanalysen, zeigt sich, dass perioperativ kaum Unterschiede in der Mobilität, Mortalität und Lebensqualität des Patienten bei den unterschiedlichen Therapieverfahren bestehen [1].Insgesamt ist davon auszugehen, dass die klassische operative Sanierung der Varikosis mittels Crossektomie, Stripping und Miniphlebektomien im Vergleich zu den endovenösen Therapieverfahren sowohl mit einem erhöhten Blutungsrisiko, also auch mit einem erhöhten postoperativen Infektionsrisiko einhergeht. Grundsätzlich ist das Blutungsrisiko, als auch das Infektionsrisiko jedoch auch bei der Operation als niedrig einzuschätzen.Das perioperative Nervenverletzungsrisiko scheint bei beiden Verfahren ähnlich häufig zu sein, wobei repräsentative Daten aus Vergleichsstudien fehlen.Das postoperative Thromboserisiko mit ggf. konsekutiver Lungenarterienembolie ist unseres Erachtens nach bei den endovenösen Verfahren höher einzustufen als nach einer klassischen operativen Sanierung der Varikosis.Kosmetisch beeinträchtigende, postinflammatorische Hyperpigmentierungen im OP-Gebiet treten häufiger nach endovenösen Therapieverfahren und nach Sklerosierungstherapien auf.

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Heat-induced thrombosis extension after endovenous laser ablation: a clinical case

Фокин¹,

Борсук²,

Сазанов³

et al. 2020

Kuban. nauсh. med. vestnik

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Endothermal heat-induced thrombosis (EHIT) is a complication of endovenous thermal ablation in treatment of varicose veins. Existing classiﬁcations do not account for the length of thrombus extension ﬂoating in the deep venous system. While the risk of extension is minor, the consequences can be baleful.Aim. To report a rare clinical case of endothermal heat-induced thrombosis extension formed in spite of ongoing anticoagulant treatment in a patient with endovenous laser ablation.Results. A 39 years-old man with endovenous laser ablation of the right great saphenous vein had class 2 EHIT with 1.92 cm length on the next day after surgery. Rivaroxaban was prescribed at a dose of 15 mg 2 times a day. EHIT extension above the inguinal ligament occurred on the 15th day after surgery, despite oral anticoagulant treatment. Open thrombectomy with high ligation was ordered. Postoperative period without complications. Preoperative Caprini score was 6 (varicose veins, BMI> 25 kg/m2 , minor surgery, personal history of venous thromboembolism (VTE)).Conclusion. The reported clinical case illustrates that both the choice of treatment strategy and follow-up of patients with EHIT need to account for the combined risk of embolism with existing EHIT and potential thrombus extension with subsequent massive embolism.

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Disappearance of Heat-Induced Thrombosis on the Third Day After the Endovenous Laser Treatment: A Case Report

Cited by 3 publications

References 16 publications

A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency

A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency

Varizenchirurgie: Belastender als andere Verfahren?

Heat-induced thrombosis extension after endovenous laser ablation: a clinical case

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