Great saphenous vein patency and endovenous heat-induced thrombosis after endovenous thermal ablation with modified catheter tip positioning

Haqqani, Omar P.; Vasiliu, Calin A.; O’Donnell, Thomas F.; Iafrati, Mark D.

doi:10.1016/j.jvs.2011.06.115

Cited by 36 publications

(34 citation statements)

References 24 publications

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“…We also agree with Haqqani et al [35] that the catheter must be advanced under direct DUS visualization to the saphenofemoral region. Blind positioning of the catheter must be avoided, as well as the advancement of the catheter into the femoral vein before it was positioned in the proximal GSV, as all these factors play an important role in preventing EHIT and DVT.…”

Section: Discussionsupporting

confidence: 92%

Conventional surgery versus endovenous radiofrequency ablation in management of patients with primary varicose veins

Hammad¹,

Modaber²,

Aliyev³

2017

Vascul Dis Ther

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Conventional surgery has been used for a long time for treatment of varicose veins with variable degrees of minor to major complications. Endovenous RA of VV has been established as a practical and effective alternative to conventional surgery. Segmental radiofrequency ablation provides high ablation rates in conjunction with a very moderate side effect profile. The advantages of RFA are far greater than its associated risks. There are certain points, which need to be carefully addressed during the RFA technique which was taken into consideration during gaining more experience with more number of cases which allowed to clarify our message from the study to achieve better results and avoid complications. Of most importance is an adequate Duplex scan to identify accessory channels and double superficial systems. Reconfirming the catheter tip position after leg elevation is a must. Blind positioning of the catheter must be avoided, as is the advancement of the catheter into the femoral vein to prevent unnecessary intimal damage. Tumescent anesthesia should be instilled below the saphenous fascia and above the deep muscular fascia surrounding the vein using ultrasound guidance. The purpose of tumescence is threefold; analgesia, protecting skin by displacing the vein away from it and neighboring structures against heat (heat sink effect) to displace heat radiating up to 1.5 mm beyond the vein wall, favoring the contact made between the electrode and a dry "saphenous vein" with inflow tributaries eliminated by compression is also created. The GSV should be compressed to separate it from the inflow tributaries, to maintenance an adequate probe temperature in contact with the vein wall. The avoidance of propagation of steam bubbles (or thrombus) by compression is of extreme importance. Further follow up ad studies is needed to improve the efficiency and decrease the incidence of complications of this well-established technique.

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Section: Discussionsupporting

confidence: 92%

Conventional surgery versus endovenous radiofrequency ablation in management of patients with primary varicose veins

Hammad¹,

Modaber²,

Aliyev³

2017

Vascul Dis Ther

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“…For this reason, some authors advise keeping a distance of approximately 2 cm from the confluence to prevent intimal damage at the SFJ, which can provoke a heat-induced thrombus or deep venous thrombosis. 16 In accordance with our study protocol, the distance from the SFJ was kept between 1.5 and 2 cm. Our previous publication on 1-year post-treatment results reported that heat-induced thrombus at the SFJ was observed on DUS in 3 patients (5%) 1 week after EVLA.…”

Section: Discussionmentioning

confidence: 99%

Five-year follow-up of a randomized, controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia

Gauw

Lawson

Keulen

et al. 2016

Journal of Vascular Surgery

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“…Yet, despite the variability of treatment regimens for EHIT, the reported rates of occlusive DVT and PE following endovenous ablation of the GSV remain low. [9][10][11][12] EHIT displays a distinct sonographic echogenicity compared with spontaneous acute DVT, and its natural history appears to be less prone to develop thrombus progression and extension. 13 Despite these differences, EHIT progression to PE has been reported in the literature and may result in life-threatening complications if not properly identified and treated.…”

Section: Discussionmentioning

confidence: 99%

Management of endovenous heat-induced thrombus using a classification system and treatment algorithm following segmental thermal ablation of the small saphenous vein

Harlander-Locke

Jiménez

Lawrence

et al. 2013

Journal of Vascular Surgery

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RFA of the SSV in symptomatic patients has a high success rate with a low risk of DVT. A classification system and treatment protocol based on the level of EHIT in relation to the saphenopopliteal junction is useful in managing patients. The approach to patients with thrombus flush with the popliteal vein or bulging has not been previously defined; our outcomes were excellent, using our treatment algorithm.

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Great saphenous vein patency and endovenous heat-induced thrombosis after endovenous thermal ablation with modified catheter tip positioning

Cited by 36 publications

References 24 publications

Conventional surgery versus endovenous radiofrequency ablation in management of patients with primary varicose veins

Conventional surgery versus endovenous radiofrequency ablation in management of patients with primary varicose veins

Five-year follow-up of a randomized, controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia

Management of endovenous heat-induced thrombus using a classification system and treatment algorithm following segmental thermal ablation of the small saphenous vein

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