Venous thromboembolism after ultrasound guided foam sclerotherapy

Aguiar, Eduardo Toledo de; Santos, Jorgete Barreto dos; Carvalho, Danielle de Almeida

doi:10.1177/0268355520957202

Cited by 2 publications

(3 citation statements)

References 21 publications

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“…There was no significant difference in bleeding events between 3 days of Fondaparinux versus Rivaroxaban, nor between Rivaroxaban 10 mg OD for 5 days versus 10 days 23,24 . Of the 11 trial arms that included VTE-related mortality as an outcome, there was 1 VTE-related death that occurred in the mechanical thromboprophylaxis alone group after a PE from an iliofemoral DVT 29 …”

Section: Resultsmentioning

confidence: 92%

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Systematic Review and Meta-analysis of the Additional Benefit of Pharmacological Thromboprophylaxis for Endovenous Varicose Vein Interventions

et al. 2022

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Objective: The primary objective of this systematic review and meta-analysis was to elucidate the rate of venous thromboembolism (VTE) after endovenous interventions for varicose veins in the presence of pharmacological and mechanical thromboprophylaxis versus mechanical thromboprophylaxis alone. Background: The VTE rate after endovenous procedures for varicose veins is higher than other day-case procedures and could be reduced with pharmacological thromboprophylaxis. Methods: The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines with a registered protocol (PROSPERO: CRD42021274963). Studies of endovenous intervention for superficial venous incompetence reporting the predefined outcomes with at least 30 patients were eligible. Data were pooled with a fixed effects model. Results: There were 221 trials included in the review (47 randomized trial arms, 105 prospective cohort studies, and 69 retrospective studies). In randomized trial arms, the rate of deep venous thrombosis with additional pharmacological thromboprophylaxis was 0.52% (95% CI, 0.23%–1.19%) (9 studies, 1095 patients, 2 events) versus 2.26% (95% CI, 1.81%–2.82%) (38 studies, 6951 patients, 69 events) with mechanical thromboprophylaxis alone. The rate of pulmonary embolism in randomized trial arms with additional pharmacological thromboprophylaxis was 0.45% (95% CI, 0.09–2.35) (5 studies, 460 participants, 1 event) versus 0.23% (95% CI, 0.1%–0.52%) (28 studies, 4834 participants, 3 events) for mechanical measures alone. The rate of EHIT grade III to IV was 0.35% (95% CI, 0.09–1.40) versus 0.88% (95% CI, 0.28%–2.70%). There was 1 VTE-related mortality and 1 instance of major bleeding, with low rates of minor bleeding. Conclusions: There is a significant reduction in the rate of DVT with additional pharmacological thromboprophylaxis and routine prescription of anticoagulation after endovenous varicose vein intervention should be considered. VTE risk for individual study participants is heterogeneous and risk stratification in future randomized interventional studies is critical to establish the clinical effectiveness and safety of additional pharmacological thromboprophylaxis.

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Section: Resultsmentioning

confidence: 92%

“… 23 , 24 Of the 11 trial arms that included VTE-related mortality as an outcome, there was 1 VTE-related death that occurred in the mechanical thromboprophylaxis alone group after a PE from an iliofemoral DVT. 29 …”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-analysis of the Additional Benefit of Pharmacological Thromboprophylaxis for Endovenous Varicose Vein Interventions

et al. 2022

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“…On the other hand, longer FHT with more HA allows the foam to travel further downstream, 35 especially after vasospasm occurs, 36 which increases the incidence of distant side effects. Severe complications such as superficial thrombophlebitis, deep venous thrombosis, 37 pulmonary embolism, and even neurologic events could lead to irreversible results. Thus, the method using HA-POL foam may be more suited to injection of low flow vascular malformations but not HUVECs in all groups died instantaneously after being treated with HA-POL solution.…”

Section: Discussionmentioning

confidence: 99%

The role of hyaluronic acid in polidocanol foam: An in vitro study

Liu

Xuanxuan

et al. 2022

Phlebology

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Objective To study the role of hyaluronic acid (HA) in polidocanol (POL) foam. Methods The dose-dependent effect of HA-POL on cultured human umbilical vein endothelial cells (HUVECs) as well as foam stability was evaluated by measuring optical density (OD) values and foam half-life time (FHT), respectively. An in vitro model was utilized for estimating the foam blood-displacement capacity by adopting maximum displacement distance (MDD) and displacement time. A comparison of foam viscosity was also carried out. Results The OD values of HUVECs treated with HA first increased and then decreased with the growing dosage of HA while cells treated with HA-POL died. Both FHT and displacement time were prolonged statistically with a gradually enhanced foam viscosity. As to MDD, there were no significant differences. Conclusions HA was found to promote HUVECs proliferation slightly, but this was almost negligible when compared to the cell-killing capacity of 1% POL. The viscosity of POL foam was enhanced by HA indicating its positive correlation with both stability and displacement capacity of POL foam.

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Venous thromboembolism after ultrasound guided foam sclerotherapy

Cited by 2 publications

References 21 publications

Systematic Review and Meta-analysis of the Additional Benefit of Pharmacological Thromboprophylaxis for Endovenous Varicose Vein Interventions

Systematic Review and Meta-analysis of the Additional Benefit of Pharmacological Thromboprophylaxis for Endovenous Varicose Vein Interventions

The role of hyaluronic acid in polidocanol foam: An in vitro study

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