Value of delayed duplex ultrasound assessment after endothermal ablation of the great saphenous vein

Journal of Vascular Surgery
Evan J RyerDavid P Franklin

Abstract

Endothermal ablation (ETA) of the great saphenous vein (GSV) is associated with a small but definite risk of endothermal heat-induced thrombosis (EHIT) extending into the common femoral vein. Follow-up duplex ultrasound imaging to detect EHIT after ETA is considered standard of care, although the exact timing of duplex ultrasound imaging to detect EHIT after ETA remains unclear. We hypothesized that an additional duplex ultrasound assessment 1 week after ETA would not identify a significant number of patients with EHIT and would significantly increase health care costs. This was a retrospective review of consecutive ETA GSV procedures from 2007 to 2014. All patients were evaluated with duplex ultrasound imaging on postprocedure day 1, and 79% of patients underwent a second ultrasound assessment 1 week postprocedure. EHIT was considered present when proximal GSV closure progressed to level ≥4, based on a six-tier classification system. From January 1, 2007, until December 31, 2014, 842 patients underwent GSV ETA. Patients with EHIT were more likely to have had a prior deep venous thrombosis (DVT; P = .002) and a larger GSV (P = .006). Forty-three procedures (5.1%) were classified as having EHIT requiring anticoagulation, based o...Continue Reading

References

Oct 8, 1999·Journal of Vascular Surgery·J J SmithA H Davies
May 21, 2003·Journal of Vascular Surgery·Robert M KaplanArnost Fronek
Feb 23, 2005·Annals of Epidemiology·Jennifer L Beebe-DimmerDavid Schottenfeld
Apr 17, 2007·Seminars in Hematology·Mary Cushman
Jul 22, 2010·Journal of Vascular Surgery·Peter F LawrenceVicki Carter
Jan 27, 2012·Journal of Thrombosis and Thrombolysis·April L RodriguezJose A Diaz
Feb 22, 2013·Vascular and Endovascular Surgery·Soo J RheeJulianne Stoughton
Nov 12, 2013·Annals of Vascular Surgery·Chad E JacobsWalter J McCarthy
Jun 10, 2014·Annals of Vascular Surgery·Katherine KaneWilliam Shutze

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