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The Journal of Cardiovascular Surgery 2021 Apr 23

DOI: 10.23736/S0021-9509.21.11898-1

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Thrombotic complications of superficial endovenous ablation: a contemporary review of thermal and non-thermal techniques

Mariya S. KOCHUBEY 1, Sammy S. SIADA 1, Megan TENET 2, Misaki M. KIGUCHI 2, Rachel C. DIRKS 1, Leigh A. O'BANION 1

1 Division of Vascular and Endovascular Surgery, University of California San Francisco-Fresno, Fresno, CA, USA; 2 Department of Vascular Surgery, MedStar Washington Hospital Center, Washington D.C., USA


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Endovenous ablation has become the preferred means to treat superficial venous insufficiency. Ablative technologies have evolved to include a variety of both thermal and nonthermal techniques. The reported thrombotic complications of endovenous heat induced thrombosis (EHIT) and deep venous thrombosis (DVT) associated with thermal techniques are low (<2% overall). However, the limited data on newer non-thermal technologies suggest these modalities may have thrombotic complication rates upwards of 6%. Additionally, the pathophysiology of thrombotic events related to mechanochemical ablative techniques may differ from EHIT, and thus, may have different implications for management. Described is a case report of a stroke after cyanoacrylate ablation of the great saphenous vein, and a review of the current literature reporting the thrombotic complications associated with current thermal and non-thermal techniques. There exists a need for high volume studies on newer ablative techniques to fully understand their associated thrombotic complications. This review highlights the need for a comprehensive classification system and standard treatment algorithm encompassing of thrombotic complications associated with both thermal and non-thermal ablative techniques.


KEY WORDS: Endovenous ablation; Thermal ablation; Non-thermal ablation; Endovenous heat induced thrombosis; Endovenous glue induced thrombosis; Deep vein thrombosis

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