Pulmonary embolism after endovenous thermal ablation of the saphenous vein

Armando Rosales-Velderrain, Peter Gloviczki, Sameh M. Said, Magdiel Trinidad Hernandez, Linda G. Canton, Manju Kalra

Research output: Contribution to journalReview article

12 Scopus citations

Abstract

Pulmonary embolism (PE) after venous procedures is fortunately rare. Our goal was to analyze the data of patients who developed PE after endovenous thermal ablation and phlebectomy for varicose veins and to review the literature on this subject. We report on three patients who developed PE after radiofrequency ablation of the great saphenous vein and mini phlebectomy for symptomatic primary lower-extremity varicose veins. Early postoperative duplex scans confirmed successful closure of the great saphenous vein in all. One patient presented with chest pain and dyspnea, one with blood-tinged sputum, and the third with symptoms of saphenous thrombophlebitis. Two patients had PE from the saphenous vein thrombus and the third had gastrocnemius vein thrombosis extending into the popliteal vein. One had previous deep vein thrombosis. Computed tomography of the chest confirmed PE in all. Two patients were treated with anticoagulation, but the third patient with small PE declined such treatment. One patient underwent temporary inferior vena cava filter placement because of recurrent PE. In conclusion, PE is very rare but it can occur after endovenous thermal ablation of lower-extremity varicose veins. Selective thrombosis prophylaxis and preoperative counseling of the patients about signs and symptoms of deep vein thrombosis and PE are warranted for early recognition and rapid treatment.

Original languageEnglish (US)
Pages (from-to)14-22
Number of pages9
JournalSeminars in Vascular Surgery
Volume26
Issue number1
DOIs
StatePublished - Mar 1 2013

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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