Heat-induced thrombosis extension after endovenous laser ablation: a clinical case
https://doi.org/10.25207/1608-6228-2020-27-4-179-188
Abstract
Endothermal heat-induced thrombosis (EHIT) is a complication of endovenous thermal ablation in treatment of varicose veins. Existing classifications do not account for the length of thrombus extension floating in the deep venous system. While the risk of extension is minor, the consequences can be baleful.
Aim. To report a rare clinical case of endothermal heat-induced thrombosis extension formed in spite of ongoing anticoagulant treatment in a patient with endovenous laser ablation.
Results. A 39 years-old man with endovenous laser ablation of the right great saphenous vein had class 2 EHIT with 1.92 cm length on the next day after surgery. Rivaroxaban was prescribed at a dose of 15 mg 2 times a day. EHIT extension above the inguinal ligament occurred on the 15th day after surgery, despite oral anticoagulant treatment. Open thrombectomy with high ligation was ordered. Postoperative period without complications. Preoperative Caprini score was 6 (varicose veins, BMI> 25 kg/m2 , minor surgery, personal history of venous thromboembolism (VTE)).
Conclusion. The reported clinical case illustrates that both the choice of treatment strategy and follow-up of patients with EHIT need to account for the combined risk of embolism with existing EHIT and potential thrombus extension with subsequent massive embolism.
About the Authors
A. A. Fokin
South-Ural State Medical University
Russian Federation
Russian Federation
Alexey A. Fokin — Dr. Sci. (Med.), Prof., Head of the Chair of Surgery
Vorovskogo str., 64, Chelyabinsk, 454092
D. A. Borsuk
Vasculab L.L.C.
Russian Federation
Russian Federation
Denis A. Borsuk — Cand. Sci. (Med.), Chief Doctor, Clinic of Phlebology and Laser Surgery
Pushkina str., 50, Chelyabinsk, 454091
A. V. Sazanov
Regional Clinical Hospital No. 3
Russian Federation
Russian Federation
Alexey V. Sazanov — Head of the Vascular Surgery Unit
Pobedy ave., 287, Chelyabinsk, 454021
H. P. Manjikyan
A.K. Eramishantsev City Clinical Hospital; A.V. Vishnevsky Institute of Surgery
Russian Federation
Russian Federation
Hovsep P. Manjikyan — Cardiovascular Surgeon, A.K. Eramishantsev City Clinical Hospital; Degree Candidate, A.V. Vishnevsky Institute of Surgery
Lenskaya str., 15, Moscow, 129327
Bolshaya Serpukhovskaya str., 27, Moscow 117997
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Review
For citations:
Fokin A.A., Borsuk D.A., Sazanov A.V., Manjikyan H.P. Heat-induced thrombosis extension after endovenous laser ablation: a clinical case. Kuban Scientific Medical Bulletin. 2020;27(4):179-188. (In Russ.) https://doi.org/10.25207/1608-6228-2020-27-4-179-188
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