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Comparative Study
. 2015 Apr;30(3):204-9.
doi: 10.1177/0268355513514047. Epub 2013 Dec 4.

Endovenous saphenous vein ablation in patients with acute isolated superficial-vein thrombosis

Wayne S Gradman  1
Affiliations
Comparative Study

Endovenous saphenous vein ablation in patients with acute isolated superficial-vein thrombosis

Wayne S Gradman. Phlebology. 2015 Apr.

Abstract

Objective: The possible benefits of endovenous saphenous ablation (EVSA) as initial treatment in patients presenting with isolated superficial-vein thrombosis (SVT) and saphenous vein reflux include: (1) definitive treatment of the underlying pathology and (2) elimination of the saphenous vein as a path for pulmonary emboli, which (3) may eliminate the need for anticoagulation.

Methods: In a ten-year review of 115 limbs presenting with acute isolated SVT, 72 limbs (71 patients) with saphenous reflux were given a choice of two treatments following an explanation of the risks and benefits of each. Group I limbs (n = 41) were treated with office EVSA using radiofrequency or laser with or without thrombophlebectomy if performed within 45 days of diagnosis. Post-treatment anticoagulants were not given. Group II limbs (n = 31) were treated with compression hose and repeat Duplex within one week, with added anticoagulants if SVT extended into the thigh.

Results: In group I, mean interval from diagnosis to treatment was 13.7 days. One calf deep vein thrombosis was noted. In group II no complications were noted. In late follow-up of group II patients, 12/29 underwent EVSA more than 45 days after initial presentation.

Conclusions: The safety and efficacy of EVSA and thrombophlebectomy appear indistinguishable from conservative measures and may be offered as initial treatment to patients presenting with SVT and saphenous reflux.

Keywords: Saphenous vein ablation; phlebectomy; saphenous reflux; superficial-vein thrombosis; treatment.

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Figures

Figure 1.
Figure 1.
Algorithm for managing patients presenting with isolated SVT. EVSA: endovenous saphenous ablation; Group I: electing EVSA; Group II: not electing EVSA; F/U: follow-up; GSV: great saphenous vein; SVT: superficial-vein thrombosis.
Figure 2.
Figure 2.
Kaplan–Meier estimate of two-year cumulative EVSA in 72 candidate patients presenting with isolated superficial-vein thrombosis. An additional four patients underwent EVSA in years 3–10. SE < 10% through year 10.
See this image and copyright information in PMC

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