演題

IS-1-7

Incidence and management of endothermal heat induced thrombosis(EHIT) after radiofrequency ablation(RFA) of saphenous veins

[演者] Brajesh Singh:1
1:Sanjay Gandhi Postgraduate Institute of Medical Sciences, India

BACKGROUND:RFA of saphenous vein has become preferred treatment for treating saphenous vein reflux. Initially it showed to have low incidence of postoperative thrombosis of femoral or popliteal vein adjacent to treated GSV or SSV. Later clinical experience suggested that the actual incidence of this event is higher and it was subsequently termed EHIT.METHODS:We reviewed pre and post treatment ultrasounds of patients undergoing RFA from 2010 to 2013 to determine the frequency of EHIT in patients we had treated and then graded them according to a previously published classification.RESULTS:There were 376 veins treated. CEAP class for these patients was 1(0),2(206),3(45),4(75),5(19),and 6(31). GSV was treated in 355, SSV in 15,and both were treated in 6 patients. EHIT occurred in 20 legs(5.31%). EHIT in femoral vein were of level 3(2),4(5),5(10), and 6(2), respectively. One patient developed EHIT in the popliteal vein after RFA of the SSV. Treatment for EHIT consisted of observation(11), anticoagulation(7), antiplatelet therapy(1), and nonsteroidal anti-inflammatory agents(1). Duration of therapy was usually 1 week. No pulmonary emboli occurred in any of these patients. EHIT resolved completely in all patients.CONCLUSIONS:EHIT after RFA occurs frequently and mainly consists of low-risk level 3, 4, and 5 deep vein thrombosis. Risk of pulmonary embolism is low and EHIT typically resolves after 1 week. It can be treated with a short course of antiplatelet or anticoagulation therapy, although observation appears to be sufficient as well for lesser grades of EHIT.
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