The Incidence, Risk Factors, and Clinical Outcomes for Endovenous Heat-induced Thrombosis after Radiofrequency Ablation

Abstract

Received October 10, 2019 Revised November 18, 2019 Accepted November 26, 2019 Purpose: Endovenous radiofrequency ablation (RFA) is a safe, effective treatment for varicose veins caused by saphenous reflux. Endovenous heat-induced thrombosis (EHIT) is a unique complication for this procedure. This study evaluated the incidence, risk factors, and clinical consequences of EHIT. Methods: We retrospectively reviewed the data of patients with varicose veins who underwent radiofrequency ablation (RFA). Duplex ultrasonography (DUS) was performed within 1 week and then 6 months after the procedure. If EHIT was found at the first postprocedural DUS, then monthly surveillance was done. The incidence of EHIT and the risk factors were analyzed. The clinical consequence was finally investigated. Results: During the study period, a total of 1,247 saphenous veins in 783 patients underwent RFA. Four hundred fifty-seven (58.4%) patients were women. The mean age was 52.9 ± 12.4 years (range: 8–85 years). EHIT was present in 7 (0.6%) saphenous veins in 7 (0.9%) patients. EHIT developed in 6 great saphenous veins (GSV) and 1 small saphenous vein. EHIT class I, II, and III were 3, 2, and 2 patients, respectively. The diameter of GSV ≥ 6 mm was the significant risk factor for the occurrence of EHIT. Six EHITs spontaneously resolved within 5 weeks after the procedure. One EHIT was resolved in 7 months after the procedure. No incidences of pulmonary embolism occurred. Conclusion: EHIT was a rare complication after RFA. Moreover, it spontaneously resolved without any clinical sequelae. Thus, performing routine DUS is not recommended to evaluate EHIT in the asymptomatic patient.