Post-ablation deep vein material extension (PDME) - classification, treatment considerations and future research objectives.

With excellent outcomes achievable using endovenous treatment of refluxing truncal veins, extension of ablative material and/or thrombus into adjacent deep veins is an important complication which can lead to deep venous thrombosis (DVT) or pulmonary embolism (PE). Previous work has used poorly defined terminology to identify patients with material in the deep venous system following ablation, limiting synthesis of results and the formation of treatment guidelines. We propose the term Post-ablation Deep vein Material Extension (PDME) to identify cases of ablative material and/or thrombus in the adjacent deep veins, with sub-categorisations according to mode of ablation used. PDME is a distinct entity from DVT, with often a shorter clinical course, few symptoms reported by patients, and possibility of resolution without treatment in some cases. This article explores the different forms of PDME, their classifications, and possible aetiology. A precise classification is proposed to ensure transparency in future research into this area.