Post Ablation Superficial Thrombus Extension (PASTE) as a consequence of endovenous ablation. An up-to-date review

After any kind of endovenous ablation, including Laser, RF and chemical ablation, it is common to find a floating thrombus, extending from the termination of the greater saphenous vein (GSV) and in continuity with the closure in the treated GSV. Post Ablation Superficial Thrombus Extension (PASTE) is not a DVT, differing from the spontaneous floating thrombus in several features. Though isolated reports of thromboembolism, PASTE is not evolutive and requires only a planned monitoring at 1 week, generally disappearing spontaneously at 2 weeks.

Some parameters can influence thrombosis extension in the saphenous femoral junction (SFJ) as the male gender and the distance of the device tip from the SFJ. Superficial epigastric vein is generally preserved in endovenous ablation (EVA) procedures in order to insure a distance to the SFJ and a washing vessel mechanism.

Washing vessels date long before and were used in the treatment of the shorter saphenous vein. PASTE is a provoked thrombosis and also an answer to a planned injury, occurring in a well defined starting moment. EVA procedures are widely applied in the human, thus they are a very big source of observations to study the evolution of thrombosis.