Endothermal Heat-Induced Thrombosis After Endovenous Laser Ablation: A Single-Center Experience

Abstract Lower limb varicose veins are a common vascular disorder producing pain and disability when truncal vein reflux is present. Endovenous laser ablation (EVLA) of the great saphenous vein (GSV) is a safe and effective method for treating this condition. An unintended complication of this procedure is endothermal heat-induced thrombosis (EHIT) of common femoral vein. An retrospective outcome analysis of patients who underwent EVLA of the GSV at King Khalid University Hospital from June 2006 to November 2018 was conducted to identify the risks factors and incidence of EHIT. Patients were assessed by clinical examination and duplex ultrasound imaging after the EVLA , and patient demographic and procedural factors for predictive of EHIT were determined . Following EVLA, 11,070 duplex ultrasound examinations were performed for 1230 limbs and EHIT was detected in 65 limbs (5.3%) in 60 patients (6.8%). Essentially all EHIT cases were detected in the 1st week (n = 63; 96.9%) and clot regression occurred over a period of 1–4 weeks. There were no significant differences in the patient demographics or procedural factors between the EHIT and non-EHIT groups, except for the percentage of women (86% vs. 73%; P = 0.02), maximum GSV diameter (6.7 ± 2.7 vs. 6.0 ± 2.1 mm; P = 0.04), and percentage of patients with a competent saphenofemoral junction (SFJ; 41% vs. 37%; P