Treatment of endovenous heat-induced thrombosis (EHIT) with rivaroxaban (Xarelto®)

S. Werth; K. Halbritter; A. Mahlmann; N. Weiss

doi:10.12687/phleb2264-4-2015

Phlebologie, Table of Contents

Phlebologie 2015; 44(04): 184-187
DOI: 10.12687/phleb2264-4-2015

Case report

Schattauer GmbH

Treatment of endovenous heat-induced thrombosis (EHIT) with rivaroxaban (Xarelto^®)

Article in several languages: English | deutsch

S. Werth

¹Universitäts GefäßCentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany

,

K. Halbritter

¹Universitäts GefäßCentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany

,

A. Mahlmann

¹Universitäts GefäßCentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany

,

N. Weiss

¹Universitäts GefäßCentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany

› Author Affiliations

Abstract

Summary

Introduction: Endovenous heat-induced thrombosis (EHIT) is a known complication after endovenous ablation of the superficial varicose veins (incidence rate 0–6 % (varies by definition and diagnostic algorithm). However, only expert suggestions for indication, duration and dosing of treatment drugs exist. The most common recommendation is low-molecular weight heparin in half-therapeutic dosage for EHIT class 2 and therapeutic dosage for patients with EHIT class 3 or 4. Rivaroxaban is an attractive option in the treatment of venous thromboembolic diseases due to the simplification of treatment.

Case report: After successful ablation of the great saphenous vein (GSV) in a patient with complete insufficiency (Hach III) combined with sclerotherapy of superificial varicose veins of the calf the patient got a prophylactic anticoagulation with low-molecular weight heparin (LMWH) and compressions stockings grade II. Nevertheless we saw in the control-compression ultrasound after 7 days an asymptomatic EHIT class 1. Due the progression to EHIT class 3 after another seven days under watchful waiting we treated the patient with Rivaroxaban for 14 days. After the treatment we saw a complete resolution of the clot. Anticoagulant treatment and compression stockings (for three weeks after EVLT) were discontinued.

Keywords

EHIT - thrombosis - endovenous - rivaroxaban

Full Text

References

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