Post ablation thrombi extensions as complication after endovenous catheter procedures (Post ablation thrombus extension [PATE])

Summary

Post ablation thrombi extensions are with a prevalence of 0.2–6% a not uncommon complication after endovenous catheter procedures. Potential risk factors have not been adequately studied, and there is a lack of standards for appropriate prophylaxis and a consistent treatment regimen. We carried out a retrospective analysis of the prevalence and possible risk factors for the occurrence of an apposition thrombus after endovenous procedures in the Vein Center Freiburg, Germany in 2015–2017. The risk factors described in the literature, such as vessel diameter> 7.5 mm, simultaneous mini-phlebectomies and an increased BMI could not be verified. The staging and designations of the apposition thrombus in international use such as EHIT (endovenous heat-induced thrombosis) and PASTE (post ablation superficial thrombus extension) are misleading as this complication may also occur in non-thermal procedures and the thrombus extension is into the deep venous system. Therefore, we recommend the modified name PATE (post ablation thrombus extension). A PATE 0 corresponds to a plan closure and is therefore a therapeutic success. PATE I describes thrombus extension with lumen narrowing up to 25%, PATE II to 50%, and PATE III> 50%. The authors recommend a therapeutic anticoagulation from PATE II on with a duration until the disappearance of the apposition thrombus.

English version available at: www.phlebologieonline.de

Keywords

Post ablation thrombus - EHIT - PASTE - PATE - endovenous laser treatment - Laser - RFA - thrombosis - varicosis

• Literatur

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