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Published on: February 26, 2013
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Late pulmonary embolism after endovenous laser ablation (EVLA)
Felipe Labaki Pavarino1, Adriano Carvalho Guimarães2, Walter Junior Boim de Araujo3
1Vascular Surgery, Associação Portuguesa de Beneficência de São José do Rio Preto, São José do Rio Preto, SP, Brazil fe_pavarino@hotmail.com.
BMJ Case Reports
|March 19, 2025
Summary
Endovenous laser ablation for great saphenous vein (GSV) incompetence can lead to type II endothermal heat-induced thrombosis, causing pulmonary embolism. Prompt anticoagulation is crucial for managing this rare complication.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiology
Background:
- Great saphenous vein (GSV) incompetence is a common condition often treated with endovenous thermal ablation.
- Complications, though rare, require thorough understanding and management.
Purpose of the Study:
- To report a case of type II endothermal heat-induced thrombosis (EHIIT) following GSV ablation.
- To highlight the potential for EHIIT to cause pulmonary embolism (PE).
Main Methods:
- A patient underwent endovenous laser ablation for bilateral GSV incompetence.
- Postoperative surveillance included duplex ultrasound (DUS) and CT angiography.
- Diagnosis of EHIIT was confirmed via DUS.
Main Results:
- The patient developed a pulmonary embolism with infarction 27 days post-procedure.
- DUS revealed type II EHIIT in the treated GSVs.
- The patient responded well to therapeutic anticoagulation.
Conclusions:
- Type II EHIIT is a rare but serious complication of endovenous laser ablation.
- Early diagnosis and anticoagulation are vital for managing EHIIT-related PE.
- This case underscores the importance of vigilant surveillance after endovenous thermal ablation procedures.
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