Endothermal heat-induced thrombosis after endovenous laser ablation in diabetic patients with varicose disease with different energy modes

Abstract

Aim: Endothermal heat-induced thrombosis (EHIT) is defined as propagation of a thrombus from a superficial vein into a deeper vein and is generally considered clinically insignificant if the thrombus does not propagate to the deep venous system. The condition can be treated with anticoagulation therapy, although monitoring may be sufficient, especially in less severe cases. Endovascular laser ablation (EVLA) have become popular techniques for treating varicose veins. Endothermal heat induced thrombosis is a complication unique to endovenous ablation. It reflects the extension of the thrombus from the ablated saphenous vein into deep venous system. Endovenous laser ablation in patients with diabetes mellitus is not well published. To compare the endothermal heat induced thrombosis incidence rate after EVLA performed with three different energy densities. The outcomes of the 140 patients with diabetes after EVLA were analyzed. Material and Methods: 80-100 J/cm energy was applied in the 1st group (n=60), 100-120 J/cm in the 2nd (n=40), and 120-140 J/cm in the 3rd group (n=40) patients. All patients received Enoxaparin 40mg subcutaneously, for thrombose prevention after EVLA for 7 days. Results: There were 32 EHIT cases (22.86%) detected with duplex US investigation 7 days after EVLA. The incidence rate among groups was 31.7%, 20%, and 12.5% accordingly. Conclusion: The analyses show that 120-140 J/cm energy density is the most safe and effective treatment mode for EVLA in patients with diabetes mellitus.