Endovenous laser ablation of the great saphenous vein in patients with von Willebrand disease

Abstract

Introduction. Patients with von Willebrand disease have a high risk of bleeding during the surgical treatment of varicose veins. Endovenous laser ablation (EVLA) of the great saphenous vein (GSV) is a minimally invasive treatment for saphenofemoral junction incompetence. The number of complications and relapse rate of EVLA are lower than in those of conventional surgical treatment. Case presentation. A patient with great saphenous vein insufficiency, von Willebrand disease and hypofibrinogenemia successfully underwent endovenous laser ablation. Replacement therapy with cryoprecipitate was administered preoperatively and postoperatively. The surgical procedure and postoperative course were unremarkable. Conclusion. In patients with von Willebrand disease and other coagulation disorders, endovenous laser ablation is a safe and effective treatment. The use of minimally invasive treatment, the adequate correction of haemostasis, and close cooperation between the haematologist, anaesthesiologist and endovascular surgeon reduce the risk of bleeding.