Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins

Venous thromboembolic complications (VTEO) after modern minimally invasive superficial vein interventions are an infrequent but very dramatic event. This article presents a review of the literature, covering the issues of prevalence, prognosis and pharmacological prevention of VTEO. The performed st...

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Main Authors: K. V. Lobastov, M. V. Shaldina, D. A. Borsuk, I. V. Schastlivtsev, L. A. Laberko, А. A. Fokin
Format: Article
Language:Russian
Published: Remedium Group LTD 2022-11-01
Series:Амбулаторная хирургия
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Online Access:https://www.a-surgeon.ru/jour/article/view/310
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author K. V. Lobastov
M. V. Shaldina
D. A. Borsuk
I. V. Schastlivtsev
L. A. Laberko
А. A. Fokin
author_facet K. V. Lobastov
M. V. Shaldina
D. A. Borsuk
I. V. Schastlivtsev
L. A. Laberko
А. A. Fokin
author_sort K. V. Lobastov
collection DOAJ
description Venous thromboembolic complications (VTEO) after modern minimally invasive superficial vein interventions are an infrequent but very dramatic event. This article presents a review of the literature, covering the issues of prevalence, prognosis and pharmacological prevention of VTEO. The performed studies demonstrate that the incidence of symptomatic thrombotic complications after endovenous thermal obliteration does not exceed 0,5%, but taking into account asymptomatic thermally induced thromboses and subclinical occlusions of the muscular veins of the lower leg, this figure can exceed 10%. There is a high heterogeneity of the data, possibly due to differences in the individual risk of VTEO. The most validated tool for assessing the latter is the Caprini Scale, which has not been sufficiently studied in the surgical treatment of varicose veins. The administration of prophylactic doses of anticoagulants after thermal obliteration of saphenous veins is widely used in routine clinical practice, despite the lack of convincing evidence for the appropriateness of this approach. In recent years, the use of direct oral anticoagulants against the official instruction (off-label) has gained great popularity as an alternative to heparin. The largest evidence base has accumulated for the use of rivaroxaban 10 mg, which is associated with high efficacy and safety. Based on completed clinical trials, it is not possible to formulate unequivocal recommendations for prophylactic anticoagulant doses after thermal obliteration of superficial veins at this time. Additional studies are required to identify patients with an individually increased risk of thrombosis in whom prophylactic doses of anticoagulants may be of maximum benefit.
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spelling doaj-art-19c59f6cfd704270938e8cbfae3d817e2025-08-20T02:17:36ZrusRemedium Group LTDАмбулаторная хирургия2712-87412782-25912022-11-01192627110.21518/1995-1477-2022-19-2-62-71269Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veinsK. V. Lobastov0M. V. Shaldina1D. A. Borsuk2I. V. Schastlivtsev3L. A. Laberko4А. A. Fokin5Pirogov Russian National Research Medical UniversityClinic of Phlebology and Laser Surgery VenoClinicaClinic of Phlebology and Laser Surgery VenoClinica; South Ural State Medical UniversityPirogov Russian National Research Medical UniversityPirogov Russian National Research Medical UniversitySouth Ural State Medical UniversityVenous thromboembolic complications (VTEO) after modern minimally invasive superficial vein interventions are an infrequent but very dramatic event. This article presents a review of the literature, covering the issues of prevalence, prognosis and pharmacological prevention of VTEO. The performed studies demonstrate that the incidence of symptomatic thrombotic complications after endovenous thermal obliteration does not exceed 0,5%, but taking into account asymptomatic thermally induced thromboses and subclinical occlusions of the muscular veins of the lower leg, this figure can exceed 10%. There is a high heterogeneity of the data, possibly due to differences in the individual risk of VTEO. The most validated tool for assessing the latter is the Caprini Scale, which has not been sufficiently studied in the surgical treatment of varicose veins. The administration of prophylactic doses of anticoagulants after thermal obliteration of saphenous veins is widely used in routine clinical practice, despite the lack of convincing evidence for the appropriateness of this approach. In recent years, the use of direct oral anticoagulants against the official instruction (off-label) has gained great popularity as an alternative to heparin. The largest evidence base has accumulated for the use of rivaroxaban 10 mg, which is associated with high efficacy and safety. Based on completed clinical trials, it is not possible to formulate unequivocal recommendations for prophylactic anticoagulant doses after thermal obliteration of superficial veins at this time. Additional studies are required to identify patients with an individually increased risk of thrombosis in whom prophylactic doses of anticoagulants may be of maximum benefit.https://www.a-surgeon.ru/jour/article/view/310varicose vein diseaseendovenous thermal obliterationendovenous laser coagulationradiofrequency ablationcaprini scalepharmacological prophylaxisvenous thromboembolic complications
spellingShingle K. V. Lobastov
M. V. Shaldina
D. A. Borsuk
I. V. Schastlivtsev
L. A. Laberko
А. A. Fokin
Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins
Амбулаторная хирургия
varicose vein disease
endovenous thermal obliteration
endovenous laser coagulation
radiofrequency ablation
caprini scale
pharmacological prophylaxis
venous thromboembolic complications
title Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins
title_full Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins
title_fullStr Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins
title_full_unstemmed Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins
title_short Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins
title_sort current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins
topic varicose vein disease
endovenous thermal obliteration
endovenous laser coagulation
radiofrequency ablation
caprini scale
pharmacological prophylaxis
venous thromboembolic complications
url https://www.a-surgeon.ru/jour/article/view/310
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