Journal of vascular and interventional radiology : JVIR · 2026
Clinical Characteristics and Risk Factors of Endovenous Heat-Induced Thrombosis After Radiofrequency Ablation vs Endovascular Microwave Ablation.
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Sun Lei, Yang Tao, Xu Huimin, Gao Hongxia
Аннотация
OBJECTIVE: To investigate the risk factors of endovenous heat-induced thrombosis (EHIT) after treatment of lower-limb varicose veins with radiofrequency ablation (RFA) and endovascular microwave ablation (EMA).
METHODS: A retrospective analysis was conducted of 246 patients with lower-limb varicose veins. Patients were divided into an RFA group (n=104), an EMA group (n=102), and a conservative-treatment group (n=40). The great saphenous vein (GSV) diameter was measured by preoperative ultrasound. Postoperative indicators included the incidence and grading of EHIT, venous clinical severity score (VCSS), and 1-month follow-up outcomes.
RESULTS: The overall EHIT incidence was 12.2% (30/246), with no significant differences among groups: RFA 13.5% (14/104), EMA 13.7% (14/102), and conservative treatment 5.0% (2/40, P>0.05). Multivariate analysis identified weight ≥ 80 kg (odds ratio [OR]=3.46, P=0.006), GSV diameter >8 mm (OR=2.89, P=0.027), postoperative D-dimer >0.5 mg/L (OR=2.76, P=0.037), postoperative CRP >15 mg/L (OR=2.97, P=0.022), and Caprini score ≥3 (OR=3.12, P=0.015) as independent risk factors for EHIT. The EHIT rate was significantly higher in patients with GSV diameter >8 mm than in those with diameter ≤8 mm (22.2% vs 7.5%, P<0.05).
CONCLUSIONS: RFA and EMA demonstrate similar EHIT incidence in the management of lower-limb varicose veins. Body weight, GSV diameter, postoperative D-dimer, postoperative CRP, and Caprini score are key risk factors for EHIT.
METHODS: A retrospective analysis was conducted of 246 patients with lower-limb varicose veins. Patients were divided into an RFA group (n=104), an EMA group (n=102), and a conservative-treatment group (n=40). The great saphenous vein (GSV) diameter was measured by preoperative ultrasound. Postoperative indicators included the incidence and grading of EHIT, venous clinical severity score (VCSS), and 1-month follow-up outcomes.
RESULTS: The overall EHIT incidence was 12.2% (30/246), with no significant differences among groups: RFA 13.5% (14/104), EMA 13.7% (14/102), and conservative treatment 5.0% (2/40, P>0.05). Multivariate analysis identified weight ≥ 80 kg (odds ratio [OR]=3.46, P=0.006), GSV diameter >8 mm (OR=2.89, P=0.027), postoperative D-dimer >0.5 mg/L (OR=2.76, P=0.037), postoperative CRP >15 mg/L (OR=2.97, P=0.022), and Caprini score ≥3 (OR=3.12, P=0.015) as independent risk factors for EHIT. The EHIT rate was significantly higher in patients with GSV diameter >8 mm than in those with diameter ≤8 mm (22.2% vs 7.5%, P<0.05).
CONCLUSIONS: RFA and EMA demonstrate similar EHIT incidence in the management of lower-limb varicose veins. Body weight, GSV diameter, postoperative D-dimer, postoperative CRP, and Caprini score are key risk factors for EHIT.