EJVES vascular forum · 2026
Early Endovenous Thermal Ablation With Concomitant Anticoagulation in Chronic Venous Insufficiency Complicated by Superficial Venous Thrombosis: A Retrospective Observational Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Zhang Jiasheng, Li Ruihao, Zhang Bingyao, Yuan Hui, Zhang Mao
Аннотация
INTRODUCTION: Whether endovenous thermal ablation (EVTA) can be performed soon after the diagnosis of superficial venous thrombosis (SVT) in patients with chronic venous insufficiency (CVI) remains uncertain. This study assessed the safety and clinical benefit of early EVTA performed under anticoagulation.
METHOD: Consecutive CVI patients with acute SVT (symptom onset ≤14 days) who underwent endovenous laser ablation (EVLA), radiofrequency ablation (RFA), or endovenous microwave ablation (EMA) between January 2022 and March 2025 were identified. All received peri-procedural anticoagulation. Co-primary endpoints were technical success (first post-procedural duplex) and clinical improvement (change in Venous Clinical Severity Score [VCSS] to six months). Secondary endpoints included immediate pain relief (numerical rating scale [NRS] at rest and movement to discharge), Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QoL) change to six months, and complications (including deep vein thrombosis [DVT] and pulmonary embolism [PE]) and recurrence.
RESULTS: The study analysed 255 patients (262 limbs) with a median follow up of 14 months. Mean procedure duration was 54.3 ± 22.1 minutes. Complications were uncommon: DVT 1.2% (3 of 262), minor bleeding 0.78% (2 of 255); there was no PE, re-operation, or infection. Pain improved substantially (NRS decreased by 2.59 points at rest and 4.15 points with movement). Clinical severity and QoL also improved (VCSS decreased by 5.73 ± 1.78 points; VEINES-QoL increased by 12.87 ± 1.92 points). Outcomes and complication rates did not differ between EVLA, RFA, and EMA.
CONCLUSION: In this cohort, early EVTA under anticoagulation appeared feasible and was associated with low thrombotic and bleeding complication rates and clinically meaningful improvements in pain, clinical severity, and quality of life. Given the non-controlled design, findings should be interpreted as hypothesis generating and warrant confirmation in comparative prospective studies.
METHOD: Consecutive CVI patients with acute SVT (symptom onset ≤14 days) who underwent endovenous laser ablation (EVLA), radiofrequency ablation (RFA), or endovenous microwave ablation (EMA) between January 2022 and March 2025 were identified. All received peri-procedural anticoagulation. Co-primary endpoints were technical success (first post-procedural duplex) and clinical improvement (change in Venous Clinical Severity Score [VCSS] to six months). Secondary endpoints included immediate pain relief (numerical rating scale [NRS] at rest and movement to discharge), Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QoL) change to six months, and complications (including deep vein thrombosis [DVT] and pulmonary embolism [PE]) and recurrence.
RESULTS: The study analysed 255 patients (262 limbs) with a median follow up of 14 months. Mean procedure duration was 54.3 ± 22.1 minutes. Complications were uncommon: DVT 1.2% (3 of 262), minor bleeding 0.78% (2 of 255); there was no PE, re-operation, or infection. Pain improved substantially (NRS decreased by 2.59 points at rest and 4.15 points with movement). Clinical severity and QoL also improved (VCSS decreased by 5.73 ± 1.78 points; VEINES-QoL increased by 12.87 ± 1.92 points). Outcomes and complication rates did not differ between EVLA, RFA, and EMA.
CONCLUSION: In this cohort, early EVTA under anticoagulation appeared feasible and was associated with low thrombotic and bleeding complication rates and clinically meaningful improvements in pain, clinical severity, and quality of life. Given the non-controlled design, findings should be interpreted as hypothesis generating and warrant confirmation in comparative prospective studies.