Vasc Spec Int.  2016 Jun;32(2):72-76. 10.5758/vsi.2016.32.2.72.

Delayed Presentation of Endovenous Heat-Induced Thrombosis Treated by Thrombolysis and Subsequent Open Thrombectomy

• Kwak JH
• Min SI
• Kim SY
• Han A
• Choi C
• Ahn S
• Ha J
• Min SK

• KMID: 2328036
• DOI: http://doi.org/10.5758/vsi.2016.32.2.72

Abstract

Although endovenous heat-induced thrombosis (EHIT) is frequently reported after endovenous laser ablation (EVLA), the incidence and timing of occurrence of EHIT are not fully understood. We present a case of EHIT successfully treated with a combination of surgical and endovascular treatments. A 57-year-old woman, two months post bilateral EVLA, presented with a swollen leg. Deep vein thrombosis was diagnosed by Doppler ultrasonography and computerized tomographic venography. We treated the patient with catheter-directed thrombolysis with urokinase after insertion of an inferior vena cava filter. After thrombolytic treatment, we performed surgical venous thrombectomy, due to the presence of a large thrombus in the femoral vein. During the operation, we found organized old thrombus at the great saphenous vein which connected to the deep femoral vein. From these findings, we confirmed the presence of EHIT despite a long time having passed after EVLA. The patient was placed on anticoagulation therapy with oral rivaroxaban for three months.

Keyword

Venous thrombosis; Laser therapy; Catheter ablation

MeSH Terms

Catheter Ablation
Female
Femoral Vein
Humans
Incidence
Laser Therapy
Leg
Middle Aged
Phlebography
Rivaroxaban
Saphenous Vein
Thrombectomy*
Thrombosis*
Ultrasonography, Doppler
Urokinase-Type Plasminogen Activator
Vena Cava Filters
Venous Thrombosis
Rivaroxaban
Urokinase-Type Plasminogen Activator