Are there higher risks for a patient with Factor V Leiden during the endovenous laser ablation procedure?
There is higher risk for DVT and superficial thrombophlebitis, but Factor V Leiden deficiency is not a contraindication to ablation.
Published on Jul 11, 2012
Endovenous Laser Ablation, ELA, has a very small but real risk of
complications such as DVT and or phlebitis. The risk is somewhere between 1
in 1000 and 1 in 10,0000 ELA will have that complication. Factor V Leiden
is a inherited disorder that increase the risk of phlebitis or DVT by 8
fold for patients heterozygous the disorder, have one copy of the gene, and
80 fold for patient homozygous have two copies of the gene. So yes there is
higher risk.
Published on Jul 11, 2012
There is a higher risk of a DVT with Leiden Factor V, but this risk can
be reduced if the blood thinner Lovenox is given prior and following
your procedure. The risk of bleeding with EVLA while on Lovenox is
minimal as long as no incisions are made. We use a very small 4f fiber
that only needs a very small puncture with a 22 ga. needle and have
never had a bleeding problem.
Published on Jul 11, 2012
Probably. Not much data out there on that though. I usually give my patients with this, prophylactic injections of low molecular weight heparin post op for a week for protection. Check with your provider.
Michael D. Ingegno
Published on Jul 11, 2012
We typically have patients who have this take Lovenox injection the morning of the procedure and for several days after with no problems. Talk with your surgeon and primary care doctor. The results of the procedures are the same.
Published on Jul 11, 2012
The risk of forming a clot at the femoral vein is low, but many physicians will place the patient on a short course of injectable anticoagulant such as Lovenox.
Stephen F. Daugherty, MD, FACS, RVT, RPhS
Published on Jul 11, 2012
Yes but they could probably be overcome with appropriate measures.
David A. Engleman M.D.
Published on Jul 11, 2012
I feel that there is a slightly higher risk for DVT following VENOUS ABLATION in patients with Leiden Factor 5 Deficiency. However, over the years, and after doing the procedure on multiple patients with this deficiency, I have not had a single case of DVT develop post procedure. Early on I would obtain a Hematology consult to see if there was a need for anticoagulation but we did nothing more than an adult ASA the day before, day of and day after the procedure. This was prophylactic and I am not sure this is even necessary. Since the procedure is done awake with tumescent anesthesia and immediate mobilization, the risk of clotting is low but I do feel that close post op follow up is necessary.
Published on Jul 11, 2012