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Is it true that blot clots relating to the endovenous laser ablation procedure are generally visible within the first 24 hours? Or, is this rather a long-term potential side-effect arising from the procedure? I am worried about this risk.
In our clinic, we bring ablation patients back in 3 days to check for DVT. The risk of DVT is present, but small.
There is a very low risk for DVT at any time after EVLT.
Answered by Dr. Stuart A. Harlin
Blood clots after thermal ablation using laser or radiofrequency are exceedingly rare, yet do occur. The events are typically observed within the first week if they are to happen. Recognizing that having varicose veins places you at risk for DVT, then in theory, if you have successful ablation you have reduced your risk of blood clots on a longer-term basis. Additional steps you should take to minimize your risk for blood clot after thermal ablation is to wear properly fitted compression, and walk. If you are unable to walk, you should not have the procedure. In summary, you are correct to be concerned about developing a blood clot. There are steps to minimize your risk. If you are still concerned, your physician may prescribe anti-coagulation for the first 3-5 days when your risk is greatest. I hope this helps ease your concerns and offers preventative support.
There wouldn't be any DVT risk with any vein treatment, only SVT. However, since those are just superficial clots, they are not a health risk, just painful. The superficial clots would only occur in the treated vein, and they stay superficial.
Most people are at a higher risk of developing a DVT post Endovenous laser ablation during the first 4-10 days.
Studies have shown it is not uncommon to develop minor DVT in the femoral vein within 1-2 weeks after ELA. However, most such DVT are small, do not cause symptoms, are unimportant, and resolve spontaneously. DVT is unlikely with expert treatment and the post-treatment use of compression stockings plus activity.
The risk can extend for quite a period of time. I usually suggest that my patients use precautions for several months. For example, I have them wear full length support hose with long travel for 2 months after the procedure.
Only in the first week does a clot appear in the common femoral vein after ablation. This is quite easily controlled with blood thinners and disappears rapidly.
Yes, blood clots after endovenous laser ablation are typically an immediate or short term risk over the first few days after the treatment. If the procedure is done correctly, there is typically a 1 percent risk of blood clot. Everyone who undergoes the procedure is screened for this complication within the first week of treatment. There is typically no long-term risk of blood clots related to the procedure.
DVT is a risk factor for most procedures, from dental, veins, orthopedic, etc. However, if an endovenous laser ablation is done correctly by an experienced surgeon who is also a trained vascular ultrasound technician, the risk factor is minimal. We recommend compression hose immediately after the procedure and worn for 1-3 week, depending upon the patient. Remaining well hydrated, and getting up and walking around frequently after the procedure are very important. If you were to develop a clot it can happen, as with any surgery, soon after the procedure of some time in the next few weeks. There are other risk factors to consider also such as family history, clotting disorders, obesity, smoking, history of cancer and age.
If none of these apply and your surgeon is experienced, you should have very low risk.
The time-frame is from the time of the procedure to about a week. Some clots may be too small to detect right away. Your risk may be enhanced by heredity factors (thrombophilia) or other factors (hormonal, smoking, inactivity). It has been our impression that the general clot risk is rare per the large numbers of these cases done over the past decade. We don't believe there is a long term risk from each procedure, and if we have concerns we anti-coagulate patients as a preventive measure for about 3 to 7 days post procedure.
The risk of DVT after venous ablation is very low. It can happen as a consequence of a technical problem during the procedure or later if the patient does not ambulate as recommended. Proper careful technique done by an experienced Vein Specialist and ambulation and exercise from the moment that the procedure is completed are crucial to avoid this complication.
Generally the first couple of days.
The risk of an endovenous ablation associated DVT is reported as less then 1 percent and is probably closer to .01 percent, so it is a very rare complication.
The incidence of DVT following endogenous ablation is very low, less than 1 percent within one month post procedure. I have been doing this procedure for over 12 years and have completed more than 12 thousand procedures. I have seen a total of 5 DVTS and 3 of them had other probable reasons for the DVT. If DVT is to occur, it can happen usually within one month of the procedure. Also, there is a recognized HEAT INDUCED THROMBUS that can occur within one week of the procedure, and fortunately, resolves spontaneously in most cases. This sometimes needs to be treated, depending on its size and appearance. Your treating vein specialist would be aware of this.
My routine post ablation is to have patients scanned in the groin area 7 days after an ablation procedure. If something suspicious is seen (scar or small clot), then I will treat them with a short course of blood thinner (Plavix for scar and Lovenox/Coumadin from presumed small clot). The overall risk of either of these being noted one week later is 1-2 percent. I think this a very acceptable risk given the symptoms that will be relieved with the procedure. Comparatively, the stripping of years ago carried with it a much greater risk of DVT post operatively. Varicose veins left alone, and also skin changes left alone, may result in complications of clots and ulcerations. So, if the procedure is done for the right indications, the risk of DVT is not a
major consideration. These are my personal observations after more than 7,500 ablation procedures.