Incidence of deep vein thrombosis after varicose vein surgery.
BACKGROUND
Varicose vein surgery is generally considered to have little risk of postoperative deep vein thrombosis (DVT). This prospective study examined the incidence of DVT in patients undergoing varicose vein surgery.


METHODS
Lower leg veins were assessed before operation by duplex ultrasonography in 377 patients, and reassessed 2-4 weeks after surgery, and again at 6 and 12 months. Patients were instructed to contact a physician if symptoms consistent with DVT occurred before the scheduled follow-up appointment. Preoperative prophylaxis (a single dose of subcutaneous heparin) was left to the discretion of the vascular surgeon.


RESULTS
DVT was detected in 20 (5.3 per cent) of the 377 patients. Of these, only eight were symptomatic and no patient developed symptoms consistent with pulmonary embolus. Eighteen of the 20 DVTs were confined to the calf veins. Subcutaneous heparin did not alter the outcome. No propagation of thrombus was observed and half of the DVTs had resolved without deep venous reflux at 1 year.


CONCLUSIONS
The incidence of DVT following varicose vein surgery was higher than previously thought, but these DVTs had minimal short- or long-term clinical significance.
van Rij
A M
AM
Department of Surgery, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand. andre.vanrij@stonebow.otago.ac.nz
Chai
J
J
Hill
G B
GB
Christie
R A
RA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000601:surgery*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology*