title: Endovenous saphenous vein ablation in patients with acute isolated superficial-vein thrombosis.
abstract: OBJECTIVE
  The possible benefits of endovenous saphenous ablation (EVSA) as initial treatment in patients presenting with isolated superficial-vein thrombosis (SVT) and saphenous vein reflux include: (1) definitive treatment of the underlying pathology and (2) elimination of the saphenous vein as a path for pulmonary emboli, which (3) may eliminate the need for anticoagulation.
  
  
  METHODS
  In a ten-year review of 115 limbs presenting with acute isolated SVT, 72 limbs (71 patients) with saphenous reflux were given a choice of two treatments following an explanation of the risks and benefits of each. Group I limbs (n = 41) were treated with office EVSA using radiofrequency or laser with or without thrombophlebectomy if performed within 45 days of diagnosis. Post-treatment anticoagulants were not given. Group II limbs (n = 31) were treated with compression hose and repeat Duplex within one week, with added anticoagulants if SVT extended into the thigh.
  
  
  RESULTS
  In group I, mean interval from diagnosis to treatment was 13.7 days. One calf deep vein thrombosis was noted. In group II no complications were noted. In late follow-up of group II patients, 12/29 underwent EVSA more than 45 days after initial presentation.
  
  
  CONCLUSIONS
  The safety and efficacy of EVSA and thrombophlebectomy appear indistinguishable from conservative measures and may be offered as initial treatment to patients presenting with SVT and saphenous reflux.
authors.affiliation: Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA wayne@gradman.com.
authors.forename: Wayne S
authors.initials: WS
authors.lastname: Gradman
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D002406:Catheterization, Peripheral / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000379:methods*; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000517:prevention & control; D012501:Saphenous Vein; D053828:Stockings, Compression; D014689:Venous Insufficiency / Q000628:therapy*; D020246:Venous Thrombosis / Q000628:therapy*
chemical_list: D000925:Anticoagulants
keywords: Saphenous vein ablation; phlebectomy; saphenous reflux; superficial-vein thrombosis; treatment