Incidence and risk factors of early deep venous thrombosis after varicose vein surgery with routine use of a tourniquet.
BACKGROUND
The incidence of early deep venous thrombosis (DVT) following varicose vein surgery (traditional open stripping) with routine use of a tourniquet remains unknown.


METHODS
A retrospective analysis of all patients who underwent varicose vein surgery with a tourniquet in the authors' unit between 1 January 2012 and 30 November 2013 was undertaken. Cases of postoperative DVT were identified from the unit database, and re-assessments conducted 1, 3 and 6 months after the initial diagnosis were recorded from the outpatient department.


RESULTS
Out of 1461 patients, 113 (7.7%) developed postoperative DVT. Nineteen (1.3%) patients had proximal DVT, and 94 (6.4%) patients had isolated distal DVT. The risk factors for postoperative DVT included old age (≥65 years), female sex and gastrocnemius vein dilation (GVD). GVD was found to be a significant independent risk factor for the occurrence of DVT, with an odds ratio of 2.437 (95% confidence interval 1.644-3.611). Five patients with distal DVT (5.7%) and eight patients with proximal DVT (44.4%) still exhibited a thrombus at 6-month follow-up, but with decreased size and at various stages of resolution.


CONCLUSIONS
This study found a higher incidence of postoperative DVT (7.7%) with routine use of a tourniquet during varicose vein surgery than has been reported previously. Among the factors examined, GVD had the highest predictive power for postoperative DVT. Both distal and proximal DVT were associated with acceptable outcomes.
Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Kai
K
Chen
Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Guan-Feng
GF
Yu
Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Jing-Yong
JY
Huang
Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Li-Dong
LD
Huang
Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Xiang
X
Su
Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Hai-Zhen
HZ
Ni
Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Le-Men
LM
Pan
Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address: vaszhengxiangtao@126.com.
Xiang-Tao
XT
Zheng
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000098:blood supply; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014111:Tourniquets / Q000009:adverse effects*; D016896:Treatment Outcome; D014648:Varicose Veins / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000009:adverse effects*; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000209:etiology*; D055815:Young Adult
D000925:Anticoagulants
Deep venous thrombosis; Gastrocnemius vein dilation; Risk factors; Tourniquet; Varicose vein