Retrospective chart review of venous thromboembolism incidence and management in rural patients undergoing varicose vein treatment

Abstract

Purpose

Determine the rate of incidence, risk factors, and management for developing venous thromboembolism (VTE) in patients undergoing radiofrequency ablation (RFA) and ultrasound-guided foam sclerotherapy (UGFS) for varicose veins.

Methods

All charts of patients undergoing venous ablation from 2016 to 2023 were reviewed at a rural vein treatment clinic. The incidence of VTE was noted and a chart review was completed to identify risk factors for VTE, EHIT score, EFIT score, and management.

Results

Patients underwent 14,172 UGFS procedures and 4865 RFAs. VTE was noted in 45 patients (0.24%), with no pulmonary embolisms and no fatal outcomes among the patient population. Patients diagnosed with VTE had a median CEAP score of 3 and a modified Caprini risk score of 7.2. Increased risk of VTE was noted in patients with prior history of DVT, patients undergoing UGFS, patients with higher Caprini scores. 90% of patients diagnosed with VTE had a prior history of DVT (p < 0.05). Patients who received UGFS treatments had a higher modified Caprini Risk Score than patients who received an RFA and UGFS, 8.7 and 6.8 respectively (p < 0.05). Increased risk of VTE was noted in patients with swollen legs prior to treatment (0.92%), visible varicose veins (0.92%), obesity (0.49%), and surgery within the prior 3 months to vein treatment (0.41%).

Conclusion

The modified Caprini score is a useful tool for risk stratification for VTE and its incidence is low for patients undergoing RFA and UGFS. Prior history of VTE represents a significant risk for recurrence in patients undergoing RFA and UGFS.