Objective: To obtain an estimate of the frequency of fatal pulmonary embolism (PE) after varicose vein surgery.
Methods: Firstly by analysis of official statistics and secondly by a postal questionnaire to surgeons carrying out varicose vein surgery. The response rate from the questionnaire was 68% (391/576). Surgeons were asked if they had encountered PE after varicose vein surgery, whether the outcome was fatal and how many years they had spent in the specialty. Further calculations were based on data obtained from the Vascular Society of Great Britain and Ireland that suggest that on average about 120 cases are operated per year per consultant surgeon.
Results: Analysis of the statistics available from official sources suggested that the risk of fatal PE after varicose vein surgery is about 1 in 15,000. Respondents to the questionnaire reported a total of 396 pulmonary emboli, of which 73 were fatal. From the questionnaire, we estimate that between one in three and one in four surgeons will encounter a fatality in the course of a full career. From knowledge of the length of time spent in the specialty by our respondents and using the figure of 120 operated cases per consultant per year, we obtained a higher estimate of the risk of fatal PE, around one in 10,000 cases.
Conclusions: While the methods used to collect these figures are imperfect and open to criticism, they suggest a risk between one in 10,000 and one in 15,000. We think it is reasonable, when obtaining consent, to warn patients of the very small risk of fatal PE, using the more pessimistic figure of one in 10,000.
