2019 Volume 28 Issue 2 Pages 115-119
Endovenous laser ablation (EVLA) is thought to be a safe treatment for vcaricose veins and is currently performed widely. In this report we describe two cases with ventricular arrhythmia during EVLA procedure for bilateral great saphenous varices caused by saphenofemoral junction (SFJ) reflux. Cases were 67 years old and 71 years old females. Under the diagnosis of both lower limb varicose veins (C3) due to SFJ reflux, we planned to perform both sides EVLA. After EVLA for right limb, ventricular arrhythmia appeared when the left great saphenous vein was punctured and a guide wire was inserted. Arrhythmia appeared reproducibly as the guidewire passed SFJ and disappeared when it was removed. Since the chest discomfort was accompanied, EVLA for left limb was suspended in both patients. Postoperatively, no ventricular arrhythmia was seen and no organic heart disease was found in both cases. In addition, EHIT (endovenous heat-induced thrombus) and venous thromboembolism were not confirmed. Intraoperative findings strongly suggested that observed arrhythmia was induced by the EVLA procedure, but at the present time reports of ventricular arrhythmia during EVLA operation were not found as far as possible to search. The causes of arrhythmia ocurrence were discussed.
