2016 Volume 27 Issue 3 Pages 331-334
We experienced a case of deep vein thrombosis and pulmonary embolism after endovenous laser abltation of great saphenous vein in treating symptomatic varicose vein with superficial vein thrombosis. A 72-year-old woman came to our hospital with pain in her leg and duplex ultrasound examination revealed superficial vein thrombosis at tributary varicosities of great saphenous vein in her right leg. She had suffered superficial vein thrombosis in her left leg 7 years before. We treated her great saphenous vein with endovenous laser ablation the next day and no propagation of superficial vein thrombosis was observed POD1 and POD8. Post operative course was uneventful with compression stocking till she noticed her right leg swelling POD21. She came to our hospital POD29, and ultrasonography revealed thrombus in her deep vein. Contrast enhanced CT scan identified a shadow defect in her gasrtocnemics vein, soleal vein, popliteal vein, femoral vein and pulmonary artery. Under the diagnosis of pulmonary embolism due to deep vein thrombosis, she admitted to our hospital and was treated with anticoagulants, urokinase, and compression stocking. After 8 months, no thrombus was detected in contrast enhanced CT scan. In patients with varicose vein and superficial thrombophlebitis, serial compression ultrasonography must be done, and it is important to treat it cautiously taking anticoagulants in consideration.
