Thrombosis and pulmonary embolism risk in patients undergoing varicose vein surgery

Varicose veins are not by themselves dangerous. Nevertheless, when treating them, it is important to prevent the occurrence of complications with potentially serious consequences such as deep vein thrombosis or pulmonary embolism. Vein operations are among the procedures carrying the lowest risk of all surgical interventions. Publications on thromboembolism after vein surgery show a striking discrepancy in the number of reported cases of thromboembolism, which is partially due to the different methods used to record them. Most thromboses are localized in the calf and their damage potential is limited, which has made some authors question the need for antithrombotic prophylaxis. Moreover, it is still unclear what the appropriate duration for this prophylaxis should be. Vein surgery may induce superficial phlebitis, which is known to flare up after several weeks. This article describes our continuously recorded data on the occurrence of clinical thromboembolic events in 8639 operations on 12724 legs. The conclusion is that an atraumatic operation, extensive mobilization, and appropriate antithrombotic prophylaxis are useful tools to reduce the risk of complications to well below 0.4%.