Anticoagulation and Interventional Treatment of Varicose Veins


The risk of venous thromboembolism following varicose vein procedures is notably low, often cited as less than 1%. Despite this low incidence, the risk is significant in terms of mortality and morbidity. The article delves into the various treatments available for varicose veins, their recommendations, and the associated thrombotic risks.

Interventional Treatments and Recommendations:

– Open surgery remains a common treatment for varicose veins in many countries.

– Thermal endovenous treatments, including endovenous laser treatment (EVLT) and radiofrequency ablation (RFA), have gained popularity in the last two decades.

– Nonthermal treatments like sclerotherapy, especially ultrasound-guided foam sclerotherapy (UGFS), are also prevalent.

– Various international forums and societies provide recommendations on the preferred treatments based on the condition’s grade.

Thrombotic Risk:

– Sclerotherapy has a low thrombotic risk, with studies reporting risks around 0.6% to 0.9%.

– Thermal endovenous treatments like laser and RFA have demonstrated long-term safety, with thromboembolism risks less than 1% in most studies.

– Nonthermal treatments also present a low thromboembolic event rate, typically less than 1%.


– Most guidelines emphasize the need to stratify thromboembolic risk based on the treatment type and the patient’s predisposition.

– The European Society of Vascular Surgery and other organizations provide specific recommendations on thromboprophylaxis, emphasizing outpatient treatment, rapid ambulation, and risk assessment.

Risk of Bleeding:

– Patients on anticoagulants undergoing varicose vein treatment should be carefully evaluated. Studies have shown that anticoagulation doesn’t significantly affect the effectiveness or safety of treatments.


Practices regarding thromboprophylaxis for varicose vein treatment remain varied. The article underscores the importance of individualized patient assessment and adherence to international guidelines to ensure optimal outcomes.

Original Source: Anticoagulation and interventional treatment of varicose veins

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