DOI: 10.24019/issn.2532-0831

Online ISSN 2532-0831

Journal of Theoretical and Applied Vascular Research

Journal website: http://www.vasculab.eu/jtavr.xml

JTAVR 2021;6(3): EPub Ahead of Print

Heparin prophylaxis in major sclerotherapy (the Prosclep study)

A Frullini¹, P Albano², P Casoni³, A Cavallini⁴, A Cristiani⁵, C D'Ascanio⁶, M Forzanini⁷, D Fruttini⁸, A Gerardi⁹, P Giannetta¹⁰, D Guarnaccia¹¹, OW Lo Parco¹², EP Lucca¹³, D Mancini¹⁴, C Ravagli¹⁵, M Rendace¹⁶, S Paradiso¹⁷, G Rosi¹⁸, P Pavei¹⁹

Abstract 
Objective
To study the incidence and the possibility of preventing thrombotic complications during major sclerotherapy for venous insufficiency of lower limbs.
Methods
A total of 2489 sclerotherapy sessions were performed on 2010 patients. 1087 sessions (43.7%) were carried out without heparin prophylaxis while in 1402 sessions (56.3%) a prophylaxis with low molecular weight (LMWH) was used. Thrombotic complications were divided into a) post sclerotherapy transient extension (POSTE) if they consisted of a simple extension of sclerotherapy, and b) deep venous thrombosis (DVT) when the complication occurred in a location separate from that of sclerosis.
Results
The overall incidence of a thrombotic complication was 0.52%. Out of 2489 sessions, 8 cases of POSTE (0.32%) and 5 thromboses of a gastrocnemius vein (0.2%) were diagnosed
The most significant figures were reached in the great saphenous vein (GSV) subgroup, where the incidence of complications was 1.91% without prophylaxis and 0.31% (p = 0.009) with prophylactic heparin.
Conclusions
In this study prophylaxis with LMWH significantly reduced the incidence of thrombotic complications when sclerotherapy of the great saphenous vein was performed.