Successful Treatment of Varicose Great Saphenous Vein Complicated with Acute Thrombosis by Balloon-Assisted Thrombectomy Combined with Radiofrequency Ablation: A Interventional Radiology

The Journal of Radiology Interventional Radiologys

  • YangBin Kou1Department of Interventional Radiology, Chengdu Xindu District Hospital of Traditional Chinese Medicine, Sichuan, PR China.
  • MengJuan Feng2Department of Ultrasound, Chengdu First People's Hospital, Sichuan, PR China.
  • Xuan Yao1Department of Interventional Radiology, Chengdu Xindu District Hospital of Traditional Chinese Medicine, Sichuan, PR China.
  • Ji Zhang1Department of Interventional Radiology, Chengdu Xindu District Hospital of Traditional Chinese Medicine, Sichuan, PR China.
  • Xiaoling Xie1Department of Interventional Radiology, Chengdu Xindu District Hospital of Traditional Chinese Medicine, Sichuan, PR China.
  • Juan Wan1Department of Interventional Radiology, Chengdu Xindu District Hospital of Traditional Chinese Medicine, Sichuan, PR China.

Volume 20 Issue 4 Pages 5

DOI: 10.3941/jrcr.6063

Abstract

Introduction: Great Saphenous Vein (GSV) varicosity is a common clinical vascular disease, frequently complicated by Superficial Venous Thrombosis (SVT). SVT may extend to the deep venous system, causing severe Venous Thromboembolism (VTE). The standard treatment for GSV varicosity with acute SVT—especially involving the Saphenofemoral Junction (SFJ)—remains controversial. Anticoagulation is the mainstream to reduce thromboembolic risk, while surgical treatment has drawbacks like significant trauma and excessive bleeding, failing to lower long-term thromboembolic incidence. This leaves gaps in optimal timing and combined regimens, with scarce evidence for alternative therapies without standard equipment. This Interventional Radiology describes a successful combined interventional therapy for a patient with 30-year untreated GSV varicosity and SVT, providing practical evidence. Case Study: A 74-year-old male presented with right lower limb swelling and pain for 10 days, along with 30-year untreated varicosity. Physical examination showed tortuous and dilated GSV (earthworm-like protrusions), hard nodules, erythema, edema, and ankle pigmentation (CEAP class 4; Venous Clinical Severity Score [VCSS] = 12; Aberdeen Varicose Vein Questionnaire [AVVQ] = 22). Color Doppler ultrasound confirmed extensive GSV thrombosis (extending to SFJ) without deep venous thrombosis. After full risk disclosure of VTE, the patient opted for surgery (declined vena cava filter placement). Lacking a Fogarty catheter, the operator used a deep venous balloon catheter to occlude the SFJ, performed above-knee GSV thrombectomy with a superficial venous balloon, followed by endovenous radiofrequency ablation. Below-knee tributaries were treated with ultrasound-guided foam sclerotherapy combined with minimally invasive phlebectomy. Postoperative anticoagulation relieved symptoms; 10-month follow-up showed no thrombosis recurrence, vessel recanalization, or adverse events

Keywords

  • Interventional Radiology
  • Clinical & imaging findings
  • Treatment & prognosis
  • Differential Diagnoses
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