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Ambulatory phlebectomy in patients with a factor V Leiden mutation


Authors: M. A. Horáková 1;  V. Křížková 2;  J. Kočová 2;  E. Horáková 1
Authors‘ workplace: Flebologická soukromá ordinace, Praha Vedoucí: Dr. med. MUDr. Magdalena Anna Horáková 1;  Lékařská fakulta UK, Plzeň Ústav histologie a embryologie Vedoucí: doc. MUDr. Jitka Kočová, CSc. 2
Published in: Prakt. Lék. 2009; 89(10): 545-551
Category: Reviews

Overview

The occurrence of sterile inflammation of both superficial and deep venous system and of embolism was evaluated in two groups of patients, which underwent an ambulatory phlebectomy of the saphenous complex. Histological examination was focused on the saphenous vein in thrombophilic patients.

In the first group (n=593), only half of the patients took sick leave. In this group, we observed a sterile inflammatory reaction in the inguinal area in 35 patients. These patients had no sickness leave, thus they were not able to follow an adequate treatment regimen.

In second group of patients (n=565), that all took sick leave, no complication occurred. As laboratory assessment of thrombophilia is not routinely performed and there is no difference in clinical symptoms of chronic venous insufficiency with or without thrombophilia, it is necessary to respect a two-week phase of healing accompanied with changes of blood acute protein levels. Thus, two weeks of sick leave following major saphenous complex resection is recommended. An ambulatory phlebectomy is a safe method even in thrombophilia, without risk of pulmonary embolism. There is no need of heparinization. Patients suffering from thrombophilia have more serious signs of vessel wall damage in comparison with others.

Key words:
ambulatory phlebectomy, thrombophilia.


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