Key result
Spanish vascular surgeons routinely prescribe post-ablation thromboprophylaxis, with ~96% predominantly using LMWH.
Why the study?
What are the current practices regarding pharmacological thromboprophylaxis after varicose vein thermal ablation among Spanish vascular surgeons?
Cross-Sectional (n=110)
Yes
What are the current practices regarding pharmacological thromboprophylaxis after varicose vein thermal ablation among Spanish vascular surgeons?
Spanish vascular surgeons widely use pharmacological thromboprophylaxis after EVTA, primarily LMWH, but significant variation in timing and duration highlights the need for standardized guidelines.
BACKGROUND: Endovenous thermal ablation (EVTA) of varicose veins is now the first-line therapy for truncal reflux, yet consensus on peri-procedural pharmacological thromboprophylaxis is lacking. METHODS: A ten-item, online, anonymized survey was distributed to all 291 members of the Spanish Chapter of Phlebology and Lymphology (CEFyL-SEACV) in February 2024. Items explored respondent demographics, anaesthesia, use, timing, drug choice and duration of pharmacological thromboprophylaxis after EVTA. Results are reported as frequencies. RESULTS: Of 291 surgeons, 120 replied (response rate 41%, 120/291); 110 routinely performed EVTA and formed the analytic sample. Most had >10 years of venous experience (84%, 101/120) and practiced in public (48%, 58/120) or private (44%, 53/120) hospitals. Pharmacological thromboprophylaxis was prescribed by 95.5% (105/110): routinely in 80.9% (89/110) and selectively in 14.5% (16/110). Low-molecular-weight heparin (LMWH) was preferred (92.7%, 102/110); direct oral anticoagulants (DOACs) were rare (6.4%, 7/110). Prophylaxis was initiated immediately post-procedure in 39.1% (41/110), within 1-6 h in 37.1% (39/110) and ≥6 h in 22.9% (24/110). Standard duration was 6-10 days for 69.5% (73/105), whereas patients with pro-thrombotic risk factors frequently received extended courses (≥15 days in 16.2%, 17/105). CONCLUSIONS: Spanish vascular surgeons widely adopt pharmacological thromboprophylaxis after EVTA, but timing and duration vary substantially in the absence of definitive guidelines. These findings highlight the need for a national, evidence-based consensus to harmonize practice and optimize patient safety.
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Fernández et al. (2026) conducted a cross-sectional in Varicose veins treated with endovenous thermal ablation (n=110). Pharmacological thromboprophylaxis was evaluated on Prescription of pharmacological thromboprophylaxis. Among surveyed Spanish vascular surgeons, 95.5% prescribe pharmacological thromboprophylaxis after endovenous thermal ablation, most commonly using low-molecular-weight heparin (92.7%).
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