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May 29, 2026International Angiology0 citations

Pharmacological thromboprophylaxis after varicose vein thermal ablation in Spain: a national survey

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MFMaday Cabrero FernándezATAgnieszka NOWAK TARNAWSKAEGEfrem Gómez-Jabalera

Key Points

  • To assess the use and practices of pharmacological thromboprophylaxis among surgeons performing EVTA in Spain.
  • Online survey distributed to 291 members of CEFyL-SEACV in February 2024
  • Items assessed included demographics, anaesthesia, and thromboprophylaxis practices
  • Responses analyzed from 120 surgeons with an analytic sample of 110 performing EVTA
  • 95.5% of surgeons prescribed thromboprophylaxis; 80.9% routinely and 14.5% selectively
  • 92.7% preferred low-molecular-weight heparin; only 6.4% used direct oral anticoagulants
  • Timing of prophylaxis initiation varied: 39.1% immediately post-procedure, 37.1% within 1-6 hours, and 22.9% ≥6 hours

Abstract

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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Cite This Study

Fernández et al. (2026) studied this question.

synapsesocial.com/papers/6a192e79fab5b468c44179afhttps://doi.org/10.23736/s0392-9590.26.05489-1
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