Incidence, risk factors, and clinical characteristics of deep vein thrombosis following combined radiofrequency ablation and sclerotherapy for varicose veins

Objective This study aims to investigate the incidence, risk factors, and clinical characteristics of deep vein thrombosis (DVT) following radiofrequency ablation (RFA) combined with sclerotherapy for varicose veins. Methods A retrospective analysis was conducted on patients who underwent combined RFA and sclerotherapy between June 2018 and June 2024. The incidence of postoperative DVT and its clinical characteristics were evaluated, with 13 potential risk factors assessed through univariate and multivariate logistic regression. Patients with distal DVT were divided into two groups: Group A (treatment with prophylactic-dose anticoagulation) and Group B (no anticoagulation), with thrombus resolution outcomes compared between the groups. Results Among 567 patients with varicose veins, including 226 males and 341 females (male-to-female ratio 1:1.51), with a mean age of 57.79 ± 11.38 years (range: 28–77 years), postoperative DVT occurred in 46 patients (8.11%), 36 of whom (78.26%) were diagnosed within 3 days. Thrombosis predominantly affected the muscular veins and posterior tibial veins (91.30%). Multivariate analysis identified a history of thrombosis, injection volume >10 mL of foam, and injection sites distal to the ankle joint as independent risk factors for DVT. Furthermore, Group A demonstrated a significantly lower prevalence of thrombosis at each time point compared to Group B ( p < .05). Conclusion The incidence of postoperative DVT following combined RFA and foam sclerotherapy for varicose veins is relatively high, with the majority occurring in the early postoperative period. Thrombosis primarily affects the muscular and posterior tibial veins. A history of thrombosis, injection volume >10 mL of foam, and injection sites distal to the ankle joint are independent risk factors. Prophylactic-dose anticoagulation therapy may facilitate thrombus resolution in patients with distal DVT.