# Acute pulmonary embolism with inferior vena caval thrombus following radiofrequency ablation of the great saphenous vein despite early ultrasound surveillance

## TL;DR

A 69-year-old woman with multiple risk factors developed pulmonary embolism after a procedure despite early ultrasound screening.

## Contribution

Highlights the limitations of ultrasound surveillance in preventing post-procedural pulmonary embolism in high-risk patients.

## Key findings

- Pulmonary embolism occurred despite early ultrasound screening after radiofrequency ablation.
- Surveillance ultrasound may not reliably detect thrombus extension in high-risk patients.
- Clinical guidelines may need reevaluation for high-risk individuals.

## Abstract

The reported incidence of pulmonary embolism in the published literature after radiofrequency ablation of the great saphenous vein is exceedingly rare. Recent societal clinical practice guidelines recommend against routine postprocedural ultrasound screening for ablation-related thrombus extension in asymptomatic average-risk patients. However, screening is recommended for asymptomatic high-risk patients. We present the case of a 69-year-old woman with multiple risk factors for the development of venous thromboembolism who developed bilateral pulmonary emboli despite early postprocedural ultrasound screening. As highlighted in this paper, surveillance ultrasound cannot be solely relied upon to detect and prevent pulmonary embolus after great saphenous vein radiofrequency ablation.