# A Fatal Case of Acute Pulmonary Embolism after Cyanoacrylate Closure for Varicose Veins

## TL;DR

An elderly woman died from a severe blood clot in her lungs after a procedure to treat varicose veins, highlighting the risks and need for careful monitoring.

## Contribution

Highlights the risk of fatal pulmonary embolism after cyanoacrylate closure and emphasizes monitoring and preventive measures.

## Key findings

- Patient died from pulmonary embolism 24 days after cyanoacrylate closure for varicose veins.
- Prolonged general anesthesia and delayed thrombus formation may increase PE risk after CAC.
- Early ambulation and extended follow-up could help prevent life-threatening complications.

## Abstract

An 81-year-old female with bilateral small saphenous vein varicosities (CEAP, C2s, Ep, As, Pr) underwent cyanoacrylate closure (CAC) and stab avulsion under general anesthesia. Fourteen days later, she developed severe dyspnea and was diagnosed with pulmonary embolism (PE) and deep vein thrombosis. Despite anticoagulation, cardiopulmonary support, and catheter-directed thrombectomy, she died 24 days after admission. Adequate heparin dosing with activated partial thromboplastin time monitoring is important. Prolonged procedures under general anesthesia may increase PE risk. Early ambulation, compression therapy, and follow-up ultrasonography beyond 24 hours may help detect delayed thrombus formation and reduce life-threatening complications after CAC.