Open Access

Chronic Venous Disease

Chronic venous disease is an important pathologic condition seen routinely by vascular surgeons. Varicose veins in the great saphenous vein (GSV) distribution are the most common manifestations of chronic venous disease and are present in 20% to 25% of women and in 10% to 15% of men . Saphenous reflux was once treated routinely with saphenofemoral ligation and vein stripping but now can be managed with multiple less-invasive therapies. Endovenous laser therapy (EVLT), radiofrequency ablation (RFA), and foam sclerotherapy are just as effective as the open procedure with less morbidity, faster recovery, and improved cosmetic results . Minimally invasive treatments aim to occlude the saphenous vein; however, high ligation of the great saphenous vein is not usually performed with these procedures. Radiofrequency ablation and EVLT offer comparable venous occlusion rates at three months after treatment of primary GSV varices with no statistical difference in efficacy. Radiofrequency ablation is associated with less periprocedural pain, analgesic requirement and bruising, making it the treatment of choice at some institutions . The RFA procedure is associated with the perioperative risk of paraesthesia (4% to 20%), phlebitis (7% to 9%), and bruising or skin pigmentation changes (6% to 19%). In addition, there is risk of endovenous heatinduced thrombosis and deep vein thrombosis (DVT) with a previously reported incidence of 0.3% after EVLT and 2.1% after RFA . This report presents a patient with an unknown patent foramen ovale (PFO) who underwent RFA of the great saphenous vein complicated by leftsided cerebral infarcts. scenario in which a patient suffered a major complication from a minimally invasive procedure.