Atlantic Health System, Morristown Medical Center, Kabnick Vein Center, Morristown, NJ.
Division of Vascular Surgery, NYU Langone Health, New York, NY.
J Vasc Surg Venous Lymphat Disord. 2021 Jan;9(1):6-22. doi: 10.1016/j.jvsv.2020.06.008. Epub 2020 Oct 1.
The American Venous Forum (AVF) and the Society for Vascular Surgery set forth these guidelines for the management of endothermal heat-induced thrombosis (EHIT). The guidelines serve to compile the body of literature on EHIT and to put forth evidence-based recommendations. The guidelines are divided into the following categories: classification of EHIT, risk factors and prevention, and treatment of EHIT. One major feature is to standardize the reporting under one classification system. The Kabnick and Lawrence classification systems are now combined into the AVF EHIT classification system. The novel classification system affords standardization in reporting but also allows continued combined evaluation with the current body of literature. Recommendations codify the use of duplex ultrasound for the diagnosis of EHIT. Risk factor assessments and methods of prevention including mechanical prophylaxis, chemical prophylaxis, and ablation distance are discussed. Treatment guidelines are tailored to the AVF EHIT class (ie, I, II, III, IV). Reference is made to the use of surveillance, antiplatelet therapy, and anticoagulants as deemed indicated, and the recommendations incorporate the use of the novel direct oral anticoagulants. Last, EHIT management as it relates to the great and small saphenous veins is discussed.
美国静脉论坛（AVF）和血管外科学会制定了这些关于热诱导血栓形成（EHIT）的管理指南。这些指南旨在汇集关于 EHIT 的文献，并提出基于证据的建议。指南分为以下几类：EHIT 的分类、风险因素和预防以及 EHIT 的治疗。一个主要特点是在一个分类系统下标准化报告。Kabnick 和 Lawrence 分类系统现在被合并到 AVF EHIT 分类系统中。新的分类系统不仅提供了报告的标准化，还允许与当前文献的综合评估。建议将双功能超声用于 EHIT 的诊断。讨论了风险因素评估和预防方法，包括机械预防、化学预防和消融距离。根据 AVF EHIT 类别（即 I、II、III、IV）制定了治疗指南。提到了根据需要使用监测、抗血小板治疗和抗凝剂，建议中还纳入了新型直接口服抗凝剂的使用。最后，讨论了与大隐静脉和小隐静脉相关的 EHIT 管理。
