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

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.