Follow-Up Timing
Standard schedule: 48-72 hours (EHIT screening), 1 week, 4-6 weeks, and 6 months. The 48-72 hour exam is the most critical for detecting early EHIT.
EHIT Classification
- Class 1: Thrombus extends to deep vein wall, does not protrude. Management: observation, repeat in 3-7 days.
- Class 2: Thrombus protrudes into deep vein, less than 50% occlusion. Management: anticoagulation per protocol.
- Class 3: Greater than 50% deep vein occlusion. Management: full anticoagulation.
- Class 4: Complete deep vein occlusion. Management: full anticoagulation, consider referral.
Assessing Vein Closure
The treated vein should appear as a non-compressible, echogenic cord with no flow on color Doppler. Measure the treated segment length and note any patent segments.
Surveillance Settings by Machine
- All machines: Use the same vascular preset as the initial mapping exam for consistency.
- MX7/M8 Elite: B-mode 10-14 MHz, color Doppler at low PRF to detect residual flow.
- Resona i9T: UMA detects micro-recanalization channels conventional Doppler may miss.
- Consona N9: Standard B-mode and color Doppler assessment.
Deep Vein Assessment at Every Visit
Always assess the deep vein at the junction (CFV for GSV ablation, popliteal for SSV ablation) to rule out EHIT or interval DVT.
Frequently Asked Questions
How soon after ablation should I scan?
48-72 hours is the standard for EHIT screening.
What does successful closure look like?
Non-compressible, echogenic vein with no color Doppler flow. The vein shrinks over time as it fibroses.
How do I detect recanalization?
Color flow within a previously closed segment. Use low PRF. Compare diameter to prior exams.