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

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.