scholarly journals Controversies in venous thromboembolism: to treat or not to treat superficial vein thrombosis

Hematology ◽  
2017 ◽  
Vol 2017 (1) ◽  
pp. 223-230 ◽  
Author(s):  
Jan Beyer-Westendorf
Keyword(s):  
Clinical Decision ◽  
Superficial Vein ◽  
Compression Stockings ◽  
Surgical Interventions ◽  
Vein Thrombosis ◽  
Superficial Vein Thrombosis ◽  
Inflammatory Drugs ◽  
Deep Vein ◽  
Current Guidelines ◽  
Insight Into

Abstract The management of superficial vein thrombosis (SVT) is poorly defined and remains controversial overall. SVT has long been considered a benign, self-limited disease, but recent studies show that SVT carries a nonnegligible risk for recurrence, deep vein thrombosis, or pulmonary embolism. Current guidelines recommend the use of low-molecular-weight heparin or fondaparinux, but results of several surveys indicate that the majority of patients with SVT receive nonanticoagulant therapy only, which includes compression stockings or bandages, nonsteroidal anti-inflammatory drugs, topical application of heparin gel, or surgical interventions. However, several recent observational and interventional studies provide better insight into the optimal treatment of patients with SVT who are at different risks for thromboembolic complications. This educational review summarizes the available evidence and aims to provide practical guidance based on a clinical decision pathway.

Patterns in the management of superficial vein thrombosis

2016 ◽  
Vol 32 (3) ◽  
pp. 207-213 ◽  
Author(s):  
Christos Karathanos ◽  
Konstantinos Spanos ◽  
Vasileios Lachanas ◽  
Athanasios Athanasoulas ◽  
Athanasios D Giannoukas
Keyword(s):  
Duplex Ultrasound ◽  
Superficial Vein ◽  
Electronic Survey ◽  
Vein Thrombosis ◽  
Mailing Lists ◽  
Superficial Vein Thrombosis ◽  
Venous Diseases ◽  
Elastic Stockings ◽  
Inflammatory Drugs ◽  
Current Guidelines

Objective To highlight current practice patterns in management of superficial vein thrombosis. Methods An electronic survey was conducted using the mailing lists of the Mediterranean League of Angiology and Vascular Surgery and European Venous Forum regarding superficial vein thrombosis diagnosis, investigation, and treatment. Results The response rate was 41% (175/430) and the majority of the participants were vascular surgeons practicing in a hospital. More experienced physicians considered superficial vein thrombosis as a medical issue of moderate seriousness and performed duplex ultrasound for confirmation of diagnosis. Elastic stockings were recommended by 87% of the physicians, while 57% prescribed nonsteroidal anti-inflammatory drugs. Eighty six percent advised anticoagulation, although a large disparity was shown regarding regime, dose, and duration. Thrombophilia test was regularly suggested by 19% of the physicians. Ligation of the saphenofemoral junction was the treatment of choice by those who suggested intervention in the acute phase of superficial vein thrombosis. Conclusions A great disparity exists in the management of superficial vein thrombosis. Current guidelines have not been adopted by physicians; more focused training is needed for those involved in the management of venous diseases.

Tinzaparin in intermediate dose for the treatment of superficial vein thrombosis: Results from an observational multicenter study—SeVEN study

2017 ◽  
Vol 33 (9) ◽  
pp. 636-645 ◽  
Author(s):  
Athanasios Giannoukas ◽  
Christos Karathanos ◽  
Konstantinos Nikolakopoulos ◽  
George S Georgiadis ◽  
Chrisostomos Maltezos ◽  
...  
Keyword(s):  
Low Grade ◽  
Minor Bleeding ◽  
Superficial Vein ◽  
Duration Of Treatment ◽  
Once Daily ◽  
Vein Thrombosis ◽  
Superficial Vein Thrombosis ◽  
Deep Vein ◽  
Intermediate Dose

Objectives Low-molecular-weight heparins are recommended in the treatment of superficial vein thrombosis but with low grade of evidence. This study was conducted to assess the treatment outcomes of acute superficial vein thrombosis with intermediate dose of Tinzaparin. Methods Retrospective analysis of records from outpatients over a period of 16 months treated in seven centers with Tinzaparin 0.5 ml (10,000 anti-Xa IU) once daily for a period that was at the treating physician’s discretion. All the patients were followed up for at least 12 weeks. Results A total of 296 patients (189 females, mean age 57.4 years) were included. Two thirds of the patients (191/296, 64.5%) received treatment for approximately five weeks (mean 36.9 days) and the remaining (105/296, 35.5%) for a shorter period (mean 16.2 days). There was no difference in patients’ characteristics between the two treatment duration groups. The presence of thrombus above the knee and restricted daily activity were associated with longer period of treatment. Only one case with minor bleeding was observed. Recurrence of thrombosis over a 12-week follow-up period occurred in 6% (superficial vein thrombosis in 14 (4.7%), deep vein thrombosis in 3 (1%) and thrombus extension in the superficial veins in 1 (0.3%)). Recurrence was not related to the duration of treatment. Conclusions Intermediate dose of Tinzaparin was an effective and safe treatment for superficial vein thrombosis in the setting of real world practice. Location of thrombus and status of patients’ mobilization were associated with longer duration of treatment. Future prospective randomized studies are needed to corroborate these findings.

scholarly journals Increased risk of venous thrombosis in persons with clinically diagnosed superficial vein thrombosis: results from the MEGA study

Blood ◽  
2011 ◽  
Vol 118 (15) ◽  
pp. 4239-4241 ◽  
Author(s):  
Kirsten van Langevelde ◽  
Willem M. Lijfering ◽  
Frits R. Rosendaal ◽  
Suzanne C. Cannegieter
Keyword(s):  
Venous Thrombosis ◽  
Factor V Leiden ◽  
Population Based ◽  
Factor V ◽  
Superficial Vein ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Superficial Vein Thrombosis ◽  
History Of ◽  
Deep Vein

Abstract Superficial vein thrombosis (SVT) is regarded a self-limiting disorder, although the authors of recent studies showed that ultrasonographically diagnosed SVT is a precursor for venous thrombosis. We aimed to determine whether the same holds true for clinically diagnosed SVT and to what extent it is associated with thrombophilia in a population-based case-control study (ie, Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis). We found that a history of clinical SVT was associated with a 6.3-fold (95% confidence interval [CI] 5.0-8.0) increased risk of deep-vein thrombosis and a 3.9-fold (95% CI 3.0-5.1) increased risk of pulmonary embolism. Blood group non-O and factor V Leiden showed a small increase in SVT risk in controls, with odds ratios of 1.3 (95% CI 0.9-2.0) and 1.5 (95% CI 0.7-3.3), respectively. In conclusion, clinically diagnosed SVT was a risk factor for venous thrombosis. Given that thrombophilia was only weakly associated with SVT, it is likely that other factors (varicosis, obesity, stasis) also play a role in its etiology.

Treatment of superficial vein thrombosis with intermediate dose of tinzaparin: A real word cohort study – The SeVEN EXTension study

2021 ◽  
pp. 026835552094730
Author(s):  
Christos Karathanos ◽  
Dimitrios Chatzis ◽  
Panagiotis Latzios ◽  
Ioannis Papakostas ◽  
Konstantinos Goumas ◽  
...  
Keyword(s):  
Treatment Duration ◽  
Prolonged Treatment ◽  
Bleeding Complications ◽  
Superficial Vein ◽  
Duration Of Treatment ◽  
Vein Thrombosis ◽  
Superficial Vein Thrombosis ◽  
History Of ◽  
Deep Vein ◽  
Intermediate Dose

Background To assess the treatment of superficial vein thrombosis (SVT) with intermediate dose of tinzaparin in a setting of real world practice. Methods Prospective observational study of consecutive patients treated by vascular physicians in the private sector with tinzaparin (131 IU/Kg) once daily. Treatment duration was at the treating physician’s discretion. The outcomes of the study were symptomatic venous thromboembolism, extension of thrombus and bleeding complications. Results 660 patients were included and followed up for at least 3 months. Median duration of treatment was 30 days (14–120). History of prior deep vein thrombosis (HR 2.77; 95% CI= 1.18–6.49; p = 0.018) and current SVT above the knee (HR1.84; 95% CI = 1.33–3.53; p = 0.0002) were associated with prolonged treatment duration. Primary efficacy outcomes occurred in 20 (3%) patients. The median time to the event was 24 (6–92) days and was not related to treatment duration. Conclusions Tinzaparin at intermediate dose is an effective and safe treatment for SVT.

scholarly journals Superficial vein thrombosis and deep vein thrombosis – a comparison

2017 ◽  
Vol 13 (3) ◽  
pp. 311-316
Author(s):  
Zbigniew Krasiński ◽  
◽  
Krzysztof Aniukiewicz ◽  
Aleksandra Krasińska ◽  
Beata Krasińska ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Superficial Vein ◽  
Vein Thrombosis ◽  
Superficial Vein Thrombosis ◽  
Deep Vein

Venous thromboembolism

2020 ◽  
pp. 363-372
Author(s):  
Charlotte Frise ◽  
Sally Collins
Keyword(s):  
Risk Factors ◽  
Molecular Weight ◽  
Venous Thromboembolism ◽  
Low Molecular Weight Heparin ◽  
Superficial Vein ◽  
Mortality And Morbidity ◽  
Vein Thrombosis ◽  
Superficial Vein Thrombosis ◽  
Maternal Mortality And Morbidity ◽  
Deep Vein

Venous thromboembolism is a major cause of maternal mortality and morbidity. This chapter discusses thromboprophylaxis (including low-molecular-weight heparin and doses by patient weight), risk factors, deep vein thrombosis, pulmonary embolism, associated investigations, and management. Anticoagulants and bleeding while anticoagulated are both covered. Finally, superficial vein thrombosis in the first month postpartum is described.

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