A clinical score to rule out the concomitant presence of deep vein thrombosis in patients presenting with superficial vein thrombosis: The ICARO study

Pomero, Fulvio; Minno, M.N.D. Di; Premunian, E. Tamburini; Malato, Alessandra; Pasca, Samantha; Barillari, Giovanni; Fenoglio, L.; Siragusa, Sergio; Minno, Giovanni Di; Ageno, Walter; Dentali, Francesco

doi:10.1016/j.thromres.2015.09.010

Cited by 10 publications

(24 citation statements)

References 21 publications

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“…When we evaluated risk factors potentially predisposing to involvement of the deep venous system or of the pulmonary tree, we found that the prevalence of DVT/PE in SVT patients is lower in younger subjects, in female patients, in the presence of a recent trauma, or during pregnancy. These results are in agreement with data from previous large studies , further supporting a potential role for these clinical variables in the prediction of deep venous system involvement in SVT patients.…”

Section: Discussionsupporting

confidence: 92%

“…Thus, 22 studies with a total of 4379 SVT patients were included in the meta‐analysis, 21 reporting data on the prevalence of DVT, and 11 reporting data on the presence of PE.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty‐one studies reported on 4358 SVT patients screened for the presence of DVT. As reported in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Thus, 22 studies [4,5,9,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] with a total of 4379 SVT patients were included in the meta-analysis, 21 [4,5,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] reporting data on the prevalence of DVT, and 11 [4,5,9,16,17,21,23,24,30,…”

Section: Resultsmentioning

confidence: 99%

“…The main characteristics of the 22 included studies are shown in Table 1. Fifteen studies had a prospective design [4,5,9,[15][16][17][18]21,23,[27][28][29][30][31][32], and seven were retrospective studies [19,20,22,[24][25][26]33].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Prevalence of deep vein thrombosis and pulmonary embolism in patients with superficial vein thrombosis: a systematic review and meta‐analysis

Minno

Ambrosino

Ambrosini

et al. 2016

Journal of Thrombosis and Haemostasis

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EssentialsThe association of superficial vein thrombosis (SVT) with venous thromboembolism (VTE) is variable. We performed a meta-analysis to assess the prevalence of concomitant VTE in patients with SVT. Deep vein thrombosis was found in 18.1%, and pulmonary embolism in 6.9%, of SVT patients. Screening for VTE may be worthy in some SVT patients to plan adequate anticoagulant treatment. Summary.Background: Some studies have suggested that patients with superficial vein thrombosis (SVT) have a non-negligible risk of concomitant deep vein thrombosis (DVT) or pulmonary embolism (PE) at the time of SVT diagnosis. Unfortunately, the available data on this association are widely variable. Objectives: To perform a systematic review and meta-analysis of the literature in order to evaluate the prevalence of concomitant DVT/PE in patients with SVT of the lower limbs. Methods: Studies reporting on the presence of DVT/PE in SVT patients were systematically searched for in the PubMed, Web of Science, Scopus and EMBASE databases. The weighted mean prevalence (WMP) of DVT and PE was calculated by use of the random effect model. Results: Twenty-one studies (4358 patients) evaluated the prevalence of DVT and 11 studies (2484 patients) evaluated the prevalence of PE in patients with SVT. The WMP of DVT at SVT diagnosis was 18.1% (95%CI: 13.9%, 23.3%) and the WMP of PE was 6.9% (95%CI: 3.9%, 11.8%). Heterogeneity among the studies was substantial. Selection of studies including outpatients only gave similar results (WMP of DVT, 18.2%, and WMP of PE, 8.2%,. Younger age, female gender, recent trauma and pregnancy were inversely associated with the presence of DVT/PE in SVT patients. Conclusions:The results of our large meta-analysis suggest that the prevalence of DVT and PE in patients presenting with SVT is not negligible. Screening for a major thromboembolic event may be worthwhile in some SVT patients, in order to allow adequate anticoagulant treatment to be planned. Other high-quality studies are warranted to confirm our findings.

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Section: Discussionsupporting

confidence: 92%

“…Thus, 22 studies with a total of 4379 SVT patients were included in the meta‐analysis, 21 reporting data on the prevalence of DVT, and 11 reporting data on the presence of PE.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty‐one studies reported on 4358 SVT patients screened for the presence of DVT. As reported in Fig.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Prevalence of deep vein thrombosis and pulmonary embolism in patients with superficial vein thrombosis: a systematic review and meta‐analysis

Minno

Ambrosino

Ambrosini

et al. 2016

Journal of Thrombosis and Haemostasis

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Ruling out deep vein thrombosis in patients with superficial vein thrombosis: external validation of the ICARO score

Frappé

Brosse

Seffert

et al. 2018

J Thromb Thrombolysis

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Prognostic Significance of Concomitant Superficial Vein Thrombosis in Patients with Deep Vein Thrombosis of the Lower Limbs

et al. 2021

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Background: The prognostic significance of concomitant superficial vein thrombosis (SVT) in patients with lower-limb deep vein thrombosis (DVT) has not been consistently evaluated. Methods: We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry to compare the rates of subsequent PE, recurrent DVT, major bleeding or death in patients with lower-limb DVT, according to the presence or absence of concomitant SVT. Results: Since March 2015 to May 2020, there were 8,743 patients with lower-limb DVT. Of these, 745 (8.5%) had concomitant SVT. Most patients (97.4% in both subgroups) received anticoagulant therapy (median duration, 138 vs. 147 days). During follow-up (median, 193 vs. 210 days), 156 (1.8%) patients developed subsequent PE, 336 (3.8%) had recurrent DVT, 201 (2.3%) had major bleeding and 844 (9.7%) died. Patients with concomitant SVT had a higher rate of subsequent PE (rate ratio [RR]: 2.11; 95%CI: 1.33-3.24) than those with isolated DVT, with no significant differences in the rates of recurrent DVT (RR: 0.80; 95%CI: 0.50-1.21), major bleeding (RR: 0.77; 95%CI: 0.41-1.33) or death (RR: 0.81; 95%CI: 0.61-1.06). On multivariable analysis, patients with DVT and SVT concomitantly were at increased risk for subsequent PE during anticoagulation (adjusted hazard ratio [HR]: 2.23; 95%CI: 1.22-4.05) and also during the entire follow-up period (adjusted HR: 2.33; 95%CI: 1.49-3.66). Conclusion: Patients with lower-limb DVT and SVT concomitantly are at increased risk to develop PE. Further studies are needed to externally validate our findings and to determine if these patients could benefit from a different management strategy.

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A clinical score to rule out the concomitant presence of deep vein thrombosis in patients presenting with superficial vein thrombosis: The ICARO study

Cited by 10 publications

References 21 publications

Prevalence of deep vein thrombosis and pulmonary embolism in patients with superficial vein thrombosis: a systematic review and meta‐analysis

Prevalence of deep vein thrombosis and pulmonary embolism in patients with superficial vein thrombosis: a systematic review and meta‐analysis

Ruling out deep vein thrombosis in patients with superficial vein thrombosis: external validation of the ICARO score

Prognostic Significance of Concomitant Superficial Vein Thrombosis in Patients with Deep Vein Thrombosis of the Lower Limbs

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