A narrative review on the epidemiology, prevention, and treatment of venous thromboembolic events in the context of chronic venous disease

Kemp, Michael T.; Andrea, T.; Henke, Peter K.; Wakefield, Thomas W.

doi:10.1016/j.jvsv.2021.03.018

Cited by 12 publications

(4 citation statements)

References 80 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Другим неоднозначным вопросом является учет подлежащих удалению варикозных вен в качестве индивидуального фактора риска ВТЭО. С одной стороны, их наличие повышает вероятность возникновения ТГВ в популяции в 2,1-5,3 раза [17], что может быть связано с генетической общностью заболеваний [18], с другой -их оперативное удаление является одним из наиболее сильно ассоциированных с тромбозом амбулаторных вмешательств [6], а риск развития симптоматической ТЭЛА после флебэктомии сохраняется повышенным на протяжении 18 нед. [19].…”

Section: возможности прогнозирования венозных тромбоэмболических осло...unclassified

Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins

Lobastov

Shaldina²,

Борсук

et al. 2022

Ambulatornaya khirurgiya

View full text Add to dashboard Cite

Venous thromboembolic complications (VTEO) after modern minimally invasive superficial vein interventions are an infrequent but very dramatic event. This article presents a review of the literature, covering the issues of prevalence, prognosis and pharmacological prevention of VTEO. The performed studies demonstrate that the incidence of symptomatic thrombotic complications after endovenous thermal obliteration does not exceed 0,5%, but taking into account asymptomatic thermally induced thromboses and subclinical occlusions of the muscular veins of the lower leg, this figure can exceed 10%. There is a high heterogeneity of the data, possibly due to differences in the individual risk of VTEO. The most validated tool for assessing the latter is the Caprini Scale, which has not been sufficiently studied in the surgical treatment of varicose veins. The administration of prophylactic doses of anticoagulants after thermal obliteration of saphenous veins is widely used in routine clinical practice, despite the lack of convincing evidence for the appropriateness of this approach. In recent years, the use of direct oral anticoagulants against the official instruction (off-label) has gained great popularity as an alternative to heparin. The largest evidence base has accumulated for the use of rivaroxaban 10 mg, which is associated with high efficacy and safety. Based on completed clinical trials, it is not possible to formulate unequivocal recommendations for prophylactic anticoagulant doses after thermal obliteration of superficial veins at this time. Additional studies are required to identify patients with an individually increased risk of thrombosis in whom prophylactic doses of anticoagulants may be of maximum benefit.

show abstract

Section: возможности прогнозирования венозных тромбоэмболических осло...unclassified

Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins

Lobastov

Shaldina²,

Борсук

et al. 2022

Ambulatornaya khirurgiya

View full text Add to dashboard Cite

show abstract

“…In most cases varicose veins are harmless; however, in severe cases they can result in chronic disabling ulcers, which can have a major impact on patients’ quality of life and ability to work. It has been estimated that half of adults experience mild venous insufficiency, and varicose veins are visible in approximately 15% of men and 35% of women[ 2 - 4 ]. Therefore, there is a need to identify suitable clinical treatments for varicose veins.…”

Section: Introductionmentioning

confidence: 99%

Endovenous laser treatment vs conventional surgery for great saphenous vein varicosities: A propensity score matching analysis

Li,

Zhang,

Yuan

et al. 2023

World J Clin Cases

View full text Add to dashboard Cite

BACKGROUND Varicosis is a common venous condition, which is typically treated surgically. However, selection of the optimal surgical approach can be challenging. Previous studies comparing endovenous laser treatment (EVLT) and conventional surgery were retrospective and observational in nature and the results may therefore have been influenced by selection bias and the presence of other confounding factors. In this study, we used propensity score matching to reduce selection bias when comparing EVLT and conventional surgery for the treatment of varicose great saphenous veins. AIM To compare the perioperative and postoperative outcomes of EVLT and conventional surgery in patients with great saphenous vein varicosis. METHODS We retrospectively reviewed the records of 1063 patients treated for primary varicosis of the great saphenous vein at the Second Affiliated Hospital of Xuzhou Medical University between January 2009 and December 2019. Among them, 56 patients were excluded owing to additional small saphenous varicose vein involvement, 81 owing to recurring varicose veins, 83 owing to complicated varicose veins (CEAP clinical classification C5-C6), and 6 owing to perioperative phlebitis. Finally, 772 patients were enrolled in this study. Standard demographic and clinicopathological data were collected from the medical records of the patients. For propensity score matching, 522 patients (261 who underwent EVLT and 261 who underwent conventional surgery) were randomly matched 1:1 by age, sex, onset time, smoking status, presence of diabetes, family history, stress therapy, C class, and the affected leg. RESULTS Of the 772 patients included in the study, 467 underwent EVLT and 305 underwent conventional surgery. There were significant differences in age, onset time, smoking and diabetes status, and family history between the two groups. Following propensity score matching, no significant differences in patients’ characteristics remained between the two groups. ELVT was associated with a shorter operation time and hospital stay than conventional surgery, both before and after propensity score matching. There were no differences in complications between the two groups after propensity score matching. Patients who underwent EVLT had a higher recurrence rate during the two-year follow-up period than those who underwent conventional surgery (33.33% vs 21.46%, χ 2 = 11.506, P = 0.001), and a greater percentage of patients who underwent EVLT experienced pain one week after the procedure (39.85% vs 19.54%, P = 0.000). CONCLUSION EVLT may not always be the best option for the treatment of great saphenous vein varicosis.

show abstract

“…Varicose veins are an important manifestation of chronic venous disease (CVD), and they can be present thought nearly the whole course of CVD from small varicosities to venous ulcer ( 1 ). Varicose veins are generally recognized as a weak risk factor of venous thromboembolic diseases, i.e., deep vein thrombosis (DVT), pulmonary embolism (PE) and venous thrombosis (VTE) ( 2 , 3 ). For patients receiving surgical procedures, the presence of lower extremity varicose veins adds one point to the total Caprini score that may result in VTE prophylaxis upgrade.…”

Section: Introductionmentioning

confidence: 99%

“…However, to our best knowledge, no study has tested whether the risk of VTE can be reduced if varicose veins are surgically removed or ablated. Therefore, it is of considerable clinical interest to investigate whether varicose veins are causally associated with VTE ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Varicose Veins and Risk of Venous Thromboembolic Diseases: A Two-Sample-Based Mendelian Randomization Study

Chen

Gui

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Background:Varicose veins are found to be associated with increased risk of venous thromboembolism (VTE) in many observational studies, but whether varicose veins are causally associated with VTE remains unclear. Therefore, we used a series of Mendelian randomization (MR) methods to investigate that association.Methods23 independent single-nucleotide polymorphisms (SNPs) for varicose veins were obtained from the Pan UK Biobank analysis. The outcomes datasets for deep vein thrombosis (DVT), pulmonary embolism (PE) and venous thromboembolism (VTE) were obtained from the FinnGen study. Before analysis, body mass index (BMI) and height were included as confounders in our MR model. Basic MR [inverse-variance weighted (IVW), weight-median, penalized weighted-median and MR-Egger methods] and MR-PRESSO were performed against each outcome using the whole SNPs and SNPs after excluding those associated with confounders. If causal associations were suggested for any outcome, a basic MR validation analysis, a multivariable MR analysis with BMI and height, a Causal Analysis Using Summary Effect estimates (CAUSE), and a two-step MR analysis with BMI and height, would follow.ResultsUsing 21 qualified SNPs, the IVW method (OR: 1.173, 95% CI: 1.070–1.286, p < 0.001, FDR = 0.002), the weighted median method (OR: 1.255, 95% CI: 1.106–1.423, p < 0.001, FDR = 0.001), the penalized weighted median method (OR: 1.299, 95% CI: 1.128–1.495, p < 0.001, FDR = 0.001) and the MR-PRESSO (OR: 1.165, 95% CI: 1.067–1.273, p = 0.003, FDR = 0.009) suggested potential causal effect of varicose veins on DVT, but no cause effect was found for PE and VTE. Excluding SNPs associated with confounders yielded similar results. The causal association with DVT was validated using a self-reported DVT cohort (IVW, OR: 1.107, 95% CI: 1.041–1.178, p = 0.001). The causal association maintained after adjustment for height (OR = 1.105, 95% CI: 1.028–1.188, p = 0.007), BMI (OR = 1.148, 95% CI: 1.059–1.244, p < 0.001) and them both (OR = 1.104, 95% CI: 1.035–1.177, p = 0.003). The causal association also survived the strict CAUSE (p = 0.018). Finally, in two-step MR, height and BMI were found to have causal effects on both varicose veins and DVT.ConclusionGenetically predicted varicose veins may have a causal effect on DVT and may be one of the mediators of obesity and taller height that predispose to DVT.

show abstract

A narrative review on the epidemiology, prevention, and treatment of venous thromboembolic events in the context of chronic venous disease

Cited by 12 publications

References 80 publications

Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins

Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins

Endovenous laser treatment vs conventional surgery for great saphenous vein varicosities: A propensity score matching analysis

Varicose Veins and Risk of Venous Thromboembolic Diseases: A Two-Sample-Based Mendelian Randomization Study

Contact Info

Product

Resources

About