A systematic review and meta-analysis for the association between duration of anticoagulation therapy and the risk of venous thromboembolism in patients with lower limb superficial venous thrombosis

Lobastov, Kirill; Dubar, Emel; Schastlivtsev, Ilya; Bargandzhiya, Astanda

doi:10.1016/j.jvsv.2023.101726

Cited by 6 publications

(1 citation statement)

References 39 publications

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“…The duration of anticoagulant treatment for 14 days was associated with the highest VTE rate. Future studies should determine the most effective duration of anticoagulation treatment [89].…”

Section: Discussion and Future Directionsmentioning

confidence: 99%

Superficial Venous Thrombosis: A Comprehensive Review

Mangiafico,

Costanzo

2024

Healthcare

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Superficial venous thrombosis (SVT), an inflammatory–thrombotic process of a superficial vein, is a relatively common event that may have several different underlying causes. This phenomenon has been generally considered benign, and its prevalence has been historically underestimated; the estimated incidence ranges from about 0.3 to 1.5 event per 1000 person-years, while the prevalence is approximately 3 to 11%, with different reports depending on the population studied. However, such pathology is not free of complications; indeed, it could extend to the deep circulation and embolize to pulmonary circulation. For this reason, an ultrasound examination is recommended to evaluate the extension of SVT and to exclude the involvement of deep circulation. Also, SVT may be costly, especially in the case of recurrence. Therefore, accurate management is necessary to prevent sequelae and costs related to the disease. This review aims to analyse the epidemiology of SVT, its complications, optimal medical treatment, and open questions with future perspectives.

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Section: Discussion and Future Directionsmentioning

confidence: 99%

Superficial Venous Thrombosis: A Comprehensive Review

Mangiafico,

Costanzo

2024

Healthcare

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Development and Evaluation of a CDSS-Enabled Early Warning System for Venous Thromboembolism Risk in Advanced Lung Cancer Patients

Fan,

Gao,

Zhao

et al. 2024

Preprint

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BACKGROUNDː This study establishes the clinical practice library of Venous Thromboembolism (VTE) complications in advanced lung cancer, forms a VTE risk warning system for advanced lung cancer patients based on the Clinical Decision Support System (CDSS) and plan to use it in hospitals in the future, and plays a role in preventing VTE complications in advanced lung cancer patients. METHODSː We summarized the VTE risk factors by searching the literature and constructed a knowledge base of advanced lung cancer complication VTE risk factors based on evidence-based medicine; collected real-world clinical data on lung cancer patients and constructed a real-world best-practice library of advanced lung cancer complication VTE by cleaning, quality control and analyzing clinical data; and constructed an equation for the prediction risk coefficient of advanced lung cancer complication VTE by logistic regression analysis. Finally, the three were combined to construct a CDSS-based VTE risk warning system for advanced lung cancer patients. Statistical analysis was performed using R software, with a test level of α = 0.05, and the difference was considered statistically significant at P < 0.05. RESULTS: A total of 12,222 patients were screened through the hospital's electronic medical record system, and 3,320 patients were included after screening in strict accordance with the exclusion criteria. The patients were divided into 67 cases in the group of lung cancer complicating VTE and 3253 cases in the group of uncomplicated VTE. According to the stepwise regression method and the AIC law, the equation of the predicted risk coefficient of advanced lung cancer complicating VTE was constructed. Combining the three basic factor modules of advanced lung cancer complicating VTE and the CDSS system, a CDSS-based risk warning system for advanced lung cancer complicating VTE was established, and the externally validated results showed that the AUC of 0.756 (95% CI: 0.726–0.785) was better than that of the Caprini risk scoring scale AUC of 0.654 (95% CI: 0.638–0.670). CONCLUSIONSː This study established a CDSS-based early warning system for the risk of concurrent VTE in advanced lung cancer. The results of comparative validation showed that this early warning system can improve the clinical diagnosis and treatment efficiency of advanced lung cancer patients with complications of VTE, and at the same time, it can achieve the purpose of real-time monitoring and timely diagnosis and treatment.

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Is it safe to discontinue anticoagulant after surgical treatment of varicose vein disease, which caused pulmonary embolism?

Kipiani,

Kozlova,

Lobastov

2024

Ambulatornaya khirurgiya

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Superficial vein thrombosis, which is mostly caused by lower extremity varicose vein disease, can be complicated by pulmonary embolism. At the same time, the optimal duration of anticoagulant therapy for pulmonary embolism originated from varicose vein thrombosis is still under debate. On the one hand, the presence of varicose veins is considered a small risk factor for the development of venous thromboembolic events, which persistence determines an increased risk of relapse and requires prolonged anticoagulant therapy. On the other hand, elimination of varicose veins is associated with reduced risk of subsequent venous thromboembolic events. The article describes a clinical case of recurrent pulmonary embolism after surgical treatment of varicose vein disease, which caused primary pulmonary embolism. A 45-year-old patient suffering from left lower extremity varicose vein disease for 5 years was admitted to the intensive care unit with suspected pulmonary embolism. The further examination revealed signs of thrombotic occlusion of the segmental and subsegmental branches of the pulmonary arteries bilaterally and the middle lobe branch of the right pulmonary artery, as well as signs of the right-sided heart overload. In this case, pulmonary embolism was found to originate from thrombosis of the trunk of the great saphenous vein ofthe left lower extremity with a proximal border at the level of the lower leg. No signs of deep vein involvement were detected. The parenteral anticoagulant therapy initiated in the hospital was followed by switching to therapeutic doses of rivaroxaban. The signs of recanalization of involved veins were identified after 6 months of treatment, and it was decided to perform endovenous laser coagulation of the trunk of the great saphenous vein combined with mini-phlebectomy of varicose tributaries on continuous oral anticoagulant therapy. The rivaroxaban therapy was completed a month after intervention. However, 7 days later the patient was diagnosed with repeated symptomatic pulmonary embolism, which originated from thrombosis of the left popliteal vein. It was recommended to resume anticoagulant therapy of indefinite duration. The article discusses the issues of optimal duration of treatment for pulmonary embolism originated from thrombosis of superficial varicose veins, as well as the possible timing of completion of anticoagulant therapy after the intervention.

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A systematic review and meta-analysis for the association between duration of anticoagulation therapy and the risk of venous thromboembolism in patients with lower limb superficial venous thrombosis

Cited by 6 publications

References 39 publications

Superficial Venous Thrombosis: A Comprehensive Review

Superficial Venous Thrombosis: A Comprehensive Review

Development and Evaluation of a CDSS-Enabled Early Warning System for Venous Thromboembolism Risk in Advanced Lung Cancer Patients

Is it safe to discontinue anticoagulant after surgical treatment of varicose vein disease, which caused pulmonary embolism?

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