How I treat superficial venous thrombosis

Kitchens, Craig S.

doi:10.1182/blood-2010-05-286690

Cited by 44 publications

(35 citation statements)

References 25 publications

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“…Some investigators argue that SVT should not be categorized separately from DVT and PE, but rather be considered as part of the venous thrombotic spectrum. 21 Results from recent studies, including ours, support this view.…”

Section: Discussionsupporting

confidence: 77%

Risk of venous and arterial thrombotic events in patients diagnosed with superficial vein thrombosis: a nationwide cohort study

Cannegieter

Horváth‐Puhó

Schmidt

et al. 2015

Blood

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Key Points• In the 3 months after isolated SVT, the risk of a deep venous event or pulmonary embolism is 3.4%.• This risk remains fivefold increased more than 5 years after the superficial event.Recently, it has become apparent that superficial vein thrombosis (SVT) can have serious complications. However, the magnitude of the risk of subsequent deep venous and arterial thrombotic events remains unknown. We examined this in a nationwide population-based setting during a period when SVT was not treated routinely with anticoagulants. The Danish National Registry of Patients, covering all Danish hospitals, was used to identify 10 973 patients with a first-time diagnosis of SVT between 1980 and 2012. A comparison cohort of 515 067 subjects, matched by age, gender, and calendar year, was selected from the general Danish population. Outcomes were venous thromboembolism, acute myocardial infarction, ischemic stroke, and death. During median follow-up of 7 years, the incidence rate of venous thromboembolism was 18.0/1000 person-years (95% confidence interval [CI], 17.2-18.9). The highest risk occurred in the first 3 months (3.4%; 95% CI, 3.0-3.7). Compared with the general population, the hazard ratio was 71.4 (95% CI, 60.2-84.7) in this period, steadily decreasing to 5.1 (95% CI 4.6-5.5), 5 years after the SVT. The hazard ratios for acute myocardial infarction, stroke, and death were 1.2 (95% CI, 1.1-1.3), 1.3 (95% CI, 1.2-1.4), and 1.3 (95% CI, 1.2-1.3), respectively, with the highest risk also shortly after SVT. These data indicate the prognostic importance of SVT and may form the basis for clinical decisionmaking regarding anticoagulation. (Blood. 2015;125(2):229-235)

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Section: Discussionsupporting

confidence: 77%

Risk of venous and arterial thrombotic events in patients diagnosed with superficial vein thrombosis: a nationwide cohort study

Cannegieter

Horváth‐Puhó

Schmidt

et al. 2015

Blood

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“…The authors of recent studies provide evidence that SVT should be seen as a form of venous thrombosis (VT), together with pulmonary embolism and deep-vein thrombosis. [1][2][3][4][5][6] In a recent clinical trial (Comparison of Arixtra in Lower Limb Superficial Vein Thrombosis with Placebo; CALISTO) investigators showed a symptomatic VT rate of 1.5% within 77 days after the diagnosis of SVT in placebo users. 2 This VT rate was probably positively influenced by the definition of SVT that CALISTO investigators used.…”

Section: Introductionmentioning

confidence: 99%

“…1 Previously called thrombophlebitis, the name suggests that both thrombosis and inflammation play a role in the disease mechanism. The authors of recent studies provide evidence that SVT should be seen as a form of venous thrombosis (VT), together with pulmonary embolism and deep-vein thrombosis.…”

Section: Introductionmentioning

confidence: 99%

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

Langevelde

Lijfering

Rosendaal

et al. 2011

Blood

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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 deepvein 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. (Blood. 2011; 118(15):4239-4241) IntroductionSuperficial vein thrombosis (SVT) is a controversial disease entity. 1 Previously called thrombophlebitis, the name suggests that both thrombosis and inflammation play a role in the disease mechanism. The authors of recent studies provide evidence that SVT should be seen as a form of venous thrombosis (VT), together with pulmonary embolism and deep-vein thrombosis. [1][2][3][4][5][6] In a recent clinical trial (Comparison of Arixtra in Lower Limb Superficial Vein Thrombosis with Placebo; CALISTO) investigators showed a symptomatic VT rate of 1.5% within 77 days after the diagnosis of SVT in placebo users. 2 This VT rate was probably positively influenced by the definition of SVT that CALISTO investigators used. Although most physicians learn that SVT is identifiable by a red, painful, palpable cord in the course of a superficial vein, 1,7 in CALISTO, SVT was only regarded as definitely diagnosed when in addition to these clinical signs an ultrasonography of the superficial vein showed a clot of at least 5 cm in length. The authors of current literature agree that such SVTs should be regarded as "real" SVT, 2,8 but this does not follow clinical practice, nor does it imply that there is no clot present in less-definite presentations. It is therefore uncertain whether patients with clinically diagnosed, but not necessarily ultrasonographically confirmed, SVT are at risk of VT and whether this risk can be explained by underlying thrombogenic causes.For these reasons we sought to determine whether a history of clinically diagnosed SVT is associated with an increased risk of subsequent VT in a large population-based case-control study (ie, Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis [MEGA] study). We also analyzed whether common thrombophilic genetic risk factors for VT increase the risk of SVT, as well as whether the presence of such thrombophilia could explain the lin...

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“…1 A lthough superficial venous thrombosis was originally perceived as a benign disease with a self-limited clinical course, it is now recognized that this condition is often associated either with concomitant venous thromboembolism or with early development of deep vein thrombosis and pulmonary embolism. [2][3][4][5] Further, Heit et al reported in…”

mentioning

confidence: 98%

“…For example, the isolated C2 domain does not compete with factor VIII for membrane binding and does not interfere with the factor VIIIa-factor IXa complex. 2 Furthermore, factor VIII engineered to lack the C2 domain, retains functional activity, although with a requirement for a higher concentration of phospholipid vesicles with a high density of negative charge. 3 In short, recent biochemical studies suggest that the C2 domain could have only marginal importance.…”

Section: Factor VIII Inhibitor Epitopes and An Enigma ---------------mentioning

confidence: 99%

Superficial venous thrombosis: recognizing the risk

Bates

2013

Blood

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How I treat superficial venous thrombosis

Cited by 44 publications

References 25 publications

Risk of venous and arterial thrombotic events in patients diagnosed with superficial vein thrombosis: a nationwide cohort study

Risk of venous and arterial thrombotic events in patients diagnosed with superficial vein thrombosis: a nationwide cohort study

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

Superficial venous thrombosis: recognizing the risk

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