Lesser Saphenous Vein Thrombophlebitis: Its Natural History and Implications for Management

Ascher, Enrico; Hanson, Judith N.; Salles-Cunha, Sérgio X.; Hingorani, Anil

doi:10.1177/153857440303700606

Cited by 30 publications

(18 citation statements)

References 8 publications

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“…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%

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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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“…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%

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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“…Specimens retrieved from patients with AVF restenosis more frequently contained apoptosis foci than specimens of primary atherosclerotic lesions (19). The adventitia of varicose vein specimens showed lack of immunopositivity for Bax, while atherosclerotic lesions of primary and restenotic types showed a lack of immunopositivity for Bcl-2 (13,19-22). cfDNA released from blood cells by ongoing apoptosis was abundantly present in the plasma of hemodialysis patients (23).…”

Section: Discussionmentioning

confidence: 97%

Assessment of apoptosis in the native vein used for hemodialysis access

et al. 2016

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AimTo determine whether apoptosis is more common in previously punctured native veins than in non-punctured native veins among patients who undergo surgical creation of arteriovenous fistula (AVF) for dialysis access.MethodsCephalic vein specimens were obtained from January 1, 2013 to December 31, 2014 from 60 patients, 30 with previously punctured native veins and 30 with non-punctured native veins. Before AVF placement, a 1-cm vein segment was excised from distal part of the vein for histological, histochemical, and immunohistochemical analysis. Vein specimens were divided into two portions along the longitudinal axis and stained with hematoxylin and eosin for routine histological evaluation. Immunohistochemical analysis was used to localize Bax, p53, caspase 3, and Bcl-2 expression.ResultsThe group with previously punctured veins showed significantly increased caspase 3 (P < 0.001, two-sided Fisher`s Exact Test) and Bax expression (P = 0.002, two-sided Fisher`s Exact Test) and significantly decreased Bcl-2 expression (P < 0.001, two-sided Fisher`s Exact Test) compared with the control group. There were no significant differences between the groups in p53 expression (χ2 = 0.071, df = 1, P = 0.791). Fistula failure was significantly more common in the study group (26.7% vs 6.7%, χ2 = 4.32, df = 1, P = 0.038).ConclusionOur study indicates a possible role of venipuncture in apoptosis development and a possible role of apoptosis in fistula failure, but we do not have sufficient evidence to conclude that it represents its main cause.

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“…Consequently, the wearing of inflight compression stockings may be a rare cause of superficial thrombophlebitis which may predispose to deep vein thrombosis in up to 42% of cases. 3 There is considerable public concern about deep vein thrombosis occurring during flights and patients in our outpatient clinic frequently enquire about wearing inflight stockings. By identifying this possible complication, we may be better able to discuss the benefits and risks of wearing the inflight compression stockings with our patients.…”

Section: Discussionmentioning

confidence: 99%