Risk factors for recurrent events in subjects with superficial vein thrombosis in the randomized clinical trial SteFlux (Superficial Thromboembolism Fluxum)

Cosmi, Benilde; Filippini, Massimo; Campana, Fausto; Avruscio, Giampiero; Ghirarduzzi, Angelo; Bucherini, Eugenio; Camporese, Giuseppe; Imberti, Davide; Legnani, Cristina; Palareti, Gualtiero

doi:10.1016/j.thromres.2013.12.005

Cited by 34 publications

(28 citation statements)

References 13 publications

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“…Although there is some evidence allowing identification of patients at high risk of thromboembolic complications that should receive a 45-day treatment, patients at lower risk who could receive a shorter 30-day course of fondaparinux (a treatment duration never tested in a clinical trial) are less easy to identify. As previously mentioned, male gender, severe venous insufficiency, SVT in a non-varicose veins, a history of DVT or PE, and a history of cancer have been reported to be independent risk factors for subsequent thromboembolic complications in patients with isolated SVT at presentation [12,[30][31][32]. Although no multivariate analysis was performed on CALISTO data, subgroup analyses on the primary outcome (day 49) showed, not surprisingly, numerically higher rates of events in patients aged over 75 years, those weighing over 100 kg, and those with a creatinine clearance below 50 mL min À1 , a history of DVT, PE or SVT or multiple SVT (even though these events were not recent in CALISTO), a qualifying SVT located above the knee, involving the GSV, or with its head < 10 cm from the SFJ (up to 14% of events at day 49) [13].…”

Section: What Is Beyond Superficiality At First Presentation?mentioning

confidence: 94%

Spontaneous acute superficial vein thrombosis of the legs: do we really need to treat?

Décousus

Bertoletti

Frappé

2015

Journal of Thrombosis and Haemostasis

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Summary Spontaneous acute superficial vein thrombosis (SVT) of the leg is now generally recognized as an integral component of venous thromboembolic disease with potentially severe consequences. However, the relatively low grades of some current international recommendations and uncertainty regarding the cost‐effectiveness of available therapies may prompt questioning of the real need to treat patients with SVT and explain the persisting heterogeneity of their management in practise. Yet several studies have consistently shown high rates of thromboembolic complications associated with SVT, whether at first presentation or during follow‐up. The CALISTO trial established for the first time the clinical benefit of a well‐defined anticoagulant regimen for the prevention of serious thromboembolic complications in SVT patients, and we believe that patients such as those included in this trial should receive this regimen as tested. However, several areas of uncertainty remain for categories of SVT patients not evaluated in CALISTO.

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Section: What Is Beyond Superficiality At First Presentation?mentioning

confidence: 94%

Spontaneous acute superficial vein thrombosis of the legs: do we really need to treat?

Décousus

Bertoletti

Frappé

2015

Journal of Thrombosis and Haemostasis

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“…Clinical risk factors for SVTE and the clinical presentation and treatment were obtained from physician chart review. Assessed risk factors included clinical conditions that have been associated with mildly increased SVTE risk (history of tobacco smoking, high body mass index), strongly increased risk (surgery or hospitalization within 30 days, active malignancy, hormonal therapy/pregnant or postpartum), provoking events (local trauma, central or peripheral intravenous catheter placement), and medical conditions that raise the risk for DVT (such as prior history of thrombosis or ischemic stroke) . Data were abstracted by a single author (B.T.S.)…”

Section: Methodsmentioning

confidence: 99%

Initial management and outcomes after superficial thrombophlebitis: The Cardiovascular Research Network Venous Thromboembolism study

Samuelson

Sung

et al. 2016

Journal of Hospital Medicine

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Although superficial thrombophlebitis (SVTE) is generally considered a benign, self-limited disease, accumulating evidence suggests that it often leads to more serious forms of venous thromboembolism. We reviewed the medical charts of 329 subjects with SVTE from the Cardiovascular Research Network Venous Thromboembolism cohort study to collect information on the acute treatment of SVTE and subsequent diagnosis of deep venous thrombosis within 1 year. All participants received care within Kaiser Permanente Northern California, a large, integrated health care delivery system. Fourteen (4.3%) subjects with SVTE received anticoagulants, 148 (45.0%) were recommended antiplatelet agents or non-steroidal-anti-inflammatory drugs, and in 167 (50.8%), there was no documented antithrombotic therapy. In the year after SVTE diagnosis, 19 (5.8%) patients had a subsequent diagnosis of a deep venous thrombosis or pulmonary embolism. In conclusion, clinically significant venous thrombosis within a year after SVTE was uncommon in our study despite infrequent use of antithrombotic therapy.

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“…• Positive family history of DVT • SVT not in varicose veins but in normal veins (5) Varicose veins as a risk factor for SVT Varicose veins are a significant risk factor for SVT. The relevance of varicose veins is demonstrated, for example, in the high frequency of SVT recurrences in patients whose varicose veins remain untreated.…”

Section: Risk Factors For Dvt As a Consequence Of Svtmentioning

confidence: 99%

Aktuelle Aspekte der Diagnostik und Therapie der Oberflächenthrombose des Beines

Stücker¹,

Reich‐Schupke²

2018

Phlebologie

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ZusammenfassungDer derzeit aktuelle Terminus Oberflächenthrombose spiegelt besser als der alte Begriff Thrombophlebitis die Ernsthaftigkeit des Krankheitsbildes wider, welches bei etwa 25% der Patienten mit weitere thromboembolischen Komplikationen wie tiefen (Bein)Venenthrombosen und Lungenembolien einhergeht. Treten die Oberflächenthrombosen in Varizen auf, sollten diese nach Abheilung der akuten OVT saniert werden. Oberflächenthrombosen abseits der Varizen treten gehäuft bei malignen Grunderkrankungen, Thrombophilie und anderen Risikofaktoren der tiefen Beinvenenthrombose auf. Obwohl die Diagnose in der Regel klinisch gestellt werden kann, ist die Duplexsonographie unverzichtbar, um die Ausdehnung des Thrombus und ein mögliches Übergreifen des Thrombus in das tiefe Beinvenensystem zu erfassen. Dabei ist das komplette Venensystem beider Beine vollständig zu sonografieren, da der entscheidende Faktor für die Oberflächenthrombose die Hyperkoagulabilität ist und daher begleitende tiefe Venenthrombosen durchaus auch auf der Gegenseite auftreten können. Die Therapie der Oberflächenthrombose ist gestaffelt nach den betroffenen Gefäßen: 1) Bei kleinkalibrigen Astthrombosen sind Kühlung, Kompressionstherapie, nicht steroidale Antiphlogistika sowie eine Stichinzision mit Thrombusexpression angezeigt. 2) Bei Oberflächenthrombosen der Saphenavenen und großkalibriger Varizenäste über 5cm Länge wird eine Antikoagulation in Prophylaxedosierung über 4–6 Wochen empfohlen, begleitet durch eine Kompressionstherapie über 3 Monate. Bei Risikofaktoren wie Krebsleiden, Autoimmunerkrankungen oder Befall nicht variköser Venen kommt es nicht selten erst nach Absetzen einer 6wöchigen Antikoagulation zu thromboembolischen Komplikationen, so dass bei diesen Patienten entsprechende Instruktionen sinnvoll sind. 3) Reicht der Thrombus näher als 3 cm an das tiefe Venensystem heran bzw. greift er auf die tiefen Venen über, wird wie bei einer tiefen Beinvenenthrombose therapiert.

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Risk factors for recurrent events in subjects with superficial vein thrombosis in the randomized clinical trial SteFlux (Superficial Thromboembolism Fluxum)

Cited by 34 publications

References 13 publications

Spontaneous acute superficial vein thrombosis of the legs: do we really need to treat?

Spontaneous acute superficial vein thrombosis of the legs: do we really need to treat?

Initial management and outcomes after superficial thrombophlebitis: The Cardiovascular Research Network Venous Thromboembolism study

Aktuelle Aspekte der Diagnostik und Therapie der Oberflächenthrombose des Beines

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