scholarly journals Endovenous saphenous vein ablation in patients with acute isolated superficial-vein thrombosis

2013 ◽  
Vol 30 (3) ◽  
pp. 204-209 ◽  
Author(s):  
Wayne S Gradman
Keyword(s):  
Saphenous Vein ◽  
Initial Treatment ◽  
Definitive Treatment ◽  
Superficial Vein ◽  
Vein Thrombosis ◽  
Group I ◽  
Superficial Vein Thrombosis ◽  
Group Ii ◽  
Deep Vein

Objective: The possible benefits of endovenous saphenous ablation (EVSA) as initial treatment in patients presenting with isolated superficial-vein thrombosis (SVT) and saphenous vein reflux include: (1) definitive treatment of the underlying pathology and (2) elimination of the saphenous vein as a path for pulmonary emboli, which (3) may eliminate the need for anticoagulation. Methods: In a ten-year review of 115 limbs presenting with acute isolated SVT, 72 limbs (71 patients) with saphenous reflux were given a choice of two treatments following an explanation of the risks and benefits of each. Group I limbs ( n = 41) were treated with office EVSA using radiofrequency or laser with or without thrombophlebectomy if performed within 45 days of diagnosis. Post-treatment anticoagulants were not given. Group II limbs ( n = 31) were treated with compression hose and repeat Duplex within one week, with added anticoagulants if SVT extended into the thigh. Results: In group I, mean interval from diagnosis to treatment was 13.7 days. One calf deep vein thrombosis was noted. In group II no complications were noted. In late follow-up of group II patients, 12/29 underwent EVSA more than 45 days after initial presentation. Conclusions: The safety and efficacy of EVSA and thrombophlebectomy appear indistinguishable from conservative measures and may be offered as initial treatment to patients presenting with SVT and saphenous reflux.

Tinzaparin in intermediate dose for the treatment of superficial vein thrombosis: Results from an observational multicenter study—SeVEN study

2017 ◽  
Vol 33 (9) ◽  
pp. 636-645 ◽  
Author(s):  
Athanasios Giannoukas ◽  
Christos Karathanos ◽  
Konstantinos Nikolakopoulos ◽  
George S Georgiadis ◽  
Chrisostomos Maltezos ◽  
...  
Keyword(s):  
Low Grade ◽  
Minor Bleeding ◽  
Superficial Vein ◽  
Duration Of Treatment ◽  
Once Daily ◽  
Vein Thrombosis ◽  
Superficial Vein Thrombosis ◽  
Deep Vein ◽  
Intermediate Dose

Objectives Low-molecular-weight heparins are recommended in the treatment of superficial vein thrombosis but with low grade of evidence. This study was conducted to assess the treatment outcomes of acute superficial vein thrombosis with intermediate dose of Tinzaparin. Methods Retrospective analysis of records from outpatients over a period of 16 months treated in seven centers with Tinzaparin 0.5 ml (10,000 anti-Xa IU) once daily for a period that was at the treating physician’s discretion. All the patients were followed up for at least 12 weeks. Results A total of 296 patients (189 females, mean age 57.4 years) were included. Two thirds of the patients (191/296, 64.5%) received treatment for approximately five weeks (mean 36.9 days) and the remaining (105/296, 35.5%) for a shorter period (mean 16.2 days). There was no difference in patients’ characteristics between the two treatment duration groups. The presence of thrombus above the knee and restricted daily activity were associated with longer period of treatment. Only one case with minor bleeding was observed. Recurrence of thrombosis over a 12-week follow-up period occurred in 6% (superficial vein thrombosis in 14 (4.7%), deep vein thrombosis in 3 (1%) and thrombus extension in the superficial veins in 1 (0.3%)). Recurrence was not related to the duration of treatment. Conclusions Intermediate dose of Tinzaparin was an effective and safe treatment for superficial vein thrombosis in the setting of real world practice. Location of thrombus and status of patients’ mobilization were associated with longer duration of treatment. Future prospective randomized studies are needed to corroborate these findings.

The risk of subsequent cancer and arterial cardiovascular events in patients with superficial vein thrombosis in the legs

Blood ◽  
2011 ◽  
Vol 118 (17) ◽  
pp. 4719-4722 ◽  
Author(s):  
Paolo Prandoni ◽  
Edoardo Casiglia ◽  
Valerie Tikhonoff ◽  
Alain Leizorovicz ◽  
Hervé Decousus ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Cardiovascular Events ◽  
Hazard Ratio ◽  
Superficial Vein ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Superficial Vein Thrombosis ◽  
Event Rates ◽  
Deep Vein

Abstract Although it has been clearly demonstrated that venous thromboembolism is associated with an increased risk of subsequent overt cancer and arterial cardiovascular events in comparison with control populations, whether this association also applies to patients with isolated (ie, without concomitant involvement of the deep vein system) superficial vein thrombosis (SVT) in the legs is unknown. In 737 consecutive patients with isolated SVT not involving the sapheno-femoral junction, we conducted a retrospective investigation to assess the rate of cancer and that of arterial cardiovascular events occurring during follow-up. The event rates were compared with those occurring in 1438 controls having comparable characteristics. Both cases and controls were followed-up for an average period of 26 ± 8 months (range, 3-45). Malignancy was diagnosed in 26 cases (3.5%) and 56 controls (3.9%), leading to a hazard ratio of 0.86 (95% confidence interval, 0.55%-1.35%). Arterial cardiovascular events occurred in 32 cases (4.3%) and 63 controls (4.4%), leading to a hazard ratio of 0.97 (95% confidence interval, 0.63%-1.50%). We conclude that the occurrence of isolated SVT in the legs does not place patients at an increased risk of malignancies or arterial cardiovascular events. Whether this conclusion also applies to patients whose thrombosis involves the sapheno-femoral junction remains to be demonstrated.

scholarly journals Giant thrombosed saphenofemoral junction aneurysm: A case report

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774101
Author(s):  
Vladimir Cojocari ◽  
Vasile Culiuc ◽  
Florin Bzovii ◽  
Dumitru Casian ◽  
Eugen Gutu
Keyword(s):  
Saphenous Vein ◽  
Surgical Intervention ◽  
Femoral Vein ◽  
Superficial Vein ◽  
Common Femoral Vein ◽  
Vein Thrombosis ◽  
Superficial Vein Thrombosis ◽  
Varicose Disease ◽  
Deep Vein ◽  
Saphenofemoral Junction

Introduction: Although saphenofemoral junction aneurysms are not so rare, only scarce of the published cases reported thrombosis of the aneurysmal sac and saphenous trunk. Presentation of case: A 65-year-old male with varicose disease, developed acute ascending superficial vein thrombosis of the left greater saphenous vein, involving the 6-cm saphenofemoral junction aneurysm. The patient underwent common femoral vein thrombectomy, aneurysm removal, and greater saphenous vein excision with uneventful postoperative course. Conclusion: Thrombosed giant saphenofemoral junction aneurysms require emergent surgical intervention aimed at preventing potential progression to deep vein thrombosis and pulmonary embolism.

Prognostic significance of concomitant superficial vein thrombosis in patients with deep vein thrombosis of the lower limbs

2021 ◽  
Author(s):  
Álvaro Dubois-Silva ◽  
Cristina Barbagelata-López ◽  
Patricia Piñeiro-Parga ◽  
Iria Francisco ◽  
Conxita Falgà ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Major Bleeding ◽  
Lower Limb ◽  
Prognostic Significance ◽  
Superficial Vein ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Superficial Vein Thrombosis ◽  
Deep Vein

<b>Background: </b>The prognostic significance of concomitant superficial vein thrombosis (SVT) in patients with lower-limb deep vein thrombosis (DVT) has not been consistently evaluated. <b>Methods: </b>We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry to compare the rates of subsequent PE, recurrent DVT, major bleeding or death in patients with lower-limb DVT, according to the presence or absence of concomitant SVT. <b>Results: </b>Since March 2015 to May 2020, there were 8,743 patients with lower-limb DVT. Of these, 745 (8.5%) had concomitant SVT. Most patients (97.4% in both subgroups) received anticoagulant therapy (median duration, 138 vs. 147 days). During follow-up (median, 193 vs. 210 days), 156 (1.8%) patients developed subsequent PE, 336 (3.8%) had recurrent DVT, 201 (2.3%) had major bleeding and 844 (9.7%) died. Patients with concomitant SVT had a higher rate of subsequent PE (rate ratio [RR]: 2.11; 95%CI: 1.33-3.24) than those with isolated DVT, with no significant differences in the rates of recurrent DVT (RR: 0.80; 95%CI: 0.50-1.21), major bleeding (RR: 0.77; 95%CI: 0.41-1.33) or death (RR: 0.81; 95%CI: 0.61-1.06). On multivariable analysis, patients with DVT and SVT concomitantly were at increased risk for subsequent PE during anticoagulation (adjusted hazard ratio [HR]: 2.23; 95%CI: 1.22-4.05) and also during the entire follow-up period (adjusted HR: 2.33; 95%CI: 1.49-3.66). <b>Conclusion:</b> Patients with lower-limb DVT and SVT concomitantly are at increased risk to develop PE. Further studies are needed to externally validate our findings and to determine if these patients could benefit from a different management strategy.

Treatment of Superficial Vein Thrombosis: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 119 (03) ◽  
pp. 479-489 ◽  
Author(s):  
Lisa Duffett ◽  
Clive Kearon ◽  
Marc Rodger ◽  
Marc Carrier
Keyword(s):  
Systematic Review ◽  
Primary Outcome ◽  
Event Rate ◽  
Meta Analysis ◽  
Vein Thrombosis ◽  
Superficial Vein Thrombosis ◽  
Venous Thromboembolic ◽  
Event Rates ◽  
Deep Vein

Background The optimal first line treatment for patients with isolated superficial venous thrombosis (SVT) of the lower extremity is unknown. Objective This article reports estimates of the rate of venous thromboembolic complications among patients with SVT according to treatment. Materials and Methods A systematic review and meta-analysis was performed using unrestricted searches of electronic databases. Reported events were transformed to event per 100 patient-years of follow-up and a random effects model was used to calculate pooled rates according to pre-specified treatment categories. The primary outcome was the occurrence of deep vein thrombosis (DVT) or pulmonary embolism (PE) during the study follow-up period. Results Seventeen articles, including 6,862 patients, were included in the meta-analysis. Fondaparinux had the lowest event rate with 1.4 events per 100 patient-years of follow-up (95% confidence interval [CI], 0.5–2.8, I 2 = 18%). Pooled event rates for DVT or PE ranged from 9.3 to 16.6 events per 100 patient-years across other treatment categories, and the pooled event rate for no treatment/placebo was 10.5 events per 100 patient-years (95% CI, 3.0–22.0). Major bleeding was low and similar across all treatment categories. Heterogeneity was moderate to high for most pooled estimates. Conclusion While pooled event rates suggest that fondaparinux achieves the lowest rate of DVT or PE, low-quality evidence for other treatments prevents firm conclusions about the optimal treatment for SVT.

ANABOLIC STEROID AND INTRAPULMONARY HEPARIN IN THE PREVENTION OF POSTOPERATIVE DEEP VEIN THROMBOSIS

1987 ◽  
Author(s):  
K Zawilska ◽  
A Tokarz ◽  
P Psuja ◽  
P Szymczak ◽  
S Kawczyński ◽  
...  
Keyword(s):  
Body Weight ◽  
Deep Vein Thrombosis ◽  
Single Dose ◽  
Anabolic Steroid ◽  
Group Iii ◽  
Vein Thrombosis ◽  
Group I ◽  
Group Ii ◽  
Long Acting ◽  
Deep Vein

150 patients over 40 years old undergoing major abdominal surgery were divided into 3 groups:1/ group I - receiving a single injection of long acting anabolic steroid /nandrolone phenylpropio-nate, 50 mg intramusculary/ a day prior to surgery 2/ gropup II - receiving the same dose of anabolic steroid plus a single dose of heparin /800 U/kg of body weight/ intrapulmonary a day prior to surgery 3/ group III - receiving only a single dose of heparin /800 U/kg of body weight/ intrapulmonary a day prior to surgery.The deep vein thrombosis /DVT/ was detected using the 125 I-fibrinogen test. The occurence of DVT was:in group I - 14%in group II - 4%in group III - 8%There were no detectable haemorrhagic complications in patients of group I and III, in 6% of patients of group II a sgliht increase of intraoperative bleeding and/or wound hematoma appeared.We conclude that prophylaxis of DVT in the postoperative period with the single dose of anabolic steroid and intrapulmonary heparin is an effective, safe and easy to handle procedure.

Reevaluation of the Incidence of Thromboembolic Complications in Congenital Factor XII Deficiency

1999 ◽  
Vol 82 (10) ◽  
pp. 1240-1246 ◽  
Author(s):  
S. Zeerleder ◽  
M. Schloesser ◽  
M. Redondo ◽  
W. A. Wuillemin ◽  
W. Engel ◽  
...  
Keyword(s):  
Life Time ◽  
Factor Xii ◽  
Superficial Vein ◽  
Thromboembolic Complications ◽  
Vein Thrombosis ◽  
Kaplan Meier ◽  
Superficial Vein Thrombosis ◽  
Thrombophilic Condition ◽  
Cerebrovascular Stroke

SummaryTo further elucidate the debated role of hereditary FXII deficiency as a thrombophilic risk factor this follow-up study on 65 subjects out of 12 Swiss families was undertaken (follow-up: 6 yrs). Fifteen severely FXII deficient subjects (FXII:C < 1%), 35 partially FXII deficient subjects (FXII:C ≥ 1-59%), 10 with normal FXII values (FXII:C ≥ 70%), and 5 non-classifiable subjects (FXII:C ≥ 60-69%) were reevaluated. Eight subjects (4 severely and 3 partially FXII deficient, 1 non-classifiable) were newly enrolled. Four instances of deep vein thrombosis, one superficial vein thrombosis and one myocardial infarction were noted in 2 out of 19 severely FXII deficient subjects during a total life-time period of 866.6 patient-years. In 38 partially FXII deficient subjects (1862.8 patient-years) one ischemic cerebrovascular stroke and one superficial vein thrombosis were recorded in 2 individuals. The 10 subjects with normal FXII values (498.2 patient-years) remained thrombosis-free. One superficial vein thrombosis occurred in an unclassifiable woman. None of the 3 different FXII gene defects revealed in our patients was specifically associated with thromboembolic complications. Kaplan-Meier analysis of thrombosis-free survival suggests that hereditary partial (and probably severe) FXII deficiency does not constitute a thrombophilic condition.

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