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. 2023 Nov 18;8(1):102263.
doi: 10.1016/j.rpth.2023.102263. eCollection 2024 Jan.

Management and outcomes of superficial vein thrombosis: a single-center retrospective study

Marie-Eve Mathieu  1 , Lisa Duffett  1 , Lucia Caiano  1 , Dimitri Scarvelis  1 , Catherine Code  1 , Philip Wells  1 , Grégoire Le Gal  1
Affiliations

Management and outcomes of superficial vein thrombosis: a single-center retrospective study

Marie-Eve Mathieu et al. Res Pract Thromb Haemost. .

Abstract

Background: Guidelines suggest but cannot recommend the optimal management of superficial vein thrombosis (SVT).

Objectives: To identify the prevalence of asymptomatic deep vein thrombosis (DVT) at the time of SVT diagnosis, and to report the treatment and 3-month complications of patients with only SVT more than 3 cm from deep vein junction (or unknown distance).

Methods: We performed a single-center retrospective review of patients referred to the Ottawa Hospital thrombosis unit with ultrasound (US)-diagnosed SVT, and followed patients with only SVT for 3 months.

Results: Three hundred sixteen patients with SVT were included. Of the 218 patients without DVT symptoms at presentation, 19 (8.7%; 95% CI, 5.7%-13.2%) were found to have asymptomatic concomitant DVT (11 proximal and 8 distal), and 45 (20.6%) had SVT within 3 cm of the saphenofemoral or saphenopopliteal junctions. Among the 192 patients diagnosed with SVT only, we observed 3-month thrombotic complications in 56 (29.2%; 95% CI, 23.2%-36.0%) patients, with a total of 69 events: 11 (5.7%) DVTs, 2 (1.0%) pulmonary embolisms, 37 (19.2%) SVT extensions, and 19 (9.8%) SVT recurrences. Eighty-two percent (9/11) of the 3-month DVT and pulmonary embolism events occurred in patients who initially received conservative management. Therapeutic treatment doses were most effective.

Conclusion: At the time of SVT diagnosis, many patients had asymptomatic DVT and SVT near the deep venous system, supporting the systematic use of initial US in patients clinically diagnosed with SVT. The observed differences in 3-month complication rates, according to the treatment provided, highlight the need for large-scale randomized controlled trials to establish optimal management.

Keywords: anticoagulant; deep vein thrombosis; pulmonary embolism; ultrasound; venous thromboembolism.

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Figures

Figure
Figure
Study flow diagram. (A) Aim 1: measuring the prevalence of deep vein thrombosis (DVT) in patients with superficial vein thrombosis (SVT) according to the presence and absence of DVT signs and symptoms. (B) Aim 2: investigating the management and outcome of patients with SVT located beyond 3 cm of the saphenofemoral junction (SFJ) or saphenopopliteal junction (SPJ). US, ultrasound.
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