Superficial thromobosis may not be as benign as once thought

January 01, 0001

Superficial thromobosis may not be as benign as once thought

Superficial venous thrombosis (SVT) is perceived to have a benign prognosis. These French authors assessed the prevalence of venous thromboembolism in patients with SVT and to determine the 3-month incidence of thromboembolic complications among 844 consecutive patients with symptomatic SVT of the lower limbs that was at least 5 cm on compression ultrasonography.

They found: "Among 844 patients with SVT at inclusion (median age, 65 years, 547 women), 210 (24.9%) also had deep venous thrombosis (DVT) or symptomatic pulmonary embolism. Among 600 patients without DVT or pulmonary embolism at inclusion who were eligible for 3-month follow-up, 58 (10.2%) developed thromboembolic complications at 3 months (pulmonary embolism 3, DVT 15, extension of SVT 18, and recurrence of SVT 10), despite 540 patients (90.5%) having received anticoagulants. Risk factors for complications at 3 months were male sex, history of DVT or pulmonary embolism, previous cancer, and absence of varicose veins. Limitations include that the findings are from a specialist referral setting, and the study was terminated before the target patient population was reached because of slow recruitment."

The authors concluded: "A substantial number of patients with SVT exhibit venous thromboembolism at presentation, and some that do not can develop this complication in the subsequent 3 months."

This evidence is too limited to justify change in primary care practice.

For the full abstract, click here.

Annals of Internal Medicine 152( 4):218-224, 16 February 2010
© 2010 to the American College of Physicians
Superficial Venous Thrombosis and Venous Thromboembolism-A Large, Prospective Epidemiologic Study. Herve Decousus, Isabelle Quere, Emilie Presles, et al.

Category: K. Circulatory. Keywords: superficial venous thrombosis, venous thromboembolism, pulmonary embolism, varicose veins, cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 2 March 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.