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VASA. Zeitschrift Fur Gefasskrankheiten Feb 2008Superficial vein thrombophlebitis (SVTP) appears in two distinct forms: varicose vein thrombophlebitis (TP) represents the principal cause. It is characterized by a... (Review)
Review
Superficial vein thrombophlebitis (SVTP) appears in two distinct forms: varicose vein thrombophlebitis (TP) represents the principal cause. It is characterized by a large thrombus in a varicose vein and a modest inflammatory process localized in the vessel surrounding but not in its wall. Rarely, SVTP affects a non-varicose vein. Abundant intima proliferation and media fibrosis with non-important thrombosis are the hallmark of this form which may be associated with a systemic disease. Although SVTP is perceived as trivial and benign coexistence of (mostly distal) deep venous thrombosis (DVT), propagation to popliteal or femoral DVT, and even pulmonary embolism (PE) have been reported. Data for prevalence vary greatly: 6-53% for coexistence, 2.6-15% for propagation, and 0-33% for (asymptomatic) PE. Risk factors for these complications are those known for DVT. SVTP is diagnosed in a clinical setting but ultrasonography is useful to check for concomitant DVT. Anticoagulant treatment is mandatory if DVT is present and thrombectomy should be considered in cases of thrombus propagation into the deep veins. Historical therapy of uncomplicated SVTP consists of compression with bandages or stockings and local or systemic anti-inflammatory agents. Low-molecular-weight heparin (LMWH) has been given in high-prophylactic doses and found equally effective when compared with anti-inflammatory agents and full-therapeutic dose LMWH. Prophylactic saphenous vein ligation alone was found less effective than conservative therapy. Ligation combined with stripping proved the potential of eliminating at once all problems associated with SVTP but was associated with a complication rate of 10% or higher. Careful patient selection and saphenous vein thrombectomy prior to stripping may be the clue for better results.
Topics: Adult; Aged; Anti-Inflammatory Agents; Anticoagulants; Female; Humans; Ligation; Male; Middle Aged; Patient Selection; Stockings, Compression; Thrombectomy; Thrombophlebitis; Treatment Outcome; Varicose Veins; Vascular Surgical Procedures; Venous Thrombosis
PubMed: 18512540
DOI: 10.1024/0301-1526.37.1.31 -
MMW Fortschritte Der Medizin Nov 2006
Topics: Diagnosis, Differential; Erythema; Humans; Leg Dermatoses; Male; Middle Aged; Skin; Thigh; Thrombophlebitis
PubMed: 17615771
DOI: 10.1007/BF03364865 -
Missouri Medicine Aug 1969
Topics: Female; Humans; Pregnancy; Pregnancy Complications; Thrombophlebitis
PubMed: 5807542
DOI: No ID Found -
Surgery, Gynecology & Obstetrics May 1967
Topics: Humans; Thrombophlebitis; Varicose Veins
PubMed: 6023848
DOI: No ID Found -
Vnitrni Lekarstvi Feb 2009Superficial thrombophlebitis (ST) is a common disease, usually considered benign. However, the practice of systemic duplex ultrasonography has revealed a large number of...
Superficial thrombophlebitis (ST) is a common disease, usually considered benign. However, the practice of systemic duplex ultrasonography has revealed a large number of deep-vein thromboses concomitant with ST. In contrast with extensive information on the management of deep vein thrombosis, little is known about the most appropriate treatment of the ST. Systematic duplex ultrasonography investigation has been proposed in the initial management of ST, to detect the presence of any underlying deep vein thrombosis. Because ST may extend into the deep venous system and potentially engender pulmonary embolism, treatment with low-molecular-weight-heparins might be the best choice. In our work diagnostic and therapeutic procedures for ST, proposed by Slovak angiological society, Slovak society for vascular surgeons, Slovak dermatological society, Slovak society for haemostasis and thrombosis, Slovak surgical society and Slovak internistic society are discussed.
Topics: Humans; Thrombophlebitis
PubMed: 19348395
DOI: No ID Found -
Surgery Jan 1982In the absence of malignancy, thrombophlebitis of the lower limb is invariably associated with pre-existent varicose veins. Not until pulmonary embolism was reported to...
In the absence of malignancy, thrombophlebitis of the lower limb is invariably associated with pre-existent varicose veins. Not until pulmonary embolism was reported to occur in superficial phlebitis did the clinician introduce anticoagulants and/or surgery in the management of this condition. In an effort to reach an effective approach to this problem, 1,000 consecutive cases of varicose veins of the lower limbs were reviewed. Of these patients, 779 were admitted for elective vein ligation and stripping and 221 presented with thrombophlebitis. The latter group was subdivided into four categories according to the mode of management: (1) local heat and anti-inflammatory agents, 60 cases; (2) anticoagulants, 22 cases; (3) phlebotomy, high saphenous ligation and anticoagulation, 4 cases; and (4) ligation and stripping, 135 cases. In category 4 the saphenous is removed in a routine fashion together wih all its tributaries. All perforators are exposed, evacuated of thrombus when present, and ligated subfascially. Thrombi were encountered in one or more perforating veins in 10 patients, but no pulmonary embolism was observed in this group of patients. All instances of documented pulmonary embolism (10 cases) occurred in category 1 with one fatality. The incidence of pulmonary embolism in the elective group of ligation and stripping (without phlebitis) was 0.5%. The data indicate that the surgical approach is safe and preferable to the other modalities for several reasons: (1) It eliminates the varicosities and the phlebitic process simultaneously, (2) a single hospitalization is necessary (cost effectiveness), and (3) no anticoagulants are needed. If, for any reason, surgery cannot be undertaken, then anticoagulants should be employed in an effort to avoid thromboembolism.
Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Anticoagulants; Female; Humans; Leg; Male; Middle Aged; Postoperative Complications; Pulmonary Embolism; Thrombophlebitis; Varicose Veins
PubMed: 7054911
DOI: No ID Found -
The Practitioner Sep 1970
Clinical Trial
Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Female; Humans; Indomethacin; Leg; Male; Middle Aged; Placebos; Thrombophlebitis
PubMed: 4922059
DOI: No ID Found -
Minerva Cardioangiologica Dec 2000Thrombophlebitis of the superficial veins (SVT) of the leg is usually regarded as a mild and uncomplicated disease. Although this is generally true for acute thrombosis...
Thrombophlebitis of the superficial veins (SVT) of the leg is usually regarded as a mild and uncomplicated disease. Although this is generally true for acute thrombosis of the branches of the saphenous vein, the natural history of SVT involving the main trunk may not be as benign. The association of SVT with deep venous thrombosis (DVT) has been reported to range from 17 to 40%; the progression of the thrombotic process from the greater saphenous vein into the deep venous system has been reported in 8.6% of the cases. For this reason, even if symptoms of DVT are lacking, it is necessary to use duplex ultrasonography to be certain that DVT does not exist concurrently with SVT. In a recent study we found that saphenous-vein thrombi embolize even when no femoral-vein involvement is evident. Of 21 patients included in the study, findings compatible with a high probability of pulmonary embolism were detected in 7 (33.3%, 95% CI, 14.6 to 57.0), although clinical symptoms were present only in 1. The risk of pulmonary embolism is similarly high in patients with and without thrombosis at the sapheno-femoral junction. These patients presumably would benefit from anticoagulation, but such a benefit remains to be proven. Superficial thrombophlebitis, in the absence of DVT proven by duplex ultrasonography, is generally treated with nonsteroidal anti-inflammatory agents. A prospective randomized study is being carried out at our Institution evaluating therapeutic doses of anticoagulant drugs in SVT. Interim report suggests that, in thrombophlebitis of the thigh, high fixed doses of unfractioned heparin are more effective than low doses for the prevention of early and late venous thromboembolic complications and are not associated with an appreciable bleeding risk.
Topics: Acute Disease; Anti-Inflammatory Agents, Non-Steroidal; Anticoagulants; Diagnosis, Differential; Fibrinolytic Agents; Heparin; Humans; Middle Aged; Phlebography; Pulmonary Embolism; Risk Factors; Thrombophlebitis; Time Factors; Ultrasonography, Doppler
PubMed: 11253344
DOI: No ID Found -
Vnitrni Lekarstvi Sep 2012Superficial thrombophlebites represent a very heterogeneous group of diseases which is caused by the difference between two basic forms of ST - varicophlebitis and... (Review)
Review
Superficial thrombophlebites represent a very heterogeneous group of diseases which is caused by the difference between two basic forms of ST - varicophlebitis and thrombophlebitis of a "healthy" vein, as well as by other factors - the ratio of thrombotic and inflammatory process, the location and extent of thrombosis in superficial venous system, the distance from deep venous system, the stage of venous insufficiency and the general thrombotic risk of a patient. ST shares many common features with deep vein thrombosis (clinical risk factors, thrombophilic disorders), both diseases often coincide or follow one another. Some authors suggest considering ST as a part of venous thromboembolism in a broader sense. There are ensuing unresolved questions regarding ST management. So far, no evidence-based treatment has been clearly defined. Anticoagulation is recommended in more serious cases but no consensus about dosing and duration has been reached. The CALISTO trial confirmed a benefit of fondaparinux in prophylactic dose in the therapy of isolated ST and the results have been reflected in recent guidelines of expert groups. Further studies to improve our knowledge of ST and to earn more evidence about its management are definitely needed.
Topics: Humans; Thrombophlebitis; Venous Thrombosis
PubMed: 23094809
DOI: No ID Found -
Angiology 2007Superficial vein thrombosis is characterized by clotting of superficial veins (ie, following direct trauma) with minimal inflammatory components. Superficial...
Superficial vein thrombosis is characterized by clotting of superficial veins (ie, following direct trauma) with minimal inflammatory components. Superficial thrombophlebitis is a minimally thrombotic process of superficial veins associated with inflammatory changes and/or infection. Treatments generally include analgesics, elastic compression, anti-inflammatory agents, exercise and ambulation, and, in some cases, local or systemic anticoagulants. It is better to avoid bed rest and reduced mobility. Topical analgesia with nonsteroidal, anti-inflammatory creams applied locally to the superficial vein thrombosis/superficial thrombophlebitis area controls symptoms. Hirudoid cream (heparinoid) shortens the duration of signs/symptoms. Locally acting anticoagulants/antithrombotics (Viatromb, Lipohep, spray Na-heparin) have positive effects on pain and on the reduction in thrombus size. Intravenous catheters should be changed every 24 to 48 hours (depending on venous flow and clinical parameters) to prevent superficial vein thrombosis/superficial thrombophlebitis and removed in case of events. Low molecular weight heparin prophylaxis and nitroglycerin patches distal to peripheral lines may reduce the incidence of superficial vein thrombosis/superficial thrombophlebitis in patients with vein catheters. In case of superficial vein thrombosis/superficial thrombophlebitis, vein lines should be removed. In neoplastic diseases and hematological disorders, anticoagulants may be necessary. Exercise reduces pain and the possibility of deep vein thrombosis. Only in cases in which pain is very severe is bed rest necessary. Deep vein thrombosis prophylaxis should be established in patients with reduced mobility. Antibiotics usually do not have a place in superficial vein thrombosis/superficial thrombophlebitis unless there are documented infections. Prevention of superficial vein thrombosis should be considered on the basis of patient's history and clinical evaluation.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Anticoagulants; Exercise Therapy; Humans; Stockings, Compression; Thrombophlebitis; Thrombosis
PubMed: 17478877
DOI: 10.1177/0003319706297643