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Internal Medicine Journal Nov 2022Cannula provoked upper extremity superficial vein thrombophlebitis (UESVT) is common. Retrospective audit of 93 consecutive patients, 51% male, median age 57 years...
Cannula provoked upper extremity superficial vein thrombophlebitis (UESVT) is common. Retrospective audit of 93 consecutive patients, 51% male, median age 57 years (range 20-91), with symptomatic UESVT revealed varied management including symptomatic management (37%), prophylactic (37%) and higher dose anticoagulation (27%). There was 2% (95% confidence interval (CI) 0-7.6) thrombus extension and 1% (95% CI 0-5.9) major bleeding, both limited to cancer. We argue anticoagulation is unnecessary in most UESVT patients.
Topics: Male; Humans; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Female; Cannula; Retrospective Studies; Upper Extremity; Thrombophlebitis; Anticoagulants
PubMed: 36326238
DOI: 10.1111/imj.15951 -
European Journal of Vascular and... Jan 2005To evaluate the clinical implications of superficial thrombophlebitis (STP) including its demographic characteristics, distribution, risk factors, relationship with deep... (Review)
Review
OBJECTIVE
To evaluate the clinical implications of superficial thrombophlebitis (STP) including its demographic characteristics, distribution, risk factors, relationship with deep vein thrombosis (DVT), pulmonary embolism (PE), diagnosis and management.
METHODS
Data were collected from relevant papers using a MEDLINE search and an extensive bibliography review. Studies were considered only when they contained pertinent material to STP. Thirty-seven papers were analysed.
RESULTS
The diversity of patients and methods used in the different studies made the comparison among them difficult. STP is a common condition with an underestimated prevalence. There are many risk factors associated with STP but the strongest relation was seen with hypercoagulable states. Malignancy may be another important factor but the strength of this association remains unknown. Coexistence with DVT was found in 6-53%. PE occurred in 0-33.3%. Propagation to DVT ranged from 2.6 to 15%. Treatment has not been standardised and may include elastic compression, anti-inflammatory drugs, anticoagulation and surgery.
CONCLUSION
The limited number of prospective randomised studies on STP does not allow strong recommendations to be given. Although STP most often is perceived as benign, it can coexist with or progress to DVT, and even give rise to PE. It is also associated with hypercoagulability and malignancy.
Topics: Humans; Pulmonary Embolism; Risk Factors; Venous Thrombosis
PubMed: 15570265
DOI: 10.1016/j.ejvs.2004.09.021 -
Cureus Jul 2022Other entities besides deep vein thrombosis (DVT) affecting the venous system, such as superficial vein phlebitis (SVP) and superficial vein thrombophlebitis (SVT),...
INTRODUCTION
Other entities besides deep vein thrombosis (DVT) affecting the venous system, such as superficial vein phlebitis (SVP) and superficial vein thrombophlebitis (SVT), receive poor attention in the literature. However, both entities may propagate proximally into the deep venous system and progress to a DVT. To our knowledge, the relevance of other venous findings such as SVP or SVT in coronavirus disease 2019 (COVID-19) patients has not been evaluated. This work aimed to assess the clinical, biochemical, and hematological variables associated with the incidence of acute venous diseases, such as DVT, SVP, and SVT, in a cohort of 74 critically ill COVID-19 patients and their association with mortality.
METHODS
Given the high thrombotic risk, all patients underwent venous imaging with bedside ultrasound. Clinical variables were obtained from medical records. Comparisons were made by the chi-square test or Fisher's exact test. We constructed Kaplan-Meier curves and used Cox proportional hazard models to calculate hazard ratios for dichotomized risk factors to identify predictors of mortality. SPSS version 21.0 (IBM Corp., Armonk, NY) was used for statistical analysis.
RESULTS
SVP occurred in 28 patients (37.8%), DVT in 22 patients (29.7%), and 28 patients died (37.8%). Elevated D-dimer was associated with DVT but not with SVP. Neither SVP nor DVT was associated with mortality. After adjusting for age, elevated troponins (OR: 2.4, 95% CI: 1.1-5.4), platelets < 244 cell/mm (2.4, 1.1-5.6), and IMPROVE (International Medical Prevention Registry on Venous Thromboembolism) bleeding score > 7 (2.8, 1.3-6.3) were predictors of mortality.
CONCLUSIONS
Acute venous findings such as SVP and DVT are highly prevalent and independent of mortality in critically ill COVID-19 patients. These entities are not related, although they may occur synchronically. DVT is frequently presented as an asymptomatic distal bilateral finding associated with elevated D-dimer, decreased ferritin, and higher vasoactive drug use but independent from chronic venous disease. Interestingly, elevated troponins, decreased platelets, and a prognostic value > 7 of the IMPROVE bleeding score were predictors of mortality in this group of critically ill COVID-19 patients.
PubMed: 35936165
DOI: 10.7759/cureus.27067 -
Medical Ultrasonography Mar 2011Some patients may have deep venous thrombosis (DVT) and superficial thrombophlebitis (ST) of the lower limbs at the same time.
INTRODUCTION
Some patients may have deep venous thrombosis (DVT) and superficial thrombophlebitis (ST) of the lower limbs at the same time.
AIMS
To analyze the frequency of risk factors for thrombosis (RF), other than thrombophilias, in patients with concomitant DVT and ST.
PATIENTS AND METHODS
Clinical examination, plasma D-dimers and duplex ultrasonography were performed in 88 consecutive patients (mean age 64.9 +/-13.9 years) admitted in Medical Clinic in 2007. Patients with DVT were divided into two groups: A (with ST - 30 subjects, 34.1%) and B (without ST - 58 patients, 65.9%).
RESULTS
Conditions known as RF were the following (Group A versus B): varicose veins (17 vs 21 patients, p=0.11), obesity (12 vs 19, p=0.66), previous venous thromboembolism (8 vs 16, p=0.87), malignancy (4 vs 10, p=0.44), chronic obstructive lung disease (4 vs 7, p=0.56), sepsis (2 vs 3, p=0.56), stroke and chemotherapy (1 vs 2, p=0.73), bed rest more than three days (1 vs 7, p=0.17), major surgery (1 vs 1, p=0.57), family history of DVT (1 vs 0, p=0.57), immobilizing plaster cast (0 vs 1, p=0.57).
CONCLUSION
One third of patients with DVT had ST. None of those conditions considered as RF for DVT correlated with DVT-ST association.
Topics: Female; Humans; Male; Middle Aged; Reproducibility of Results; Sensitivity and Specificity; Thrombophlebitis; Ultrasonography; Venous Thrombosis
PubMed: 21390340
DOI: No ID Found -
Actas Dermo-sifiliograficas Jun 2008Superficial migratory thrombophlebitis (SMT) or thrombophlebitis migrans is characterized by recurrent episodes of localized thrombosis of the superficial veins in the...
INTRODUCTION
Superficial migratory thrombophlebitis (SMT) or thrombophlebitis migrans is characterized by recurrent episodes of localized thrombosis of the superficial veins in the limbs and trunk. It has been associated with various systemic diseases that should be taken into consideration when assessing the patient.
MATERIAL AND METHODS
Between 1997 and 2007, 8 patients with SMT were seen at Hospital General Universitario de Valencia in Valencia, Spain. We review the clinical features and histopathology, along with the associated diseases.
RESULTS
The most common clinical presentation was with painful nodules mimicking erythema nodosum on the lower extremities. Other sites were on the abdomen and trunk. Only in 1 case was SMT diagnosed clinically. In other cases, the clinical diagnoses were cellulitis, lymphangitis, nodular vasculitis, and panarteritis nodosa. The histologic characteristics were compatible with superficial thrombophlebitis, and orcein staining revealed the internal elastic lamina to be absent in all cases. No evidence of an occult tumor was found in any of the cases. Two cases had a history of Buerger disease and in another the condition presented in association with a fever of unknown origin.
CONCLUSION
The possible association of SMT with systemic diseases, including cancer, makes its diagnosis important. In our case series we did not find evidence of associated disease in the majority of cases. However, since cancer can manifest months and even years after the appearance of SMT, follow-up is necessary in these patients.
Topics: Adult; Female; Humans; Male; Middle Aged; Skin; Thrombophlebitis
PubMed: 18501171
DOI: No ID Found -
Journal of Hospital Medicine Jun 2016Although superficial thrombophlebitis (SVTE) is generally considered a benign, self-limited disease, accumulating evidence suggests that it often leads to more serious...
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 healthcare delivery system. Fourteen (4.3%) subjects with SVTE received anticoagulants, 148 (45.0%) were recommended antiplatelet agents or nonsteroidal 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. Journal of Hospital Medicine 2016;11:432-434. © 2016 Society of Hospital Medicine.
Topics: Anticoagulants; California; Disease Management; Female; Humans; Male; Middle Aged; Platelet Aggregation Inhibitors; Pulmonary Embolism; Retrospective Studies; Thrombophlebitis; Venous Thromboembolism
PubMed: 27253585
DOI: 10.1002/jhm.2553 -
Journal of Vascular Surgery Apr 2003Superficial thrombophlebitis (ST) is a frequent and potentially serious disease if complicated with venous thromboembolism (VTE). Data on risk factors and incidence... (Comparative Study)
Comparative Study
OBJECTIVE
Superficial thrombophlebitis (ST) is a frequent and potentially serious disease if complicated with venous thromboembolism (VTE). Data on risk factors and incidence rates for ST are scarce. It is also unknown whether ST is a risk factor for recurrence of VTE.
METHODS
After discontinuation of secondary thromboprophylaxis for a first spontaneous VTE, we prospectively observed 615 patients on average for 30 +/- 26 months. Patients with natural coagulation inhibitor deficiency, lupus anticoagulant, or cancer, who were pregnant, or were receiving long-term antithrombotic therapy were excluded. The study outcomes were occurrence of symptomatic ST or objectively documented recurrent symptomatic VTE.
RESULTS
ST developed in 45 patients (7.3%) with a first VTE. High factor VIII concentration emerged as an independent risk factor for ST (relative risk [RR], 2.0; 95% confidence interval [CI], 1.0-5.2), compared with lower levels after adjustment for age and sex; factor V Leiden and prothrombin G20210A concentration; hyperhomocysteinemia; high body mass index; and duration of oral anticoagulation therapy. VTE recurred in 12 (27%) of 45 patients with ST and in 67 (12%) of 570 patients without ST. In patients with VTE, subsequent ST emerged as an independent risk factor for recurrent VTE. Patients with ST had twofold higher RR (2.1; 95% CI, 1.0-4.2) for recurrence than did patients without ST after adjustment for putative confounding variables.
CONCLUSION
Patients with a first spontaneous VTE and subsequent ST are at increased risk for recurrent VTE. High factor VIII concentration is an independent risk factor for ST.
Topics: Adult; Aged; Cohort Studies; Factor VIII; Female; Humans; Incidence; Male; Middle Aged; Observation; Prospective Studies; Pulmonary Embolism; Recurrence; Risk Factors; Thromboembolism; Thrombophlebitis
PubMed: 12663985
DOI: 10.1067/mva.2003.157 -
Journal of Vascular Surgery Dec 2007Acute venous disorders include deep venous thrombosis, superficial venous thrombophlebitis, and venous trauma. Deep venous thrombosis (DVT) most often arises from the... (Review)
Review
Acute venous disorders include deep venous thrombosis, superficial venous thrombophlebitis, and venous trauma. Deep venous thrombosis (DVT) most often arises from the convergence of multiple genetic and acquired risk factors, with a variable estimated incidence of 56 to 160 cases per 100,000 population per year. Acute thrombosis is followed by an inflammatory response in the thrombus and vein wall leading to thrombus amplification, organization, and recanalization. Clinically, there is an exponential decrease in thrombus load over the first 6 months, with most recanalization occurring over the first 6 weeks after thrombosis. Pulmonary embolism (PE) and the post-thrombotic syndrome (PTS) are the most important acute and chronic complications of DVT. Despite the effectiveness of thromboembolism prophylaxis, appropriate measures are utilized in as few as one-third of at-risk patients. Once established, the treatment of venous thromboembolism (VTE) has been defined by randomized clinical trials, with appropriate anticoagulation constituting the mainstay of management. Despite its effectiveness in preventing recurrent VTE, anticoagulation alone imperfectly protects against PTS. Although randomized trials are currently lacking, at least some data suggests that catheter-directed thrombolysis or combined pharmaco-mechanical thrombectomy can reduce post-thrombotic symptoms and improve quality of life after acute ileofemoral DVT. Inferior vena caval filters continue to have a role among patients with contra-indications to, complications of, or failure of anticoagulation. However, an expanded role for retrievable filters for relative indications has yet to be clearly established. The incidence of superficial venous thrombophlebitis is likely under-reported, but it occurs in approximately 125,000 patients per year in the United States. Although the appropriate treatment remains controversial, recent investigations suggest that anticoagulation may be more effective than ligation in preventing DVT and PE. Venous injuries are similarly under-reported and the true incidence is unknown. Current recommendations include repair of injuries to the major proximal veins. If repair not safe or possible, ligation should be performed.
Topics: Acute Disease; Humans; Risk Factors; Thrombolytic Therapy; Vascular Surgical Procedures; Veins; Venous Thrombosis
PubMed: 18068560
DOI: 10.1016/j.jvs.2007.08.037 -
British Medical Journal Oct 1975
Topics: Humans; Infusions, Parenteral; Thrombophlebitis
PubMed: 1191979
DOI: 10.1136/bmj.4.5989.163 -
Clinical Case Reports Nov 2019Penile Mondor's disease or thrombophlebitis of the superficial dorsal penile vein is a rare disorder of the penis. Reported cases in the literature are mostly focal...
Penile Mondor's disease or thrombophlebitis of the superficial dorsal penile vein is a rare disorder of the penis. Reported cases in the literature are mostly focal thrombus. We present clinical and sonographic images of an extensive superficial dorsal penile vein thrombosis.
PubMed: 31788306
DOI: 10.1002/ccr3.2469