Superficial vein thrombosis and recurrent venous thromboembolism: a pooled analysis of two observational studies.
J Thromb Haemost. 2012 Mar 19;
Authors: Galanaud JP, Bosson JL, Genty C, Presles E, Cucherat M, Sevestre MA, Quere I, Decousus H, Leizorovicz A
Abstract
Background:? The management strategies of symptomatic isolated superficial-vein thrombosis (SVT) (without concomitant deep-vein thrombosis [DVT] or pulmonary embolism [PE]) have yet to achieve widespread consensus. Concerns have been raised regarding the usefulness of prescribing anticoagulant treatments to all patients with isolated SVT. Determining the isolated SVT sub-groups who have the highest risks of venous thromboembolic (VTE) recurrence (composite of DVT, PE and new SVT) may facilitate identifying patients likely to benefit from anticoagulant treatment. Design and methods:? We performed a pooled-analysis on individual data from two observational, multicenter, prospective studies, to determine predictors for VTE recurrence and their impact in an unselected population of symptomatic isolated SVT patients. Results:? 1,074 cases of symptomatic isolated SVT were followed-up at three months. VTE recurrence was observed in 3.9% of the patients. 16.2% of the patients did not receive anticoagulants; 0.6% experienced a VTE recurrence. Cancer, personal history of VTE and a sapheno-femoral/popliteal involvement significantly increased the risk of subsequent VTE or DVT/PE in univariate analyses. Only male sex significantly increased the risk of VTE or DVT/PE recurrence in multivariate analyses. 12% of the patients had cancer or a sapheno-femoral junction involvement and were at higher risk of DVT/PE recurrence than patients without those characteristics (4.7% vs. 1.9%, p=0.06). Conclusion:? In patients with symptomatic SVT, only male sex significantly and independently increased the risk of VTE recurrence. Patients with cancer or a sapheno-femoral junction involvement defined a population at high risk for deep VTE recurrence. Some SVT might be safely managed without anticoagulants. © 2012 International Society on Thrombosis and Haemostasis.
PMID: 22429908 [PubMed - as supplied by publisher]