Phlebology最新文献

{"title":"A modified Delphi process to form an expert consensus in Ireland on the essential information to be included in shared decision making for varicose vein surgery.","authors":"Aoife Kiernan,&nbsp;Daragh Moneley,&nbsp;Frank Doyle,&nbsp;Denis W Harkin","doi":"10.1177/02683555231158284","DOIUrl":"https://doi.org/10.1177/02683555231158284","url":null,"abstract":"<p><strong>Objective: </strong>To reach consensus on a core set of essential information for inclusion in the informed consent process to standardize consent for VV surgery.</p><p><strong>Methods: </strong>Using a modified electronic Delphi (e-Delphi) method, a panel of experts in Ireland, were asked to rate statements of essential information to include in the informed consent process with patients. Statements were rated using a 5-point Likert scale. The definition of consensus was declared at 70% agreement by the panel.</p><p><strong>Results: </strong>Twenty-three panel members accepted the invitation to participate across three e-Delphi rounds. Consensus was reached on 33/42 statements, covering general and procedural information and the risks, benefits and alternatives of varicose veins (VV) surgery. Several statements remained equivocal, having not met consensus by the panel.</p><p><strong>Conclusion: </strong>Considerable consensus was reached within the panel of experts but some gaps in available research were also highlighted. This consensus may provide the framework to aid physicians to deliver a standardized discussion of the key elements of consent and shared decision making with patients.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 4","pages":"259-269"},"PeriodicalIF":1.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9770003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sclerotherapy of lower limb veins: Indications, contraindications and treatment strategies to prevent complications - A consensus document of the International Union of Phlebology-2023.","authors":"Mandy Wong,&nbsp;Kurosh Parsi,&nbsp;Kenneth Myers,&nbsp;Marianne De Maeseneer,&nbsp;Joseph Caprini,&nbsp;Attilio Cavezzi,&nbsp;David E Connor,&nbsp;Alun H Davies,&nbsp;Sergio Gianesini,&nbsp;Jean-Luc Gillet,&nbsp;Louis Grondin,&nbsp;Jean-Jérôme Guex,&nbsp;Claudine Hamel-Desnos,&nbsp;Nick Morrison,&nbsp;Giovanni Mosti,&nbsp;Alvaro Orrego,&nbsp;Hugo Partsch,&nbsp;Eberhard Rabe,&nbsp;Pauline Raymond-Martimbeau,&nbsp;Michel Schadeck,&nbsp;Roberto Simkin,&nbsp;Lorenzo Tessari,&nbsp;Paul K Thibault,&nbsp;Jorge H Ulloa,&nbsp;Mark Whiteley,&nbsp;Takashi Yamaki,&nbsp;Steven Zimmet,&nbsp;Mina Kang,&nbsp;Selene Vuong,&nbsp;Anes Yang,&nbsp;Lois Zhang","doi":"10.1177/02683555231151350","DOIUrl":"https://doi.org/10.1177/02683555231151350","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sclerotherapy is a non-invasive procedure commonly used to treat superficial venous disease, vascular malformations and other ectatic vascular lesions. While extremely rare, sclerotherapy may be complicated by serious adverse events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To categorise contraindications to sclerotherapy based on the available scientific evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An international, multi-disciplinary panel of phlebologists reviewed the available scientific evidence and developed consensus where evidence was lacking or limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;&lt;i&gt;Absolute Contraindications&lt;/i&gt; to sclerotherapy where the risk of harm would outweigh any benefits include known hypersensitivity to sclerosing agents; acute venous thromboembolism (VTE); severe neurological or cardiac adverse events complicating a previous sclerotherapy treatment; severe acute systemic illness or infection; and critical limb ischaemia. &lt;i&gt;Relative Contraindications&lt;/i&gt; to sclerotherapy where the potential benefits of the proposed treatment would outweigh the risk of harm or the risks may be mitigated by other measures include pregnancy, postpartum and breastfeeding; hypercoagulable states with risk of VTE; risk of neurological adverse events; risk of cardiac adverse events and poorly controlled chronic systemic illness. Conditions and circumstances where &lt;i&gt;Warnings and Precautions&lt;/i&gt; should be considered before proceeding with sclerotherapy include risk of cutaneous necrosis or cosmetic complications such as pigmentation and telangiectatic matting; intake of medications such as the oral contraceptive and other exogenous oestrogens, disulfiram and minocycline; and psychosocial factors and psychiatric comorbidities that may increase the risk of adverse events or compromise optimal treatment outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Sclerotherapy can achieve safe clinical outcomes provided that (1) patient-related risk factors and in particular all material risks are (1a) adequately identified and the risk benefit ratio is clearly and openly discussed with treatment candidates within a reasonable timeframe &lt;i&gt;prior&lt;/i&gt; to the actual procedure; (1b) when an individual is not a suitable candidate for the proposed intervention, conservative treatment options including the option of '&lt;i&gt;no intervention as a treatment option&lt;/i&gt;' are discussed; (1c) complex cases are referred for treatment in controlled and standardised settings and by practitioners with more expertise in the field; (1d) only suitable individuals with no absolute contraindications or those with relative contraindications where the benefits outweigh the risks are offered intervention; (1e) if proceeding with intervention, appropriate prophylactic measures and other risk-mitigating strategies are adopted and appropriate follow-up is organised; and (2) procedure-related risk factors are minimised by ensuring the treating physicians (2a) have adequate t","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 4","pages":"205-258"},"PeriodicalIF":1.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9786935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic congestion syndrome, migraine and dilating venous disease: Interesting but not surprising.","authors":"Ertan Yetkin,&nbsp;Hasan Atmaca,&nbsp;Bilal Cuglan,&nbsp;Kenan Yalta","doi":"10.1177/02683555231156017","DOIUrl":"https://doi.org/10.1177/02683555231156017","url":null,"abstract":"Dear Editor, We have recently read the exciting article published by Smith et al. with great pleasure and enthusiasm. They have admirably assessed the prevalence of coexisting symptoms and self-reported syndrome diagnoses among women with pelvic congestion syndrome (PCS). The most commonly encountered symptoms are severe fatigue (72%), dizziness (63%), irritable bowel syndrome symptoms (61%), migraines (49%), polyuria or dysuria (41%). This survey conducted by Smith et al. is an example of multi-disciplinary approach to PCS by means of self-reported co-existing symptoms or syndromes. Notably PCS, also known as pelvic varicocele, comprises the pathologic dilatation of broad ligament, ovarian plexus veins and incompetent ovarian veins and has been also classified as a member of dilating venous diseases (DVD). It has been proposed that lower extremity peripheral varicose veins, varicocele, hemorrhoids and PCS per se are not only the localized disease of related venous vascular territory but also a localized manifestation of systemic venous or vascular wall abnormality. We would like to pay particular attention on the relatively high prevalence of migraine. Given the fact that pelvic congestion syndrome or pelvic varicosities is a member and localized manifestation of DVDs, it is interesting but not surprising to see high prevalence of migraine in patients with PCS. Indeed, it has recently been documented that migraineours have a higher degree of venous leg complaints and discomfort assessed by the VEINES-Sym questionnaire compared to non-migraineours. Abnormal venous wall structure, decreased venous elasticity, increased venous pressure and eventual venous congestion of brain have also been involved in the pathogenesis of migraine. Therefore, venous circulation abnormality is likely to be a contributing factor on the pathophysiology of migraines. In this regard, coincidental high prevalence of migraine in patients with PCS deserves to be investigated to elucidate the pathophysiological association between the PCS and migraine in terms of cerebral venous vascular pathology and DVD.","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 4","pages":"287-288"},"PeriodicalIF":1.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound assessment is linked to histological vein wall thickness in chronic venous disease.","authors":"Sammi Zerrouk,&nbsp;Paolo Casoni,&nbsp;Edoardo Cervi,&nbsp;Rafik Amirat,&nbsp;Guilhem Bousquet,&nbsp;Christophe Leboeuf,&nbsp;Anne Janin,&nbsp;Frédéric Pamoukdjian","doi":"10.1177/02683555231160896","DOIUrl":"https://doi.org/10.1177/02683555231160896","url":null,"abstract":"<p><strong>Objectives: </strong>Few studies compared both ultrasound and histological approaches for the same series of patients with chronic venous disease (CVD). We aimed to assess the diagnostic performances of duplex ultrasound assessment (US) of Vein Wall Thickness (VWT) among patients with CVD.</p><p><strong>Methods: </strong>38 adults with primary varicose veins having undergone Great Saphenous Vein thermal ablation with phlebectomy, and agreeing to biopsy of the Posterior Accessory Great Saphenous Vein (PASV) were consecutively included in a two-center prospective study. VWT assessment of the PASV was performed using both US, and microscope examination. High values for microscope-assessed VWT were defined at > 0.5 mm.</p><p><strong>Results: </strong>The mean age was 53.0 ± 13.1 years, 71% were women. Maximization of US performances was obtained with a threshold of 0.6 mm: Sensitivity (Se) = 92.9%, Specificity (Sp) = 91.7%, positive (86.7%) and negative predictive value (NPV) (95.7%), positive (11.1) and negative likelihood ratio (NLR) (0.07).</p><p><strong>Conclusions: </strong>US assessment of VWT could be a non-invasive tool for diagnosis and follow-up in CVD, and an interesting in vivo parameter complementing diameter and reflux measures, with a view to optimizing treatment. It could help to determine i) the energy level necessary in case of endovenous laser ablation, and ii) the sclerosing agent concentration in case of chemical ablation.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 4","pages":"270-280"},"PeriodicalIF":1.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9423178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cardiac conditions with venous leg ulcers in patients with chronic venous insufficiency.","authors":"Alejandro Pizano,&nbsp;Beau Bequeaith,&nbsp;Sebastian Cifuentes,&nbsp;Valentin Figueroa,&nbsp;Haider Al Rustem,&nbsp;Hunter M Ray,&nbsp;Sheila Coogan,&nbsp;Charles Miller,&nbsp;Jorge H Ulloa,&nbsp;Stuart A Harlin","doi":"10.1177/02683555231162294","DOIUrl":"https://doi.org/10.1177/02683555231162294","url":null,"abstract":"<p><strong>Introduction: </strong>Venous leg ulcers (VLUs) are the final stage of chronic venous insufficiency. This study aims to characterize the association between cardiovascular diseases and VLU.</p><p><strong>Methods: </strong>A multicentric case-control study analyzed 17,788 patients between 2015 and 2020. Cases were matched (1:2) by age and sex, and odds ratios (OR) were analyzed with conditional logistic regressions adjusted by risk factors.</p><p><strong>Results: </strong>The prevalence of VLU was 15.2%. 2390 cases were analyzed. Diseases found to be associated with VLU were atrial fibrillation (OR, 1.21; 95% CI: 1.03-1.42), pulmonary hypertension (OR, 1.45; 95% CI: 1.06-2.00), right heart failure (OR, 1.27; 95% CI: 1.13-1.43), peripheral artery disease (OR, 2.21; 95% CI: 1.90-2.56), and history of pulmonary embolism (OR, 1.45; 95% CI: 1.06-2.00).</p><p><strong>Conclusions: </strong>Certain cardiovascular conditions showed an association with VLU. Further studies are warranted to evaluate the effect that treating concomitant cardiovascular diseases might exert on the natural history of venous leg ulcers.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 4","pages":"281-286"},"PeriodicalIF":1.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9418126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nd:Yag laser combined with injection sclerotherapy in the treatment of reticular veins and telangiectasias (CLaCS method): A triple-blind randomized clinical trial comparing two sclerosing agents associated with same laser patterns.","authors":"Marcos M Fonseca,&nbsp;Faberson João Mocelin,&nbsp;Marcelo Halfen Grill,&nbsp;Sergio Gianesini,&nbsp;Kasuo Miyake,&nbsp;Rodrigo Argenta,&nbsp;Adamastor H Pereira","doi":"10.1177/02683555231153533","DOIUrl":"https://doi.org/10.1177/02683555231153533","url":null,"abstract":"<p><strong>Background: </strong>Cryo-Laser & Cryo-Sclerotherapy (CLaCS) is a technique which combines thermal sclerotherapy and injection sclerotherapy. Telangiectasias and small varicosities are targeted by a transdermal laser and right after receive injection sclerotherapy. A cooling device blows -20°C air onto the skin and needle in a pre-, parallel-, and post-fashion.</p><p><strong>Objective: </strong>Our objective was to establish if there is a difference in result and complications by varying the sclerosing agent but keeping the same ND:Yag long pulse laser parameters in the treatment of small varicosities.</p><p><strong>Methods: </strong>Fifty five patients were enrolled prospectively and randomized to two groups; in the group 1 dextrose 75% was the sclerosing agent used in combination with the ND:Yag long pulse laser and, in the group 2, the same laser technique was used but the sclerosing agent was polidocanol 0.3% and dextrose 67%.</p><p><strong>Results: </strong>The results were evaluated 30 days after the treatment by the patients and for blinded evaluators using before and after standardized photos with and without augmented reality. In the patient's perspective and in the blinded evaluation of the regular photos, no differences between the groups were found. Both groups had low rates of hyperpigmentation and bruising with no statistical difference. Patients treated with polidocanol had less pain after the treatment and a better clearance rate in the photos with augmented reality. No major complications were found.</p><p><strong>Conclusion: </strong>The treatment of small varicosities with CLaCS using Dextrose 75% or polidocanol 0.3% and Dextrose 67.5% is a safe and effective procedure and both sclerosing agents can be used with similar results. Possibly, in the polidocanol group more nonvisible reticular veins were cleared, but the implication of this find is not clear.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 3","pages":"165-171"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9243246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linear endovenous energy density (LEED) should always be quoted with the power used in endovenous thermal ablation - results from an in-vitro porcine liver model study.","authors":"Amanda G Nielsen,&nbsp;Alexandra A Croucher,&nbsp;Simon D Muschamp,&nbsp;Ethan Losty,&nbsp;Thomas Worthington,&nbsp;Melissa J Kiely,&nbsp;Mark S Whiteley","doi":"10.1177/02683555231156015","DOIUrl":"https://doi.org/10.1177/02683555231156015","url":null,"abstract":"<p><strong>Background: </strong>Linear Endovenous Energy Density (LEED) is the energy used per cm of vein in endovenous thermal ablation (EVTA) but does not include time. This study examines the effect of time during EVTA.</p><p><strong>Method: </strong>EVTA was performed in a previously validated porcine liver model. LEEDs of 40, 60, 80 and 100 J/cm, using different powers were repeated 5 times each. Thermal spread, tissue carbonisation and device-tissue sticking during treatment were recorded.</p><p><strong>Result: </strong>LEED positively correlated to thermal spread and carbonisation of the tissue. Power was correlated with carbonisation but not thermal spread. Pullback had no correlations with thermal spread or carbonisation. Catheter sticking found occurred in powers >= 15 W or LEED >= 80 J/cm.</p><p><strong>Conclusion: </strong>LEED is a good measure of EVTA but does not include time. Power, which does include time, correlates with carbonisation and with device-tissue sticking. The power used must be quoted with the LEED.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 3","pages":"172-180"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9243774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selected phlebological abstracts.","authors":"Lowell S Kabnick,&nbsp;Katheen Ozsvath,&nbsp;Jorge H Ulloa","doi":"10.1177/02683555231165850","DOIUrl":"https://doi.org/10.1177/02683555231165850","url":null,"abstract":"The authors conducted a review of the literature available in order to better understand the premise that, in addition to best medical practice (BMP), including anticoagulation, compression, exercise, and skin care, antiplatelet agents may also be helpful in minimizing the risk of post thrombotic syndrome (PTS) and pulmonary embolism (PE). The authors concluded that in chronic deep vein thrombosis (DVT) following initial standard treatment with anticoagulants, there is low certainty evidence that antiplatelets in addition to BPM may reduce recurrent venous thromboembolism compared to BPM + placebo. There is no discernable increase in adverse events in patients treated with BPM + antiplatelet agents. The authors suggest further study.","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 3","pages":"198-200"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9646898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early results of cyanoacrylate adhesive ablation versus laser ablation for the treatment of great saphenous vein insufficiency in the Chinese mainland population.","authors":"Xiaotong Qi,&nbsp;Mingyi Zhang,&nbsp;Wu Yu,&nbsp;Kun Ran,&nbsp;Yikuan Chen","doi":"10.1177/02683555231151769","DOIUrl":"https://doi.org/10.1177/02683555231151769","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we present our early outcomes of cyanoacrylate ablation (CA) versus endovenous laser ablation (EVLA) for the treatment of great saphenous vein (GSV) insufficiency in the Chinese mainland population.</p><p><strong>Methods: </strong>We retrospectively analyzed 108 patients (53 patients in the CA group and 55 patients in the EVLA group) with GSV insufficiency who were treated with CA and EVLA between May 2020 and May 2021. The Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire were used to assess clinical symptoms and quality of life, respectively. Total closure rates and procedure-related adverse events were also recorded in both groups.</p><p><strong>Results: </strong>There was no significant difference between patients treated with CA or EVLA in terms of demographic and clinical characteristics. The average procedure time was 17 min in the CA group and 35 min in the EVLA group (<i>p</i> < 0.001). The CA group had lower pain scores during the procedure and 3 days afterward than the EVLA group (<i>p</i> < 0.001). At month 12, the CA group had a 90.4% closure rate, while the EVLA group had an 83.0% closure rate, with no significant difference between the two groups (<i>p</i> > 0.05). There was no significant difference in the Venous Clinical Severity Score or Aberdeen Varicose Vein Questionnaire score between the groups (<i>p</i> > 0.05). During follow-up, neither group experienced any significant adverse events, such as pulmonary embolism or deep venous thrombosis. The incidence of ecchymosis and paresthesia was significantly lower in the CA group than in the EVLA group (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Cyanoacrylate ablation has a high feasibility profile and is an effective approach to accomplish complete GSV target vein closure at early follow-up in the Chinese patients. Compared to EVLA, the improvement in quality-of-life outcomes is also sustained and similar, with less pain and fewer complications due to the absence of tumescence anesthesia and postprocedural compression stockings.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 3","pages":"157-164"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9243222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of recurrent thromboembolic events according to treatment duration in patients with superficial vein thrombosis treated with intermediate dose of tinzaparin.","authors":"Christos Karathanos, Stavros K Kakkos, Georgios Georgiadis, Christos Ioannou, Spyros Vasdekis, Dimitrios Chatzis, Panagiotis Latzios, Athanasios D Giannoukas","doi":"10.1177/02683555221143576","DOIUrl":"10.1177/02683555221143576","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the risk of symptomatic venous thromboembolism (VTE) recurrence at 3 months in relation to treatment duration, according to baseline risk factor profiles, in patients with superficial vein thrombosis (SVT) treated with intermediate dose of tinzaparin.</p><p><strong>Methods: </strong>We performed a pooled analysis on individual data from two prospective studies designed to assess the efficacy and safety of tinzaparin in intermediate dose (131 IU/kg) in patients with SVT. Treatment duration was at the treating physician's discretion. All patients were followed up for at least 3 months.</p><p><strong>Results: </strong>A total of 956 patients (65% female, mean age 58.7 ± 13.7 years) were included. The median treatment duration was 30 days (range, 3-200 days). History of deep vein thrombosis (DVT), location of SVT above the knee, and palpable induration were the only independent factors associated with prolonged treatment duration. During follow-up, 95.9% of patients were event free. Outcomes-related adverse events occurred in 39 (4.1%) patients and their median duration of treatment was 33 days (range, 7-200 days). Recurrent VTE events occurred in 33 patients, including 22 cases of SVT recurrence, 8 cases of DVT, and 1 case of pulmonary embolism. The median time to the event was 29 (6-113) days. Recurrent thromboembolic events were not related to treatment duration as occurred in 17 patients (51.5%) treated up to 30 days and in 16 patients (48.8%) received prolong treatment (<i>p</i> = .46). Length of thrombus at the index event was significantly associated with higher risk for VTE recurrence.</p><p><strong>Conclusions: </strong>Intermediate dose of tinzaparin for 30 days is an effective and safe treatment for SVT. The risk of recurrent VTE events may be higher in patients with greater amount of thrombus at index event.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 3","pages":"141-149"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/16/10.1177_02683555221143576.PMC10070553.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9259820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}