FEATURES OF SUPERFICIAL VEIN THROMBOSIS IN PATIENTS WITH A LARGE DIAMETER OF GREAT SAPHENOUS VEIN

  • Viktoriia Mishura Department of Surgery, Traumatology, Orthopedics, and Phthisiology, Sumy State University, Sumy, Ukraine https://orcid.org/0000-0001-9668-8070
  • Yurii Melekhovets Department of Surgery, Traumatology, Orthopedics, and Phthisiology, Sumy State University, Sumy, Ukraine
Keywords: superficial vein thrombosis, great saphenous vein, large diameter, chronic venous disease

Abstract

Introduction. Superficial vein thrombosis is characterized by the formation of thrombi in the superficial veins with subocclusion or occlusion of the venous lumen and its inflammatory reaction, which occurs more often in the lower extremities. Chronic venous disease in 75–88% of cases is the most important clinically identified factor in the development of superficial vein thrombosis. The great saphenous vein is affected in 60–80% of cases. A population-based study found that the chronic venous disease is a risk factor for venous thromboembolism and correlates with an increased risk of mortality in patients. Venous thromboembolism is a major burden of the disease worldwide, with approximately 10 000 000 cases per year.

Objective: to assess the prevalence of superficial vein thrombosis in patients with chronic venous disease and to identify the relationship between the diameter of the great saphenous vein and superficial vein thrombosis.

Materials and methods. Total of 925 chronic venous disease cases were analyzed from January 2019 to December 2021 at the Clinical Department of Surgery, Traumatology, Orthopedics, and Phthisiology of Sumy State University (Sumy Laser Clinic, LLC) for the prevalence of superficial vein thrombosis in patients with chronic venous disease who were undergoing treatment. The patients with superficial vein thrombosis were examined for the diameters of great saphenous vein and venous reflux using ultrasound 10 mm below the sapheno-femoral junction, in the upper and lower thirds of the thigh.

Results: Of 925 chronic venous disease cases, superficial vein thrombosis was observed in 53 cases, which accounted for 5.73 % of the total. Women accounted for 67.9 % (36), men – for 32.1 % (17). The study included patients aged 25 to 69 years (mean age 52.62 ± 10.48 years). In 69.8 % (37) of superficial vein thrombosis cases, the diameter of great saphenous vein was ≥ 10 mm at a level 10 mm below the sapheno-femoral junction; in 49 % (26) of cases – in the upper third of the thigh; in 30.2 % (16) of cases – in the lower third of the thigh. That is, the extension of the sapheno-femoral junction trunk to the lower third of the thigh was preserved in 43.24% of cases.

Conclusion. The results of the study revealed a high prevalence (5.73%) of superficial vein thrombosis. 69.8% of all cases of superficial vein thrombosis was registered in patients with a large diameter (≥ 10 mm) of great saphenous vein.

Author Biographies

Viktoriia Mishura, Department of Surgery, Traumatology, Orthopedics, and Phthisiology, Sumy State University, Sumy, Ukraine

Postgraduate student, Department of Surgery, Traumatology, Orthopedics, and Phthisiology, Sumy State University, 2 Rimskogo-Korsakova st., 40007, Sumy, Ukraine.

Рhone: +380990027509

e-mail: v.mishura@med.sumdu.edu.ua

Yurii Melekhovets, Department of Surgery, Traumatology, Orthopedics, and Phthisiology, Sumy State University, Sumy, Ukraine

Candidate of Medical Sciences, assistant of the Department of Surgery, Traumatology, Orthopedics, and Phthisiology, Sumy State University, 2 Rimskogo-Korsakova st., 40007, Sumy, Ukraine.

Рhone: +380662138769

e-mail: melehovets19@gmail.com

References

1. Beyer-Westendorf J. Controversies in venous thromboembolism: to treat or not to treat superficial vein thrombosis. Hematology Am Soc Hematol Educ Program. 2017 Dec 8;2017(1):223-230. doi: 10.1182/asheducation-2017.1.223. PMID: 29222259; PMCID: PMC6142594.
2. Frappé P, Buchmuller-Cordier A, Bertoletti L, Bonithon-Kopp C, Couzan S et al. STEPH Study Group. Annual diagnosis rate of superficial vein thrombosis of the lower limbs: the STEPH community-based study. J Thromb Haemost. 2014 Jun;12(6):831-8. doi: 10.1111/jth.12575. Erratum in: J Thromb Haemost. 2015 Aug;13(8):1538. PMID: 24679145.
3. Décousus H, Bertoletti L, Frappé P. Spontaneous acute superficial vein thrombosis of the legs: do we really need to treat? J Thromb Haemost. 2015 Jun;13 Suppl 1:S230-7. doi: 10.1111/jth.12925. PMID: 26149029.
4. Geersing GJ, Cazemier S, Rutten F, Fitzmaurice DA, Hoes AW. Incidence of superficial venous thrombosis in primary care and risk of subsequent venous thromboembolic sequelae: a retrospective cohort study performed with routine healthcare data from the Netherlands. BMJ Open. 2018 Apr 20;8(4):e019967. doi: 10.1136/bmjopen-2017-019967. PMID: 29678975; PMCID: PMC5914716.
5. Scott G, Mahdi AJ, Alikhan R. Superficial vein thrombosis: a current approach to management. Br J Haematol. 2015 Mar;168(5):639-45. doi: 10.1111/bjh.13255. Epub 2014 Dec 17. PMID: 25521017.
6. Cosmi B. Management of superficial vein thrombosis. J Thromb Haemost. 2015 Jul;13(7):1175-83. doi: 10.1111/jth.12986. Epub 2015 May 25. PMID: 25903684.
7. Di Minno MN, Ambrosino P, Ambrosini F, Tremoli E, Di Minno G, Dentali F. Prevalence of deep vein thrombosis and pulmonary embolism in patients with superficial vein thrombosis: a systematic review and meta-analysis. J Thromb Haemost. 2016 May;14(5):964-72. doi: 10.1111/jth.13279. Epub 2016 Mar 15. PMID: 26845754.
8. Bauersachs R, Gerlach HE, Heinken A, Hoffmann U, Langer F et al. Management and Outcomes of Patients with Isolated Superficial Vein Thrombosis under Real Life Conditions (INSIGHTS-SVT). Eur J Vasc Endovasc Surg. 2021 Aug;62(2):241-249. doi: 10.1016/j.ejvs.2021.04.015. Epub 2021 Jun 29. PMID: 34210599.
9. Galanaud JP, Bosson JL, Genty C, Presles E, Cucherat M et al. Superficial vein thrombosis and recurrent venous thromboembolism: a pooled analysis of two observational studies. J Thromb Haemost 2012;10:1004–11.
10. Akhter MS, Hamali HA, Mobarki AA, Rashid H, Oldenburg J, Biswas A. SARS-CoV-2 Infection: Modulator of Pulmonary Embolism Paradigm. J Clin Med. 2021 Mar 4;10(5):1064. doi: 10.3390/jcm10051064. PMID: 33806540; PMCID: PMC7961449.
11. Miesbach W, Makris M. COVID-19: Coagulopathy, Risk of Thrombosis, and the Rationale for Anticoagulation. Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620938149. doi: 10.1177/1076029620938149. PMID: 32677459; PMCID: PMC7370334.
12. Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020 Jun;18(6):1421-1424. doi: 10.1111/jth.14830. Epub 2020 May 6. PMID: 32271988; PMCID: PMC7262324.
13. Almeida MJ, Guillaumon AT, Miquelin D, Joviliano EE, Hafner L et al. Guidelines for superficial venous thrombosis. J Vasc Bras. 2019 Nov 20;18:e20180105. doi: 10.1590/1677-5449.180105. PMID: 31807127; PMCID: PMC6880617.
14. Nasr H, Scriven JM. Superficial thrombophlebitis (superficial venous thrombosis). BMJ. 2015 Jun 22;350:h2039. doi: 10.1136/bmj.h2039. PMID: 26099257.
15. Bzovii F, Casian D, Culiuc V, Gutu E. Management of Superficial Vein Thrombosis in Patients with Varicose Veins: A Survey among Members of National Surgical Society from Republic of Moldova. Vasc Specialist Int. 2020 Jun 30;36(2):105-111. doi: 10.5758/vsi.200021. PMID: 32611843; PMCID: PMC7333083.
16. Czysz A, Higbee SL. Superficial Thrombophlebitis. 2022 Jan 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 32310477. Bookshelf ID: NBK556017. https://www.ncbi.nlm.nih.gov/books/NBK556017/
17. Gillet JL, Ffrench P, Hanss M, Allaert FA, Chleir F. Valeur des D-dimères lors des thromboses veineuses superficielles des membres inférieurs [Predictive value of D-dimer assay in superficial thrombophlebitis of the lower limbs]. J Mal Vasc. 2007 Apr;32(2):90-5. French. doi: 10.1016/j.jmv.2007.01.111. PMID: 17379463.
18. Sartori M, Migliaccio L, Favaretto E, Cini M, Legnani C et al. D-dimer for the diagnosis of upper extremity deep and superficial venous thrombosis. Thromb Res. 2015 Apr;135(4):673-8. doi: 10.1016/j.thromres.2015.02.007. Epub 2015 Feb 14. PMID: 25700619.
19. Kakkos SK, Gohel M, Baekgaard N, Bauersachs R, et al. Editor's Choice - European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis. Eur J Vasc Endovasc Surg. 2021 Jan;61(1):9-82. doi: 10.1016/j.ejvs.2020.09.023. Epub 2020 Dec 15. PMID: 33334670.
20. Van Langevelde K, Lijfering WM, Rosendaal FR, Cannegieter SC. Increased risk of venous thrombosis in persons with clinically diagnosed superficial vein thrombosis: results from the MEGA study. Blood. 2011 Oct 13;118(15):4239-41. doi: 10.1182/blood-2011-05-356071. Epub 2011 Aug 17. PMID: 21849479.
21. Leizorovicz A, Becker F, Buchmüller A, Quéré I, Prandoni P; CALISTO Study Group. Clinical relevance of symptomatic superficial-vein thrombosis extension: lessons from the CALISTO study. Blood. 2013 Sep 5;122(10):1724-9. doi: 10.1182/blood-2013-04-498014. Epub 2013 Jul 2. PMID: 23821661.
22. Galanaud JP, Sevestre MA, Pernod G, Kahn SR, Genty C et al. Long-term risk of venous thromboembolism recurrence after isolated superficial vein thrombosis. J Thromb Haemost. 2017 Jun;15(6):1123-1131. doi: 10.1111/jth.13679. Epub 2017 May 5. PMID: 28317330.
23. Maddox RP, Seupaul RA. What Is the Most Effective Treatment of Superficial Thrombophlebitis? Ann Emerg Med. 2016 May; 67 (5): 671-2. doi: 10.1016/j.annemergmed.2015.10.018. Epub 2015 Dec 18. PMID: 26707361.
24. Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev. 2018 Feb 25;2(2):CD004982. doi: 10.1002/14651858.CD004982.pub6. PMID: 29478266; PMCID: PMC6953389.
25. Beyer-Westendorf J, Schellong SM, Gerlach H, Rabe E, Weitz JI; SURPRISE investigators. Prevention of thromboembolic complications in patients with superficial-vein thrombosis given rivaroxaban or fondaparinux: the open-label, randomised, non-inferiority SURPRISE phase 3b trial. Lancet Haematol. 2017 Mar;4(3):e105-e113. doi: 10.1016/S2352-3026(17)30014-5. Epub 2017 Feb 16. PMID: 28219692.
26. Werth S, Bauersachs R, Gerlach H, Rabe E, Schellong S, Beyer-Westendorf J. Superficial vein thrombosis treated for 45 days with rivaroxaban versus fondaparinux: rationale and design of the SURPRISE trial. J Thromb Thrombolysis. 2016 Aug;42(2):197-204. doi: 10.1007/s11239-016-1354-3. PMID: 26973347.
27. Chan WS, Rey E, Kent NE; VTE in Pregnancy Guideline Working Group, Chan WS, Kent NE, Rey E, Corbett T, David M, Douglas MJ, Gibson PS, Magee L, Rodger M, Smith RE; Society of Obstetricians and Gynecologists of Canada. Venous thromboembolism and antithrombotic therapy in pregnancy. J Obstet Gynaecol Can. 2014 Jun;36(6):527-53. doi: 10.1016/s1701-2163(15)30569-7. PMID: 24927193.
28. Cosmi B. Management of superficial vein thrombosis. J Thromb Haemost. 2015 Jul;13(7):1175-83. doi: 10.1111/jth.12986. Epub 2015 May 25. PMID: 25903684.
29. Boehler K, Kittler H, Stolkovich S, Tzaneva S. Therapeutic effect of compression stockings versus no compression on isolated superficial vein thrombosis of the legs: a randomized clinical trial. Eur J Vasc Endovasc Surg. 2014 Oct;48(4):465-71. doi: 10.1016/j.ejvs.2014.06.047. Epub 2014 Aug 10. PMID: 25116277.
30. Di Nisio M, Peinemann F, Porreca E, Rutjes AW. Treatment for superficial infusion thrombophlebitis of the upper extremity. Cochrane Database Syst Rev. 2015 Nov 20;2015(11):CD011015. doi: 10.1002/14651858. CD011015.pub2. PMID: 26588711; PMCID: PMC6885032.
31. Li R, Chen Z, Gui L, Wu Z, Miao Y, Gao Q, Diao Y, Li Y. Varicose Veins and Risk of Venous Thromboembolic Diseases: A Two-Sample-Based Mendelian Randomization Study. Front Cardiovasc Med. 2022 Apr 14;9:849027. doi: 10.3389/fcvm.2022.849027. PMID: 35498031; PMCID: PMC9047357.
32. Chang SL, Huang YL, Lee MC, Hu S, Hsiao YC et al. Association of Varicose Veins With Incident Venous Thromboembolism and Peripheral Artery Disease. JAMA. 2018 Feb 27;319(8):807-817. doi: 10.1001/jama.2018.0246. PMID: 29486040; PMCID: PMC5838574.
33. Turetz M, Sideris AT, Friedman OA, Triphathi N, Horowitz JM. Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism. Semin Intervent Radiol. 2018 Jun;35(2):92-98. doi: 10.1055/s-0038-1642036. Epub 2018 Jun 4. PMID: 29872243; PMCID: PMC5986574.
34. Labropoulos N, Kokkosis AA, Spentzouris G, Gasparis AP, Tassiopoulos AK. The distribution and significance of varicosities in the saphenous trunks. J Vasc Surg. 2010 Jan;51(1):96-103. doi: 10.1016/j.jvs.2009.08.069. PMID: 20117497.
35. Conway AM, Nordon IM, Hinchliffe RJ, Thompson MM, Loftus IM. Patient-reported symptoms are independent of disease severity in patients with primary varicose veins. Vascular. 2011 Oct;19(5):262-8. doi: 10.1258/vasc.2011.oa0303. Epub 2011 Aug 5. PMID: 21821663.
36. Yang Q, Zhao Y, Chen X, et al. Association between vein diameters, reflux characteristics, and clinical severity in patients with chronic venous insufficiency in Northwest China. J Vasc Surg Venous Lymphat Disord. 2021;9(2):401-408.e1. doi:10.1016/j.jvsv.2020.07.006.
Published
2022-09-30
How to Cite
Viktoriia Mishura, & Yurii Melekhovets. (2022). FEATURES OF SUPERFICIAL VEIN THROMBOSIS IN PATIENTS WITH A LARGE DIAMETER OF GREAT SAPHENOUS VEIN. Eastern Ukrainian Medical Journal, 10(3), 292-300. https://doi.org/10.21272/eumj.2022;10(3):292-300