Prevalence of deep vein thrombosis and pulmonary embolism in superficial thrombophlebitis of the lower limbs: prospective study of 60 cases.
OBJECTIVE
Superficial thrombophlebitis (ST) ascending the lower limbs is a common disease, which may be associated with deep vein thrombosis (DVT) and pulmonary embolism (PE). The aim of this study was to investigate the prevalence of DVT and PE as complications of ascending ST of the lower limbs in the great saphenous vein (GSV) or SSV (SSV) and probable risk factors.


METHODS
For this study 60 consecutive patients were enrolled with ascending ST of the GSV or SSV, seen between 2000 and 2003 at a public hospital in Botucatu, SP, Brazil. All patients were assessed clinically, by venous Duplex scanning of the lower limbs to confirm ST and test for DVT, and by means of pulmonary scintigraphy to test for PE.


RESULTS
In 13 ST cases (21.67%) there was concomitant DVT and 17 ST patients (28.33%) also had PE. Eleven patients had a clinical status suggestive of DVT, but only in eight of these (61.5%), this clinical diagnosis was confirmed. Fourteen patients had a clinical status suggestive of PE, and this diagnosis was confirmed in six cases (35.30%). ST patients who also had DVT and/or PE were given anticoagulant treatment with heparin and warfarin. None of the variables studied was predictive of DVT or PE (P>0.05). However, the presence of varicose veins reduced the risk of patients having DVT (relative risk=9.09; 95%CI:1.75 - 50.00 and P=0.023).


CONCLUSIONS
The prevalence rates of PE (28.3%) and DVT (21.6%) were elevated in this sample of ascending ST cases, indicating a need for detailed assessment of patients for signs of these complications, including for therapeutic management decision making.
Sobreira
M Lima
ML
Department of Orthopedic Surgery, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil. mlsobreira@gmail.com
Maffei
F Humberto De Abreu
FH
Yoshida
W Bonetti
WB
Rollo
H Almeida
HA
Lastória
S
S
Griva
B Lotufo
BL
De Carvalho
L Raquel
LR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D011877:Radionuclide Imaging; D018570:Risk Assessment; D012307:Risk Factors; D012501:Saphenous Vein; D013924:Thrombophlebitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
D000925:Anticoagulants