Recent findings in the epidemiology, diagnosis and treatment of superficial-vein thrombosis.
Recent data on lower-limb superficial-vein thrombosis (SVT) may substantially impact its clinical management. Thus, the clear confirmation that SVT is closely linked to deep-vein thrombosis (DVT) or pulmonary embolism (PE) highlights the potential severity of the disease. DVT or PE are diagnosed in 20-30% of SVT patients. Moreover, clinically relevant symptomatic thromboembolic events complicate isolated SVT (without concomitant DVT or PE at diagnosis) in 4-8% of patients. For the first time, an anticoagulant treatment, once-daily 2.5 mg fondaparinux for 45 days, was demonstrated to be effective and safe for preventing these symptomatic thromboembolic events in patients with lower-limb isolated SVT in the randomized placebo-controlled CALISTO study. Based on these recent findings, new recommendations on the management of SVT patients, including complete ultrasonography examination of the legs, and in patients with isolated SVT, prescription of once-daily 2.5 mg fondaparinux subcutaneously for 45 days on top of symptomatic treatments, may be proposed.
INSERM, CIE3, Université Jean Monnet, EA3065, CHU Saint-Etienne, Service de Médecine et Thérapeutique, Saint-Etienne, F-42055 France. herve.decousus@chu-st-etienne.fr
Hervé
H
Décousus
Laurent
L
Bertoletti
Paul
P
Frappé
François
F
Becker
Asma El
AE
Jaouhari
Patrick
P
Mismetti
Nathalie
N
Moulin
Emilie
E
Presles
Isabelle
I
Quéré
Alain
A
Leizorovicz
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D000077425:Fondaparinux; D006801:Humans; D035002:Lower Extremity / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000627:therapeutic use*; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology*; D055815:Young Adult
D000925:Anticoagulants; D011134:Polysaccharides; D000077425:Fondaparinux