title: Superficial vein thrombosis and recurrent venous thromboembolism: a pooled analysis of two observational studies.
abstract: BACKGROUND
  The management strategies for 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 subgroups who have the highest risks of venous thromboembolism (VTE) recurrence (composite of DVT, PE, and new SVT) may facilitate the identification of patients who are likely to benefit from anticoagulant treatment.
  
  
  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
  One thousand and seventy-four cases of symptomatic isolated SVT were followed up at 3 months. VTE recurrence was observed in 3.9% of the patients; 16.2% of the patients did not receive anticoagulants, and 0.6% experienced a VTE recurrence. Cancer, personal history of VTE and saphenofemoral/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. Twelve percent of the patients had cancer or saphenofemoral junction involvement, and were at higher risk of DVT/PE recurrence than patients without those characteristics (4.7% vs. 1.9%, P= 0.06).
  
  
  CONCLUSIONS
  In patients with symptomatic SVT, only male sex significantly and independently increased the risk of VTE recurrence. Cancer or saphenofemoral junction involvement defined a population at high risk for deep VTE recurrence. Some SVTs might be safely managed without anticoagulants.
authors.affiliation: Department of Internal Medicine, Montpellier University Hospital, and Research unit EA 2992, University Montpellier 1, Montpellier, France. jp-galanaud@chu-montpellier.fr
authors.forename: J P
authors.initials: JP
authors.lastname: Galanaud
authors.forename: J L
authors.initials: JL
authors.lastname: Bosson
authors.forename: C
authors.initials: C
authors.lastname: Genty
authors.forename: E
authors.initials: E
authors.lastname: Presles
authors.forename: M
authors.initials: M
authors.lastname: Cucherat
authors.forename: M A
authors.initials: MA
authors.lastname: Sevestre
authors.forename: I
authors.initials: I
authors.lastname: Quere
authors.forename: H
authors.initials: H
authors.lastname: Decousus
authors.forename: A
authors.initials: A
authors.lastname: Leizorovicz
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005602:France; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology; D016016:Proportional Hazards Models; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality
chemical_list: D000925:Anticoagulants