title: Epidemiology, diagnosis, treatment and management of superficial-vein thrombosis of the legs.
abstract: Recent data on lower-limb superficial-vein thrombosis (SVT) may substantially impact its clinical management. Particularly, 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 is 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. More recent data from another randomized trial support these 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, wherever the cost of fondaparinux is acceptable. Superficial-vein thrombosis (SVT) of the lower limbs has long been regarded as a benign, self-limiting disease, expected to resolve spontaneously and rapidly, and requiring only symptomatic treatments [1,2]. However, the perception of this disease is now changing with the recent publication of data indicating its potential severity [3] and showing for the first time the benefit of a therapeutic strategy based on the administration of an anticoagulant treatment [4]. The overall management of this frequent disease therefore needs to be reconsidered.
authors.affiliation: Service de Médecine et Thérapeutique, CHU Saint-Etienne, France. herve.decousus@chu-st-etienne.fr
authors.forename: Hervé
authors.initials: H
authors.lastname: Decousus
authors.forename: Paul
authors.initials: P
authors.lastname: Frappé
authors.forename: Sandrine
authors.initials: S
authors.lastname: Accassat
authors.forename: Laurent
authors.initials: L
authors.lastname: Bertoletti
authors.forename: Andrea
authors.initials: A
authors.lastname: Buchmuller
authors.forename: Benjamin
authors.initials: B
authors.lastname: Seffert
authors.forename: Adel
authors.initials: A
authors.lastname: Merah
authors.forename: François
authors.initials: F
authors.lastname: Becker
authors.forename: Isabelle
authors.initials: I
authors.lastname: Queré
authors.forename: Alain
authors.initials: A
authors.lastname: Leizorovicz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D000077425:Fondaparinux; D005602:France / Q000453:epidemiology; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000494:pharmacology / Q000627:therapeutic use*; D011655:Pulmonary Embolism / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D016032:Randomized Controlled Trials as Topic; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology
chemical_list: D000925:Anticoagulants; D011134:Polysaccharides; D000077425:Fondaparinux