Żylakowatość powierzchowna (tromboflebitis powierzchowna)
Epidemiologia
Żylakowatość powierzchowna (tromboflebitis powierzchowna) to zapalne schorzenie żył powierzchownych z towarzyszącą zakrzepicą, o częstości występowania szacowanej na 0,3-1,5/1000 osobolat, z wyższą zapadalnością u osób starszych (0,7-1,5/1000 osobolat) i kobiet (50-70% przypadków). Choroba dotyczy głównie kończyn dolnych, zwłaszcza żyły odpiszczelowej wielkiej (60-80%) i małej (10-20%). Występuje częściej u osób w wieku około 60 lat, z czterokrotnym wzrostem częstości u mężczyzn między 30. a 80. rokiem życia. Czynniki ryzyka obejmują wiek >60 lat, ciążę, okres połogu oraz terapię estrogenową. Zapadalność w ciąży wzrasta od 0,1/1000 osobolat w I trymestrze do 1,6/1000 osobolat w okresie poporodowym. Chorobowość w populacji ogólnej wynosi 3-11%, a u pacjentów z żylakami 4-59%. Żylakowatość powierzchowna nie jest już uważana za łagodne schorzenie ze względu na częste współwystępowanie z zakrzepicą żył głębokich (DVT) i zatorowością płucną (PE), które występują u 6-36% pacjentów, a w niektórych badaniach nawet do 30% przy pierwszej prezentacji. Ryzyko nawrotu wynosi 1,6-12,2% w leczonych i 3,3-36,7% w nieleczonych przypadkach.
- Epidemiologia żylakowatości powierzchownej (tromboflebitis powierzchowna)
- Powikłania i współistniejące schorzenia
- <a href="#wspolistnienie-z-zakrzepica-zyl-glebokich”>Współistnienie z zakrzepicą żył głębokich
- Ryzyko zatorowości płucnej
- Śmiertelność i ryzyko nawrotu
- Nadzór i diagnostyka
- Specyficzne rodzaje żylakowatości powierzchownej
- Implikacje dla zdrowia publicznego
Epidemiologia żylakowatości powierzchownej (tromboflebitis powierzchowna)
Żylakowatość powierzchowna (tromboflebitis powierzchowna) jest zapalnym schorzeniem żył powierzchownych z towarzyszącą zakrzepicą. Dokładna częstość występowania tego schorzenia nie jest w pełni znana i prawdopodobnie jest niedoszacowana, ponieważ wielu pacjentów z łagodnymi objawami nie szuka pomocy medycznej. Różne badania przedstawiają zróżnicowane dane dotyczące epidemiologii tego schorzenia.12
Zapadalność i chorobowość
Szacuje się, że zapadalność na żylakowatość powierzchowną wynosi od 0,3 do 1,5 przypadku na 1000 osobolat, gdzie u osób młodszych wynosi około 0,3-0,6 przypadku, a u starszych pacjentów 0,7-1,5 przypadku na 1000 osobolat.3 Francuskie badanie STEPH, przeprowadzone wśród populacji osób dorosłych, wykazało roczną zapadalność na poziomie 0,64%.4 Natomiast badanie holenderskie, wykorzystujące dane z podstawowej opieki zdrowotnej, wskazało na zapadalność wynoszącą 1,31 przypadku na 1000 osobolat.5
Chorobowość żylakowatości powierzchownej w populacji ogólnej szacuje się na poziomie 3-11%.67 Niektóre źródła sugerują, że występowanie tego schorzenia jest 2-6 razy częstsze niż zakrzepicy żył głębokich (DVT) i zatorowości płucnej (PE).8 Włoskie badanie Anemone, przeprowadzone wśród dawców krwi, wykazało częstość występowania zakrzepicy żylnej na poziomie 2,9% u kobiet i 0,8% u mężczyzn w wieku ≥49 lat.9
Charakterystyka demograficzna
Żylakowatość powierzchowna występuje częściej u kobiet, które stanowią 50-70% wszystkich przypadków.1011 Średni wiek zachorowania wynosi około 60 lat.1213 Obserwuje się czterokrotny wzrost częstości występowania od trzeciej do ósmej dekady życia u mężczyzn.14 Badania sugerują również, że wiek powyżej 60 lat jest czynnikiem ryzyka, choć u starszych pacjentów występuje mniej powikłań.15
Ciąża, okres połogu i terapia wysokimi dawkami estrogenów są znanymi czynnikami ryzyka żylakowatości powierzchownej.16 Zapadalność w czasie ciąży różni się w zależności od trymestru i okresu poporodowego. Na 1000 osobolat wynosi odpowiednio: 0,1 w pierwszym trymestrze, 0,2 w drugim, 0,5 w trzecim i 1,6 w okresie poporodowym.1718
Lokalizacja zmian
Żylakowatość powierzchowna najczęściej dotyczy kończyn dolnych, szczególnie żyły odpiszczelowej wielkiej (60-80% przypadków) lub żyły odpiszczelowej małej (10-20% przypadków).1920 Może również występować w innych lokalizacjach (10-20%) oraz obustronnie (5-10%).2122 Choć może rozwijać się wzdłuż żył ramienia, pleców czy szyi, noga jest zdecydowanie najczęstszą lokalizacją.23
W przypadku pacjentów z żylakami, żylakowatość powierzchowna częściej ogranicza się do żylakowatych dopływów niż do pni żył odpiszczelowych. Chorobowość żylakowatości powierzchownej u pacjentów z żylakami waha się od 4% do 59%.24
Powikłania i współistniejące schorzenia
zakrzepica-zyl-glebokich”>Współistnienie z zakrzepicą żył głębokich
Obecnie żylakowatość powierzchowna nie jest już uważana za łagodne schorzenie ze względu na częste współwystępowanie z zakrzepicą żył głębokich i zatorowością płucną.25 Liczne badania wykazały współwystępowanie DVT z żylakowatością powierzchowną u 6-36% pacjentów.26 Niektóre retrospektywne badania zarówno z ośrodków podstawowej, jak i specjalistycznej opieki zdrowotnej wykazały, że współistniejące DVT lub objawowa zatorowość płucna występują przy pierwszej prezentacji w 25-30% przypadków.2728
Badanie obejmujące 42 kolejnych pacjentów z rozpoznaną żylakowatością powierzchowną wykazało, że 12% z nich miało również DVT. DVT wystąpiła u 17% pacjentów z żylakowatością powierzchowną sięgającą powyżej kolana.29 W przypadku żylakowatości powierzchownej dotyczącej odcinka żyły odpiszczelowej wielkiej powyżej kolana, związek z DVT odnotowano w 18% przypadków, w porównaniu do 4% w przypadku żylakowatości powierzchownej ograniczonej do żyły odpiszczelowej małej.30
Ryzyko zatorowości płucnej
Badania kliniczne wskazują na podejrzenie współistniejącej zatorowości płucnej u 2-13% pacjentów z żylakowatością powierzchowną.31 Regularne wykonywanie skanów płuc ujawniło, że częstość występowania bezobjawowej zatorowości płucnej sięga 33%.32 W przypadku bardziej rygorystycznego procesu badań przesiewowych u pacjentów bezobjawowych, częstość współistniejącej zatorowości płucnej wzrosła do 17%.33
Szacuje się, że 20-33% przypadków żylakowatości powierzchownej, prawie jedna trzecia, powikłana jest bezobjawową zatorowością płucną, podczas gdy 2-13% jest związanych z zagrażającą życiu objawową zatorowością płucną.3435
Śmiertelność i ryzyko nawrotu
U osób z historią żylakowatości powierzchownej, ryzyko wystąpienia DVT lub zatorowości płucnej w ciągu życia wzrasta 4-6 razy.3637 Podczas gdy 3-miesięczna śmiertelność u pacjentów z DVT lub zatorowością płucną wynosi około 5%, w przypadku żylakowatości powierzchownej jest to mniej niż 1%.38 Jednym z proponowanych wyjaśnień niższej śmiertelności u pacjentów z żylakowatością powierzchowną jest młodszy wiek pacjentów i mniejsza liczba towarzyszących chorób współistniejących.39
Ryzyko nawrotu waha się między 1,6-12,2% w leczonych przypadkach i 3,3-36,7% w nieleczonych przypadkach, w zależności od obecności lub braku czynników ryzyka.40
Nadzór i diagnostyka
Metody diagnostyczne
Diagnostyka żylakowatości powierzchownej opiera się głównie na badaniu ultrasonograficznym. Jest to kluczowe dla potwierdzenia diagnozy, określenia zasięgu schorzenia oraz wykluczenia współistniejącej zakrzepicy żył głębokich.4142 Niektóre badania sugerują, że u wszystkich pacjentów z żylakowatością powierzchowną należy wykonać obustronne badanie duplex, aby wykluczyć DVT.43
W przypadku gdy żylakowatość powierzchowna rozwija się po niedawnym zabiegu chirurgicznym lub rozciąga się powyżej kolana, nadzór diagnostyczny powinien być szczególnie rygorystyczny. Gdy wyniki badań nieinwazyjnych są niejednoznaczne, wskazana jest flebografia, aby wykluczyć DVT.44
Znaczenie nadzoru w praktyce klinicznej
Biorąc pod uwagę wysoką częstość współwystępowania DVT i ryzyko progresji zakrzepicy oraz zatorowości płucnej, zaleca się stosowanie diagnostyki ultrasonograficznej we wszystkich przypadkach żylakowatości powierzchownej kończyn dolnych.45
Personel medyczny powinien rozpoznać, że żylakowatość powierzchowna nie jest już uważana za łagodne schorzenie, ze względu na częstość współistniejącej żylnej choroby zakrzepowo-zatorowej i możliwość rozprzestrzeniania się.46
Specyficzne rodzaje żylakowatości powierzchownej
Żylakowatość związana z cewnikiem żylnym
Żylakowatość powierzchowna związana z obwodowymi cewnikami żylnymi pozostaje najczęstszym powikłaniem obwodowego wlewu dożylnego, występującym u 25-35% hospitalizowanych pacjentów, co znacznie przewyższa 5% częstość uznawaną za akceptowalną przez wytyczne Intravenous Nurses Society.4748
Obecna częstość występowania septycznego zapalenia żył związanego z cewnikiem (obwodowym) szacowana jest na 0,5 przypadku zakażeń krwiopochodnych na 1000 dni stosowania obwodowo wprowadzonego urządzenia dożylnego.49 Żylakowatość może prowadzić do poważnych powikłań medycznych, które negatywnie wpływają zarówno na pacjentów, jak i instytucje opieki zdrowotnej, w tym opóźnienia w podawaniu terapii dożylnej i przedłużenie pobytu w szpitalu o 2-5 dni.50
Żylakowatość w szczególnych grupach pacjentów
Osoby w skrajnych przedziałach wiekowych, takie jak noworodki i osoby starsze, wydają się być najbardziej narażone na septyczne zapalenie żył. Przypisuje się to niedostatecznie rozwiniętym mechanizmom obronnym u noworodków oraz spadkowi funkcji immunologicznych i dodatkowym chorobom współistniejącym u osób starszych.51
W przypadku pyleflebitis (septycznego zapalenia żyły wrotnej), częstość występowania wynosi około 0,37-2,7 przypadku na 100 000 osobolat, z częstszym występowaniem u mężczyzn (70,5%) i medianą wieku wynoszącą 50 lat.52 Zapalenie żył miednicy występuje najczęściej u kobiet w wieku rozrodczym, poniżej 20 roku życia, a częstość waha się od 1:500 do 1:2000 przy porodach cesarskich, podczas gdy dla porodów pochwowych częstość wynosi 1:9000.53
Choroba Mondora, rzadko opisywana w literaturze, dominuje u kobiet w wieku 30-60 lat, z częstością występowania 0,5-0,8%, która odzwierciedla jedynie populację objawową.54
Implikacje dla zdrowia publicznego
Żylakowatość powierzchowna jest stosunkowo częstym schorzeniem, a jej rzeczywista częstość występowania jest prawdopodobnie niedoszacowana. Biorąc pod uwagę potencjalne powiązania z zakrzepicą żył głębokich i zatorowością płucną, schorzenie to ma istotne implikacje dla zdrowia publicznego.5556
Potrzebne są nowe badania wykorzystujące nowoczesne technologie diagnostyczne, takie jak ultrasonografia, aby umożliwić lepszą definicję epidemiologiczną schorzenia i jego powikłań.57 Zrozumienie epidemiologii żylakowatości powierzchownej jest użyteczne do określenia, którzy pacjenci są narażeni na zwiększone ryzyko powikłań.58
Warto zauważyć, że większość danych dotyczących pacjentów z żylakowatością powierzchowną pochodzi ze starszych badań z ograniczeniami metodologicznymi, co podkreśla potrzebę bardziej aktualnych i metodologicznie solidnych badań w tym obszarze.59
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Materiały źródłowe
- #1 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
Superficial thrombophlebitis is an inflammatory disorder of superficial veins with coexistent venous thrombosis. It usually affects lower limbs, particularly the great saphenous vein (60% to 80%) or the small/short saphenous vein (10% to 20%). However, it can occur at other sites (10% to 20%) and may occur bilaterally (5% to 10%). […] The true incidence of superficial thrombophlebitis is unclear. In France, 1 community-based study noted the incidence of SVT to be 0.64%, while a different community-based study found the incidence to be half that of DVT and similar to PE. Other studies suggest its prevalence in the general population is 2 to 6 times higher than the incidence of DVT and PE. SVT is commonly seen in the outpatient population, usually, women, who made up 50% to 70% of the affected patients in 1 study; 60 years mean age; a body mass index that exceeds 25 kg/m2; and those with varicose veins.
- #2 Superficial Venous Thrombosis: A Comprehensive Reviewhttps://www.mdpi.com/2227-9032/12/4/500
Superficial venous thrombosis (SVT), an inflammatoryâthrombotic process of a superficial vein, is a relatively common event that may have several different underlying causes. This phenomenon has been generally considered benign, and its prevalence has been historically underestimated; the estimated incidence ranges from about 0.3 to 1.5 event per 1000 person-years, while the prevalence is approximately 3 to 11%, with different reports depending on the population studied. […] SVT is a relatively common disease that mostly affects the lower limbs. The incidence is estimated to be 0.3â0.6 events per 1000 person-years in young people and 0.7â1.5 events per 1000 person-years in older patients, not so different than DVT, which is estimated to be about 1 in every 1000 cases. However, the real incidence of STV is probably underestimated.
- #3 Superficial Venous Thrombosis: A Comprehensive Reviewhttps://www.mdpi.com/2227-9032/12/4/500
Superficial venous thrombosis (SVT), an inflammatoryâthrombotic process of a superficial vein, is a relatively common event that may have several different underlying causes. This phenomenon has been generally considered benign, and its prevalence has been historically underestimated; the estimated incidence ranges from about 0.3 to 1.5 event per 1000 person-years, while the prevalence is approximately 3 to 11%, with different reports depending on the population studied. […] SVT is a relatively common disease that mostly affects the lower limbs. The incidence is estimated to be 0.3â0.6 events per 1000 person-years in young people and 0.7â1.5 events per 1000 person-years in older patients, not so different than DVT, which is estimated to be about 1 in every 1000 cases. However, the real incidence of STV is probably underestimated.
- #4 Superficial Venous Thrombosis: A Comprehensive Reviewhttps://www.mdpi.com/2227-9032/12/4/500
The STEPH study was a descriptive, multicentre, community-based study conducted over 1 year in the adult resident population of an urban area in France. The study included 265,687 adults and 171 of them had symptomatic SVT, confirmed with ultrasound performed by vascular specialists. The measured annual diagnosis rate of SVT was 0.64% of adults; however, it is possible that the primary care setting underestimated the true prevalence. […] Another retrospective cohort study evaluated the Dutch population and the annual incidence of SVT by using healthcare-coded data from the Utrecht General Practitioner Network database. The diagnosis of SVT was clinical, through the description of typical signs and symptoms. The incidence of SVT events recorded in primary care was 1.31 events per 1000 person-years of follow-up.
- #5 Superficial Venous Thrombosis: A Comprehensive Reviewhttps://www.mdpi.com/2227-9032/12/4/500
The STEPH study was a descriptive, multicentre, community-based study conducted over 1 year in the adult resident population of an urban area in France. The study included 265,687 adults and 171 of them had symptomatic SVT, confirmed with ultrasound performed by vascular specialists. The measured annual diagnosis rate of SVT was 0.64% of adults; however, it is possible that the primary care setting underestimated the true prevalence. […] Another retrospective cohort study evaluated the Dutch population and the annual incidence of SVT by using healthcare-coded data from the Utrecht General Practitioner Network database. The diagnosis of SVT was clinical, through the description of typical signs and symptoms. The incidence of SVT events recorded in primary care was 1.31 events per 1000 person-years of follow-up.
- #6 Superficial Thrombophlebitis | Doctorhttps://patient.info/doctor/superficial-thrombophlebitis-pro
How common is superficial thrombophlebitis? (Epidemiology) This is a very common condition and, although figures are difficult to find. Some reports estimate an incidence of between 3-11% of the general population. It has a female preponderance, and seasonal variation (more common in warmer months) has also been reported. Women make up 50-70% of reported cases of superficial venous thrombophlebitis. […] The risk of recurrence ranges between 1.6-12.2% in treated cases and 3.3-36.7% in untreated cases, depending on the presence or absence of underlying risk factors. […] Superficial thrombophlebitis and risk for recurrent venous thromboembolism.
- #7 Superficial Thrombophlebitis | 5-Minute Clinical Consulthttps://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688629/all/Superficial_Thrombophlebitis?q=Deep-vein+thrombosis
Overall incidence is not well established. Current estimates put the incidence around 1.31 per 1,000 person-years, with increasing age associated with higher rates. Current incidence of catheter-associated septic thrombophlebitis is 0.5 per 1,000 days of peripherally inserted catheters. In pregnancy, incidence varies by trimester and postpartum. Per 1,000 person-years, incidence rates were 0.1, 0.2, 0.5, and 1.6 during the 1st, 2nd, and 3rd trimesters, and postpartum, respectively. Aseptic primary hypercoagulable state: Antithrombin III and heparin cofactor II deficiency incidence is 50/100,000 persons. Superficial migratory thrombophlebitis in 27% of patients with thromboangiitis obliterans. […] Superficial thrombophlebitis is common with prevalence estimated between 3% and 11% of the general population. 1/3 of patients in a medical ICU develop thrombophlebitis that eventually progresses to the deep veins.
- #8 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
Superficial thrombophlebitis is an inflammatory disorder of superficial veins with coexistent venous thrombosis. It usually affects lower limbs, particularly the great saphenous vein (60% to 80%) or the small/short saphenous vein (10% to 20%). However, it can occur at other sites (10% to 20%) and may occur bilaterally (5% to 10%). […] The true incidence of superficial thrombophlebitis is unclear. In France, 1 community-based study noted the incidence of SVT to be 0.64%, while a different community-based study found the incidence to be half that of DVT and similar to PE. Other studies suggest its prevalence in the general population is 2 to 6 times higher than the incidence of DVT and PE. SVT is commonly seen in the outpatient population, usually, women, who made up 50% to 70% of the affected patients in 1 study; 60 years mean age; a body mass index that exceeds 25 kg/m2; and those with varicose veins.
- #9 Superficial Venous Thrombosis: A Comprehensive Reviewhttps://www.mdpi.com/2227-9032/12/4/500
The venous thrombosis prevalence rate was found to be 2.9% in women and 0.8% in men aged â¥49 in an Italian study (Anemone) that used a self-managed questionnaire to investigate the prevalence of the condition in blood donors. […] In conclusion, it is worth noting that most data about patients with SVT are derived from old studies with methodological limitations. New studies using diagnostic technologies such as ultrasound could allow for a better epidemiological definition of pathology and complications.
- #10 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
Superficial thrombophlebitis is an inflammatory disorder of superficial veins with coexistent venous thrombosis. It usually affects lower limbs, particularly the great saphenous vein (60% to 80%) or the small/short saphenous vein (10% to 20%). However, it can occur at other sites (10% to 20%) and may occur bilaterally (5% to 10%). […] The true incidence of superficial thrombophlebitis is unclear. In France, 1 community-based study noted the incidence of SVT to be 0.64%, while a different community-based study found the incidence to be half that of DVT and similar to PE. Other studies suggest its prevalence in the general population is 2 to 6 times higher than the incidence of DVT and PE. SVT is commonly seen in the outpatient population, usually, women, who made up 50% to 70% of the affected patients in 1 study; 60 years mean age; a body mass index that exceeds 25 kg/m2; and those with varicose veins.
- #11 Superficial Thrombophlebitis | 5-Minute Clinical Consulthttps://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688629/all/Superficial_Thrombophlebitis?q=Deep-vein+thrombosis
Superficial thrombophlebitis refers to a thrombosis-related inflammatory process of superficial veins. Most common in the lower extremities with 60-80% of total cases involving the greater saphenous vein but can occur in any location. Classically, it was considered a benign and self-limiting process, but recent evidence associates it with increased risk of thromboembolic complications including progression to venous thromboembolism (VTE), subsequent VTE, or recurrent superficial thrombophlebitis. […] Mean age is 60 years old. 50-70% in women. More common in those with varicose veins. Epidemiology by thrombophlebitis types: Traumatic/IV related has no predominant age/sex. Suppurative and more common in extremes of ages (neonates, elderly). Aseptic primary hypercoagulable state: Childhood to young adult. Aseptic secondary hypercoagulable state: Mondor disease: women, ages 21 to 55 years. Thromboangiitis obliterans onset: ages 20 to 50 years.
- #12 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
Superficial thrombophlebitis is an inflammatory disorder of superficial veins with coexistent venous thrombosis. It usually affects lower limbs, particularly the great saphenous vein (60% to 80%) or the small/short saphenous vein (10% to 20%). However, it can occur at other sites (10% to 20%) and may occur bilaterally (5% to 10%). […] The true incidence of superficial thrombophlebitis is unclear. In France, 1 community-based study noted the incidence of SVT to be 0.64%, while a different community-based study found the incidence to be half that of DVT and similar to PE. Other studies suggest its prevalence in the general population is 2 to 6 times higher than the incidence of DVT and PE. SVT is commonly seen in the outpatient population, usually, women, who made up 50% to 70% of the affected patients in 1 study; 60 years mean age; a body mass index that exceeds 25 kg/m2; and those with varicose veins.
- #13 Superficial thrombophlebitis – Wikipediahttps://en.wikipedia.org/wiki/Superficial_thrombophlebitis
Some 125,000 cases a year have been reported in the United States, but actual incidence of spontaneous thrombophlebitis is unknown. […] A fourfold increased incidence from the third to the eight decade in men and a preponderance among women of approximately 55-70%. […] The average mean age of affected patients is 60 years. […] Thrombophlebitis can develop along the arm, back, or neck veins, the leg is by far the most common site. When it occurs in the leg, the great saphenous vein is usually involved, although other locations are possible.
- #14 Superficial thrombophlebitis – Wikipediahttps://en.wikipedia.org/wiki/Superficial_thrombophlebitis
Some 125,000 cases a year have been reported in the United States, but actual incidence of spontaneous thrombophlebitis is unknown. […] A fourfold increased incidence from the third to the eight decade in men and a preponderance among women of approximately 55-70%. […] The average mean age of affected patients is 60 years. […] Thrombophlebitis can develop along the arm, back, or neck veins, the leg is by far the most common site. When it occurs in the leg, the great saphenous vein is usually involved, although other locations are possible.
- #15 Superficial Thrombophlebitis: Practice Essentials, Pathophysiology, Etiologyhttps://emedicine.medscape.com/article/463256-overview
Superficial thrombophlebitis is a common condition worldwide. […] In the author’s experience, superficial thrombophlebitis most frequently occurs in the age group ranging from young adulthood to middle age. However, Markovic et al reported that a common risk factor is age older than 60 years, though fewer complications occur in this age group. […] As previously mentioned, pregnancy, puerperium, and high-dose estrogen therapy are recognized risk factors for phlebitis. However, there are no intrinsic sex-linked risks for the disease.
- #16 Superficial Thrombophlebitis: Practice Essentials, Pathophysiology, Etiologyhttps://emedicine.medscape.com/article/463256-overview
Superficial thrombophlebitis is a common condition worldwide. […] In the author’s experience, superficial thrombophlebitis most frequently occurs in the age group ranging from young adulthood to middle age. However, Markovic et al reported that a common risk factor is age older than 60 years, though fewer complications occur in this age group. […] As previously mentioned, pregnancy, puerperium, and high-dose estrogen therapy are recognized risk factors for phlebitis. However, there are no intrinsic sex-linked risks for the disease.
- #17 Superficial Thrombophlebitis | 5-Minute Clinical Consulthttps://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688629/all/Superficial_Thrombophlebitis?q=Deep-vein+thrombosis
Overall incidence is not well established. Current estimates put the incidence around 1.31 per 1,000 person-years, with increasing age associated with higher rates. Current incidence of catheter-associated septic thrombophlebitis is 0.5 per 1,000 days of peripherally inserted catheters. In pregnancy, incidence varies by trimester and postpartum. Per 1,000 person-years, incidence rates were 0.1, 0.2, 0.5, and 1.6 during the 1st, 2nd, and 3rd trimesters, and postpartum, respectively. Aseptic primary hypercoagulable state: Antithrombin III and heparin cofactor II deficiency incidence is 50/100,000 persons. Superficial migratory thrombophlebitis in 27% of patients with thromboangiitis obliterans. […] Superficial thrombophlebitis is common with prevalence estimated between 3% and 11% of the general population. 1/3 of patients in a medical ICU develop thrombophlebitis that eventually progresses to the deep veins.
- #18 Superficial Thrombophlebitis | 5-Minute Clinical Consulthttps://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688629/all/Superficial_Thrombophlebitis?q=Contact+Dermatitis%2C
Overall incidence is not well established. Current estimates put the incidence around 1.31 per 1,000 person-years, with increasing age associated with higher rates. Current incidence of catheter-associated septic thrombophlebitis is 0.5 per 1,000 days of peripherally inserted catheters. In pregnancy, incidence varies by trimester and postpartum. Per 1,000 person-years, incidence rates were 0.1, 0.2, 0.5, and 1.6 during the 1st, 2nd, and 3rd trimesters, and postpartum, respectively. Aseptic primary hypercoagulable state: Antithrombin III and heparin cofactor II deficiency incidence is 50/100,000 persons. Superficial migratory thrombophlebitis in 27% of patients with thromboangiitis obliterans. […] Superficial thrombophlebitis is common with prevalence estimated between 3% and 11% of the general population. 1/3 of patients in a medical ICU develop thrombophlebitis that eventually progresses to the deep veins.
- #19 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
Superficial thrombophlebitis is an inflammatory disorder of superficial veins with coexistent venous thrombosis. It usually affects lower limbs, particularly the great saphenous vein (60% to 80%) or the small/short saphenous vein (10% to 20%). However, it can occur at other sites (10% to 20%) and may occur bilaterally (5% to 10%). […] The true incidence of superficial thrombophlebitis is unclear. In France, 1 community-based study noted the incidence of SVT to be 0.64%, while a different community-based study found the incidence to be half that of DVT and similar to PE. Other studies suggest its prevalence in the general population is 2 to 6 times higher than the incidence of DVT and PE. SVT is commonly seen in the outpatient population, usually, women, who made up 50% to 70% of the affected patients in 1 study; 60 years mean age; a body mass index that exceeds 25 kg/m2; and those with varicose veins.
- #20 Current management of superficial thrombophlebitis of the lower limb – Servier – PhlebolymphologyServier – Phlebolymphologyhttps://www.phlebolymphology.org/current-management-of-superficial-thrombophlebitis-of-the-lower-limb/
STP involves the greater saphenous system more often (60-80%) than the lesser saphenous system (10%-20%). When STP develops in patients with varicose veins it is confined to the varicose tributaries rather than the saphenous trunks. The prevalence of STP in patients with varicose veins ranges from 4%-59%; bilateral SPT is reported in 5%-10% of patients. Several factors including obesity, age, and protein-S deficiency are associated with SPT in patients with varicose veins. […] The development of STP in the absence of varicose veins is relatively rare (5%-10% of all cases) and various conditions have been implicated in its etiology including autoimmune disease (Behcets, Buergers, and Mondors disease), malignancy, thrombophilia, mechanical or chemical trauma or injury (venous infusion, catheter introduction), radiation injury, and bacterial or fungal infections. Risk factors are the same as those for the development of deep vein thrombosis (DVT) and include a history of thrombotic events, pregnancy, use of oral contraceptives and hormone replacement therapy, immobilization, obesity, recent surgery and trauma, and sclerotherapy.
- #21 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
Superficial thrombophlebitis is an inflammatory disorder of superficial veins with coexistent venous thrombosis. It usually affects lower limbs, particularly the great saphenous vein (60% to 80%) or the small/short saphenous vein (10% to 20%). However, it can occur at other sites (10% to 20%) and may occur bilaterally (5% to 10%). […] The true incidence of superficial thrombophlebitis is unclear. In France, 1 community-based study noted the incidence of SVT to be 0.64%, while a different community-based study found the incidence to be half that of DVT and similar to PE. Other studies suggest its prevalence in the general population is 2 to 6 times higher than the incidence of DVT and PE. SVT is commonly seen in the outpatient population, usually, women, who made up 50% to 70% of the affected patients in 1 study; 60 years mean age; a body mass index that exceeds 25 kg/m2; and those with varicose veins.
- #22 Current management of superficial thrombophlebitis of the lower limb – Servier – PhlebolymphologyServier – Phlebolymphologyhttps://www.phlebolymphology.org/current-management-of-superficial-thrombophlebitis-of-the-lower-limb/
STP involves the greater saphenous system more often (60-80%) than the lesser saphenous system (10%-20%). When STP develops in patients with varicose veins it is confined to the varicose tributaries rather than the saphenous trunks. The prevalence of STP in patients with varicose veins ranges from 4%-59%; bilateral SPT is reported in 5%-10% of patients. Several factors including obesity, age, and protein-S deficiency are associated with SPT in patients with varicose veins. […] The development of STP in the absence of varicose veins is relatively rare (5%-10% of all cases) and various conditions have been implicated in its etiology including autoimmune disease (Behcets, Buergers, and Mondors disease), malignancy, thrombophilia, mechanical or chemical trauma or injury (venous infusion, catheter introduction), radiation injury, and bacterial or fungal infections. Risk factors are the same as those for the development of deep vein thrombosis (DVT) and include a history of thrombotic events, pregnancy, use of oral contraceptives and hormone replacement therapy, immobilization, obesity, recent surgery and trauma, and sclerotherapy.
- #23 Superficial thrombophlebitis – Wikipediahttps://en.wikipedia.org/wiki/Superficial_thrombophlebitis
Some 125,000 cases a year have been reported in the United States, but actual incidence of spontaneous thrombophlebitis is unknown. […] A fourfold increased incidence from the third to the eight decade in men and a preponderance among women of approximately 55-70%. […] The average mean age of affected patients is 60 years. […] Thrombophlebitis can develop along the arm, back, or neck veins, the leg is by far the most common site. When it occurs in the leg, the great saphenous vein is usually involved, although other locations are possible.
- #24 Current management of superficial thrombophlebitis of the lower limb – Servier – PhlebolymphologyServier – Phlebolymphologyhttps://www.phlebolymphology.org/current-management-of-superficial-thrombophlebitis-of-the-lower-limb/
STP involves the greater saphenous system more often (60-80%) than the lesser saphenous system (10%-20%). When STP develops in patients with varicose veins it is confined to the varicose tributaries rather than the saphenous trunks. The prevalence of STP in patients with varicose veins ranges from 4%-59%; bilateral SPT is reported in 5%-10% of patients. Several factors including obesity, age, and protein-S deficiency are associated with SPT in patients with varicose veins. […] The development of STP in the absence of varicose veins is relatively rare (5%-10% of all cases) and various conditions have been implicated in its etiology including autoimmune disease (Behcets, Buergers, and Mondors disease), malignancy, thrombophilia, mechanical or chemical trauma or injury (venous infusion, catheter introduction), radiation injury, and bacterial or fungal infections. Risk factors are the same as those for the development of deep vein thrombosis (DVT) and include a history of thrombotic events, pregnancy, use of oral contraceptives and hormone replacement therapy, immobilization, obesity, recent surgery and trauma, and sclerotherapy.
- #25 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] Multiple studies have found concomitant DVT with SVT in 6 to 36% of patients. These same studies clinically suspected concomitant PE in 2 to 13%, and regular performance of lung scans revealed the rate of asymptomatic PE approached 33%. Other retrospective studies from both primary and secondary/tertiary centers reported concomitant DVT or symptomatic PE on the initial presentation to be 25 to 30%. About 5 to 7% of these patients had symptomatic PE. However, the incidence of coexisting PE increased to 17% with a more rigorous screening process for asymptomatic patients. […] Given the incidence of concomitant venous thromboembolic disease and the possibility of extension, it is paramount for healthcare team members to recognize that superficial thrombophlebitis is no longer considered a benign entity.
- #26 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] Multiple studies have found concomitant DVT with SVT in 6 to 36% of patients. These same studies clinically suspected concomitant PE in 2 to 13%, and regular performance of lung scans revealed the rate of asymptomatic PE approached 33%. Other retrospective studies from both primary and secondary/tertiary centers reported concomitant DVT or symptomatic PE on the initial presentation to be 25 to 30%. About 5 to 7% of these patients had symptomatic PE. However, the incidence of coexisting PE increased to 17% with a more rigorous screening process for asymptomatic patients. […] Given the incidence of concomitant venous thromboembolic disease and the possibility of extension, it is paramount for healthcare team members to recognize that superficial thrombophlebitis is no longer considered a benign entity.
- #27 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] Multiple studies have found concomitant DVT with SVT in 6 to 36% of patients. These same studies clinically suspected concomitant PE in 2 to 13%, and regular performance of lung scans revealed the rate of asymptomatic PE approached 33%. Other retrospective studies from both primary and secondary/tertiary centers reported concomitant DVT or symptomatic PE on the initial presentation to be 25 to 30%. About 5 to 7% of these patients had symptomatic PE. However, the incidence of coexisting PE increased to 17% with a more rigorous screening process for asymptomatic patients. […] Given the incidence of concomitant venous thromboembolic disease and the possibility of extension, it is paramount for healthcare team members to recognize that superficial thrombophlebitis is no longer considered a benign entity.
- #28 Superficial Thrombophlebitishttps://mobile.fpnotebook.com/HemeOnc/CV/SprfclThrmbphlbts.htm
Superficial Venous Thrombosis accounts for 5% of VTE […] DVT identified in 25% at time of Superficial Venous Thrombosis diagnosis […] DVT identified in 10% at 3 months after Superficial Venous Thrombosis diagnosis […] Most Superficial Thrombophlebitis resolves with symptomatic management […] Upper extremity Thrombophlebitis uncommonly progresses to DVT (except in cases of PICC Line Thrombosis).
- #29 Simultaneous occurrence of superficial and deep thrombophlebitis in the lower extremity – PubMedhttps://pubmed.ncbi.nlm.nih.gov/2193177/
Forty-two consecutive patients diagnosed with superficial phlebitis were seen during a 5-year period. The diagnosis of superficial phlebitis was made by the presence of palpable subcutaneous cords in the course of the greater saphenous vein or its tributaries in association with tenderness, erythema, and edema. The presence of concurrent deep venous thrombosis (DVT) was assessed by impedance plethysmography in 37 patients, compression venous ultrasonography in 3 patients, and venography in 8 patients. Five of the 42 patients (12%) had DVT. DVT occurred in 17% of the patients with above-knee extension of the superficial phlebitis. In the clinical management of superficial lower-limb thrombophlebitis, noninvasive tests should be performed to guide therapy. […] When superficial phlebitis develops after recent surgery or the superficial phlebitis extends above the knee, diagnostic surveillance should be especially strict. When the noninvasive test results are equivocal, phlebography is indicated to rule out DVT.
- #30 Current management of superficial thrombophlebitis of the lower limb – Servier – PhlebolymphologyServier – Phlebolymphologyhttps://www.phlebolymphology.org/current-management-of-superficial-thrombophlebitis-of-the-lower-limb/
As STP may coexist with DVT in 6%-53% of patients presenting with STP it is important to perform a duplex scan to exclude DVT and to confirm the presence of STP and its extent. Thrombus extension from the superficial system into the deep veins may occur through the saphenofemoral and saphenopopliteal junctions and the perforating veins. Extension from the greater saphenous vein (GSV), particularly when the above knee segment is involved, into the femoral vein is the most common scenario and occurs in 17%-19% of cases. When STP affects the below knee segment of the GSV an association with DVT has been reported in only 4-5% of cases. It should be noted that STP may be a risk factor for the development and recurrence of DVT. […] In the literature, pulmonary embolism in patients with STP has been reported at rates varying from 1.5% to 33%. STP is also a risk factor for the recurrence of pulmonary embolism. Pulmonary embolism is more common when thrombosis is confined to the GSV above the knee (18%) as compared with thrombosis confined to the short saphenous vein (4%). However, it is unclear whether pulmonary embolism associated with STP results from a thrombus in the superficial veins, or after its progression to the deep venous system.
- #31 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] Multiple studies have found concomitant DVT with SVT in 6 to 36% of patients. These same studies clinically suspected concomitant PE in 2 to 13%, and regular performance of lung scans revealed the rate of asymptomatic PE approached 33%. Other retrospective studies from both primary and secondary/tertiary centers reported concomitant DVT or symptomatic PE on the initial presentation to be 25 to 30%. About 5 to 7% of these patients had symptomatic PE. However, the incidence of coexisting PE increased to 17% with a more rigorous screening process for asymptomatic patients. […] Given the incidence of concomitant venous thromboembolic disease and the possibility of extension, it is paramount for healthcare team members to recognize that superficial thrombophlebitis is no longer considered a benign entity.
- #32 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] Multiple studies have found concomitant DVT with SVT in 6 to 36% of patients. These same studies clinically suspected concomitant PE in 2 to 13%, and regular performance of lung scans revealed the rate of asymptomatic PE approached 33%. Other retrospective studies from both primary and secondary/tertiary centers reported concomitant DVT or symptomatic PE on the initial presentation to be 25 to 30%. About 5 to 7% of these patients had symptomatic PE. However, the incidence of coexisting PE increased to 17% with a more rigorous screening process for asymptomatic patients. […] Given the incidence of concomitant venous thromboembolic disease and the possibility of extension, it is paramount for healthcare team members to recognize that superficial thrombophlebitis is no longer considered a benign entity.
- #33 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] Multiple studies have found concomitant DVT with SVT in 6 to 36% of patients. These same studies clinically suspected concomitant PE in 2 to 13%, and regular performance of lung scans revealed the rate of asymptomatic PE approached 33%. Other retrospective studies from both primary and secondary/tertiary centers reported concomitant DVT or symptomatic PE on the initial presentation to be 25 to 30%. About 5 to 7% of these patients had symptomatic PE. However, the incidence of coexisting PE increased to 17% with a more rigorous screening process for asymptomatic patients. […] Given the incidence of concomitant venous thromboembolic disease and the possibility of extension, it is paramount for healthcare team members to recognize that superficial thrombophlebitis is no longer considered a benign entity.
- #34 Superficial vein thrombosis: more dangerous than anticipated – Servier – PhlebolymphologyServier – Phlebolymphologyhttps://www.phlebolymphology.org/superficial-vein-thrombosis-more-dangerous-than-anticipated/
Superficial vein thrombosis (SVT) of the lower limbs is considered by most clinicians to be a rather innocent entity. However, recent information indicates that SVT has a high prevalence and is quite often accompanied by pulmonary embolism, putting the patient at immediate risk. […] The exact incidence of SVT in not known. It is estimated to be two to three times more frequent than deep vein thrombosis. […] It is estimated that 20%-33% of SVT cases, almost one-third, are complicated by asymptomatic pulmonary embolism, while 2%-13% are associated with life-threatening symptomatic pulmonary embolism. […] SVT has been considered by many in the medical world to be an innocent entity without significant consequences. However, a recent review of previously published data has pointed toward a high prevalence of pulmonary emboli associated with this condition. […] An understanding of the epidemiology of SVT is useful to determine which patients are at increased risk.
- #35 SciELO Brazil – Diretrizes de conceito, diagnóstico e tratamento da trombose venosa superficial Diretrizes de conceito, diagnóstico e tratamento da trombose venosa superficialhttps://www.scielo.br/j/jvb/a/Z5nCYnYHcpLws5Gx8XFNbTS/?lang=en
Superficial venous thrombosis (SVT) or superficial thrombophlebitis is characterized by thrombi within superficial veins, with partial involvement or occlusion of the lumen and inflammatory reaction along the course of the vein. […] SVT can be associated with deep venous thrombosis in 6 to 40% of cases, with asymptomatic pulmonary embolism (PE) in 20 to 33%, and with symptomatic PE in 2 to 13%. […] Despite the morbidity and complications, there are currently no Brazilian guidelines for SVT. […] Superficial venous thrombosis can be associated with deep venous thrombosis (DVT) in 6 to 40% of patients and can also be linked to more serious complications, such as asymptomatic pulmonary embolism (PE), in 20 to 33% of cases, and symptomatic PE, in 2 to 13% of cases. […] Rapid implementation of diagnostic and therapeutic strategies is crucial to avoiding these complications.
- #36 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] Multiple studies have found concomitant DVT with SVT in 6 to 36% of patients. These same studies clinically suspected concomitant PE in 2 to 13%, and regular performance of lung scans revealed the rate of asymptomatic PE approached 33%. Other retrospective studies from both primary and secondary/tertiary centers reported concomitant DVT or symptomatic PE on the initial presentation to be 25 to 30%. About 5 to 7% of these patients had symptomatic PE. However, the incidence of coexisting PE increased to 17% with a more rigorous screening process for asymptomatic patients. […] Given the incidence of concomitant venous thromboembolic disease and the possibility of extension, it is paramount for healthcare team members to recognize that superficial thrombophlebitis is no longer considered a benign entity.
- #37 Superficial Thrombophlebitis | Treatment & Management | Point of Carehttps://www.statpearls.com/point-of-care/30109
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] The migration of the thrombus towards the deep veins at the saphenofemoral junction, the saphenopopliteal junction, or from a perforating vein during a hypercoagulability state may cause the association between SVT and DVT or PE.
- #38 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] Multiple studies have found concomitant DVT with SVT in 6 to 36% of patients. These same studies clinically suspected concomitant PE in 2 to 13%, and regular performance of lung scans revealed the rate of asymptomatic PE approached 33%. Other retrospective studies from both primary and secondary/tertiary centers reported concomitant DVT or symptomatic PE on the initial presentation to be 25 to 30%. About 5 to 7% of these patients had symptomatic PE. However, the incidence of coexisting PE increased to 17% with a more rigorous screening process for asymptomatic patients. […] Given the incidence of concomitant venous thromboembolic disease and the possibility of extension, it is paramount for healthcare team members to recognize that superficial thrombophlebitis is no longer considered a benign entity.
- #39 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] Multiple studies have found concomitant DVT with SVT in 6 to 36% of patients. These same studies clinically suspected concomitant PE in 2 to 13%, and regular performance of lung scans revealed the rate of asymptomatic PE approached 33%. Other retrospective studies from both primary and secondary/tertiary centers reported concomitant DVT or symptomatic PE on the initial presentation to be 25 to 30%. About 5 to 7% of these patients had symptomatic PE. However, the incidence of coexisting PE increased to 17% with a more rigorous screening process for asymptomatic patients. […] Given the incidence of concomitant venous thromboembolic disease and the possibility of extension, it is paramount for healthcare team members to recognize that superficial thrombophlebitis is no longer considered a benign entity.
- #40 Superficial Thrombophlebitis | Doctorhttps://patient.info/doctor/superficial-thrombophlebitis-pro
How common is superficial thrombophlebitis? (Epidemiology) This is a very common condition and, although figures are difficult to find. Some reports estimate an incidence of between 3-11% of the general population. It has a female preponderance, and seasonal variation (more common in warmer months) has also been reported. Women make up 50-70% of reported cases of superficial venous thrombophlebitis. […] The risk of recurrence ranges between 1.6-12.2% in treated cases and 3.3-36.7% in untreated cases, depending on the presence or absence of underlying risk factors. […] Superficial thrombophlebitis and risk for recurrent venous thromboembolism.
- #41 Current management of superficial thrombophlebitis of the lower limb – Servier – PhlebolymphologyServier – Phlebolymphologyhttps://www.phlebolymphology.org/current-management-of-superficial-thrombophlebitis-of-the-lower-limb/
The typical clinical presentation of STP includes local pain, warmth, erythema, and swelling, with the superficial vein becoming solid like a cord. It is important to reiterate here the value of Duplex ultrasound for the confirmation of STP, estimation of thrombus extent, exclusion of DVT and for follow-up. […] In summary, all patients with STP should have bilateral duplex scanning to exclude DVT. As far as treatment is concerned, LMWH in intermediate doses for at least 1 month or fondaparinux 2.5 mg daily for at least 4 weeks are effective therapies. Surgery is no more effective than LMWH, but when the thrombus is close to the saphenofemoral or saphenopopliteal junctions, both are acceptable options depending on the patients characteristics and the treating physicians preference. For isolated STP at the below knee segment confined to varicosities, local application of heparinoids, NSAIDs and elastic stockings form an acceptable treatment option.
- #42 SciELO Brazil – Diretrizes de conceito, diagnóstico e tratamento da trombose venosa superficial Diretrizes de conceito, diagnóstico e tratamento da trombose venosa superficialhttps://www.scielo.br/j/jvb/a/Z5nCYnYHcpLws5Gx8XFNbTS/?lang=en
The objective of these guidelines is to standardize treatment for SVT and report the evidence levels supporting the different treatments that are available. […] Superficial venous thrombosis is a clinical condition that may be associated with VTE events, such as DVT and PE. […] Patients with DVT and/or PE had a 10% prevalence of SVT. […] Thrombotic involvement of the great saphenous vein, particularly close to the saphenofemoral junction in cases with varicose veins, has been identified by some authors as a risk factor for DVT and PE. […] It is therefore concluded that SVT with saphenofemoral junction or saphenopopliteal junction involvement is associated with an increased risk of recurrent VTE. […] There are no studies specifically comparing the accuracy and effectiveness of different diagnostic methods for SVT.
- #43 Current management of superficial thrombophlebitis of the lower limb – Servier – PhlebolymphologyServier – Phlebolymphologyhttps://www.phlebolymphology.org/current-management-of-superficial-thrombophlebitis-of-the-lower-limb/
The typical clinical presentation of STP includes local pain, warmth, erythema, and swelling, with the superficial vein becoming solid like a cord. It is important to reiterate here the value of Duplex ultrasound for the confirmation of STP, estimation of thrombus extent, exclusion of DVT and for follow-up. […] In summary, all patients with STP should have bilateral duplex scanning to exclude DVT. As far as treatment is concerned, LMWH in intermediate doses for at least 1 month or fondaparinux 2.5 mg daily for at least 4 weeks are effective therapies. Surgery is no more effective than LMWH, but when the thrombus is close to the saphenofemoral or saphenopopliteal junctions, both are acceptable options depending on the patients characteristics and the treating physicians preference. For isolated STP at the below knee segment confined to varicosities, local application of heparinoids, NSAIDs and elastic stockings form an acceptable treatment option.
- #44 Simultaneous occurrence of superficial and deep thrombophlebitis in the lower extremity – PubMedhttps://pubmed.ncbi.nlm.nih.gov/2193177/
Forty-two consecutive patients diagnosed with superficial phlebitis were seen during a 5-year period. The diagnosis of superficial phlebitis was made by the presence of palpable subcutaneous cords in the course of the greater saphenous vein or its tributaries in association with tenderness, erythema, and edema. The presence of concurrent deep venous thrombosis (DVT) was assessed by impedance plethysmography in 37 patients, compression venous ultrasonography in 3 patients, and venography in 8 patients. Five of the 42 patients (12%) had DVT. DVT occurred in 17% of the patients with above-knee extension of the superficial phlebitis. In the clinical management of superficial lower-limb thrombophlebitis, noninvasive tests should be performed to guide therapy. […] When superficial phlebitis develops after recent surgery or the superficial phlebitis extends above the knee, diagnostic surveillance should be especially strict. When the noninvasive test results are equivocal, phlebography is indicated to rule out DVT.
- #45 SciELO Brazil – Diretrizes de conceito, diagnóstico e tratamento da trombose venosa superficial Diretrizes de conceito, diagnóstico e tratamento da trombose venosa superficialhttps://www.scielo.br/j/jvb/a/Z5nCYnYHcpLws5Gx8XFNbTS/?lang=en
Considering the high incidence of DVT combined with the risk of progression of thrombosis and of PE, it is recommended that DM is used to examine all cases of SVT in the lower limbs. […] The objectives of SVT treatment are to: a) alleviate symptoms (reduce inflammation along the path of the veins involved and neighboring tissues); b) prevent thrombosis extension along the superficial vein system and/or into the deep system; c) avoid recurrence; and d) prevent thromboembolic complications (DVT and PE). […] The existence of several different series in the literature, with differing methods and contradictory results has made it difficult to standardize treatment. […] Systemic anticoagulation should thus be preferred in SVT cases with non-varicose saphenous trunk involvement, thereby reducing the chances of associated thromboembolic complications. […] Superficial venous thrombosis is a common disease and a risk factor for thromboembolic complications similar to those related to DVT.
- #46 Superficial Thrombophlebitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK556017/
For people who have a history of SVT, the lifetime risk of DVT or PE increases 4 to 6 times. While the 3-month mortality is about 5% in patients with DVT or PE, it is less than 1% for those with SVT. One suggested reason for the lower mortality in patients with SVT is the younger age of the patients with fewer associated comorbidities. […] Multiple studies have found concomitant DVT with SVT in 6 to 36% of patients. These same studies clinically suspected concomitant PE in 2 to 13%, and regular performance of lung scans revealed the rate of asymptomatic PE approached 33%. Other retrospective studies from both primary and secondary/tertiary centers reported concomitant DVT or symptomatic PE on the initial presentation to be 25 to 30%. About 5 to 7% of these patients had symptomatic PE. However, the incidence of coexisting PE increased to 17% with a more rigorous screening process for asymptomatic patients. […] Given the incidence of concomitant venous thromboembolic disease and the possibility of extension, it is paramount for healthcare team members to recognize that superficial thrombophlebitis is no longer considered a benign entity.
- #47 Management of superficial venous thrombophlebitis associated with peripheral venous catheters: A review. | Published in Global Journal of Surgery and Case Reportshttps://www.gjscr.com/article/118529-management-of-superficial-venous-thrombophlebitis-associated-with-peripheral-venous-catheters-a-review
Superficial thrombophlebitis associated with peripheral venous catheters remains the most frequent complication of peripheral venous infusion and leads to serious medical complications that impact negatively both patients and healthcare institutions. […] Superficial venous thrombophlebitis (SVT) associated with peripheral venous cannulation is the most frequent complication of peripheral venous infusion, occurring in in 25% to 35% of hospitalized patients, which is much higher than the 5% incidence considered acceptable by the Intravenous Nurses Society’s guidelines. […] SVT can lead to serious medical complications that impact negatively both patients and healthcare institutions. […] Thrombophlebitis causes patient discomfort and occlusion of the intravenous catheters, both requiring removal and re-siting of the catheter.
- #48 What are the stages of catheter-related phlebitis?https://www.medicalnewstoday.com/articles/stages-of-phlebitis
Phlebitis is the inflammation of a vein, which results in redness, swelling, and pain. It can happen in an arm when a person receives IV therapy in a hospital. […] Approximately 2535% of people who receive IV therapy in a hospital acquire phlebitis, notes an older 2002 study. […] Aside from IV therapy, thrombophlebitis can cause injury or trauma to a vein. If it affects a vein close to the skin surface, doctors call this superficial thrombophlebitis. […] If phlebitis involves an IV site, a diagnosis may be evident by observing the symptoms. […] Doctors do not use phlebitis stages to diagnose the severity of thrombophlebitis. Instead, the diagnostic process involves a physical exam, history, and ultrasound. […] There are some differences in treatment between IV-related phlebitis and thrombophlebitis. Yet both conditions may entail treatment with nonsteroidal anti-inflammatory drugs or anticoagulants.
- #49 Septic Thrombophlebitis | Treatment & Management | Point of Carehttps://www.statpearls.com/point-of-care/30108
Individuals at extremes of age, such as neonates and the elderly appear to be the most vulnerable to STP. This is likely attributable to undeveloped host defenses in neonates, and a decline in immunologic function as well as additional comorbid disease in the elderly. […] The current incidence of catheter-associated (peripheral) STP is estimated at 0.5 cases of bloodstream infections per 1000 days of a peripherally inserted intravenous device. For non-tunneled, non-medicated, central venous catheters, the incidence is estimated at 2.7 per 1000 intravenous device days. Approximately 4.2% of burn patients have been reported to experience peripheral STP. […] Deep (non-catheter associated) STP is seen much less common; the exact incidence, therefore, not yet described. However, in the case of pelvic STP, which is seen most frequently in women of childbearing age, younger than 20 years old, the frequency has been reported to vary from 1:500 to 1:2000 in cesarean deliveries, while the frequency for vaginal deliveries has been reported to be 1:9000. Other risk factors associated with pelvic STP are the black race and multiple gestations.
- #50 Management of superficial venous thrombophlebitis associated with peripheral venous catheters: A review. | Published in Global Journal of Surgery and Case Reportshttps://www.gjscr.com/article/118529-management-of-superficial-venous-thrombophlebitis-associated-with-peripheral-venous-catheters-a-review
This generates unnecessarily delays in administration of intravenous therapy and more invasive venous access procedures with associated risks and ultimately prolongs hospital stay by 2-5 days. […] SVT does also significantly increase the risk of catheter-related bloodstream infections in up to 50% of patients. […] Furthermore, thrombosis associated with SVT can become infected, leading to suppurative thrombophlebitis in 0.2% to 2% of peripheral vein catheter insertions and sepsis. […] Superficial thrombophlebitis associated with peripheral venous catheters remains the most frequent complication of peripheral venous infusion and leads to serious medical complications that impact negatively both patients and healthcare institutions.
- #51 Septic Thrombophlebitis | Treatment & Management | Point of Carehttps://www.statpearls.com/point-of-care/30108
Individuals at extremes of age, such as neonates and the elderly appear to be the most vulnerable to STP. This is likely attributable to undeveloped host defenses in neonates, and a decline in immunologic function as well as additional comorbid disease in the elderly. […] The current incidence of catheter-associated (peripheral) STP is estimated at 0.5 cases of bloodstream infections per 1000 days of a peripherally inserted intravenous device. For non-tunneled, non-medicated, central venous catheters, the incidence is estimated at 2.7 per 1000 intravenous device days. Approximately 4.2% of burn patients have been reported to experience peripheral STP. […] Deep (non-catheter associated) STP is seen much less common; the exact incidence, therefore, not yet described. However, in the case of pelvic STP, which is seen most frequently in women of childbearing age, younger than 20 years old, the frequency has been reported to vary from 1:500 to 1:2000 in cesarean deliveries, while the frequency for vaginal deliveries has been reported to be 1:9000. Other risk factors associated with pelvic STP are the black race and multiple gestations.
- #52 Pylephlebitis: A Systematic Review on Etiology, Diagnosis, and Treatment of Infective Portal Vein Thrombosishttps://www.mdpi.com/2075-4418/13/3/429
Pylephlebitis has a low incidence of approximately 0.37â2.7 cases per 100,000 person-years. […] The number of reported cases has increased over time, with only 43 patients (19.5%) reported between 1971 and 1999, 60 cases (27.3%) between 2000 and 2009, and 117 cases (53.2%) between 2010 and 2022. […] Of the 220 included individuals, 155 (70.5%) were male with a median age of 50 years. […] The diagnosis of liver cirrhosis was never reported in patients published before 2010 but was present in approximately 4.9% of cases published between 2010 and 2022. […] Pylephlebitis can virtually complicate any intra-abdominal or pelvic infections that develop within areas drained by the portal venous circulation. […] The process behind pylephlebitis starts with localized thrombophlebitis of small veins surrounding an infected area, which then extend or migrate to the main branches of the portal vein.
- #53 Septic Thrombophlebitis | Treatment & Management | Point of Carehttps://www.statpearls.com/point-of-care/30108
Individuals at extremes of age, such as neonates and the elderly appear to be the most vulnerable to STP. This is likely attributable to undeveloped host defenses in neonates, and a decline in immunologic function as well as additional comorbid disease in the elderly. […] The current incidence of catheter-associated (peripheral) STP is estimated at 0.5 cases of bloodstream infections per 1000 days of a peripherally inserted intravenous device. For non-tunneled, non-medicated, central venous catheters, the incidence is estimated at 2.7 per 1000 intravenous device days. Approximately 4.2% of burn patients have been reported to experience peripheral STP. […] Deep (non-catheter associated) STP is seen much less common; the exact incidence, therefore, not yet described. However, in the case of pelvic STP, which is seen most frequently in women of childbearing age, younger than 20 years old, the frequency has been reported to vary from 1:500 to 1:2000 in cesarean deliveries, while the frequency for vaginal deliveries has been reported to be 1:9000. Other risk factors associated with pelvic STP are the black race and multiple gestations.
- #54 Mondor disease (breast) | Radiology Reference Article | Radiopaedia.orghttps://radiopaedia.org/articles/mondor-disease-breast?lang=us
Although Mondor disease is rarely reported in the literature, this is likely in part due to a lack of awareness of the entity. It tends to dominate in women between 30-60 years. […] Incidence rates of 0.5-0.8% have been reported, however, it reflects only the symptomatic population.
- #55 Superficial Venous Thrombosis: A Comprehensive Reviewhttps://www.mdpi.com/2227-9032/12/4/500
Superficial venous thrombosis (SVT), an inflammatoryâthrombotic process of a superficial vein, is a relatively common event that may have several different underlying causes. This phenomenon has been generally considered benign, and its prevalence has been historically underestimated; the estimated incidence ranges from about 0.3 to 1.5 event per 1000 person-years, while the prevalence is approximately 3 to 11%, with different reports depending on the population studied. […] SVT is a relatively common disease that mostly affects the lower limbs. The incidence is estimated to be 0.3â0.6 events per 1000 person-years in young people and 0.7â1.5 events per 1000 person-years in older patients, not so different than DVT, which is estimated to be about 1 in every 1000 cases. However, the real incidence of STV is probably underestimated.
- #56 Superficial Venous Thrombosis: A Comprehensive Reviewhttps://www.mdpi.com/2227-9032/12/4/500
The venous thrombosis prevalence rate was found to be 2.9% in women and 0.8% in men aged â¥49 in an Italian study (Anemone) that used a self-managed questionnaire to investigate the prevalence of the condition in blood donors. […] In conclusion, it is worth noting that most data about patients with SVT are derived from old studies with methodological limitations. New studies using diagnostic technologies such as ultrasound could allow for a better epidemiological definition of pathology and complications.
- #57 Superficial Venous Thrombosis: A Comprehensive Reviewhttps://www.mdpi.com/2227-9032/12/4/500
The venous thrombosis prevalence rate was found to be 2.9% in women and 0.8% in men aged â¥49 in an Italian study (Anemone) that used a self-managed questionnaire to investigate the prevalence of the condition in blood donors. […] In conclusion, it is worth noting that most data about patients with SVT are derived from old studies with methodological limitations. New studies using diagnostic technologies such as ultrasound could allow for a better epidemiological definition of pathology and complications.
- #58 Superficial vein thrombosis: more dangerous than anticipated – Servier – PhlebolymphologyServier – Phlebolymphologyhttps://www.phlebolymphology.org/superficial-vein-thrombosis-more-dangerous-than-anticipated/
Superficial vein thrombosis (SVT) of the lower limbs is considered by most clinicians to be a rather innocent entity. However, recent information indicates that SVT has a high prevalence and is quite often accompanied by pulmonary embolism, putting the patient at immediate risk. […] The exact incidence of SVT in not known. It is estimated to be two to three times more frequent than deep vein thrombosis. […] It is estimated that 20%-33% of SVT cases, almost one-third, are complicated by asymptomatic pulmonary embolism, while 2%-13% are associated with life-threatening symptomatic pulmonary embolism. […] SVT has been considered by many in the medical world to be an innocent entity without significant consequences. However, a recent review of previously published data has pointed toward a high prevalence of pulmonary emboli associated with this condition. […] An understanding of the epidemiology of SVT is useful to determine which patients are at increased risk.
- #59 Superficial Venous Thrombosis: A Comprehensive Reviewhttps://www.mdpi.com/2227-9032/12/4/500
The venous thrombosis prevalence rate was found to be 2.9% in women and 0.8% in men aged â¥49 in an Italian study (Anemone) that used a self-managed questionnaire to investigate the prevalence of the condition in blood donors. […] In conclusion, it is worth noting that most data about patients with SVT are derived from old studies with methodological limitations. New studies using diagnostic technologies such as ultrasound could allow for a better epidemiological definition of pathology and complications.