Prevalence of Isolated Asymptomatic Deep Vein Thrombosis in Varicose Vein Patients with Superficial Thrombophlebitis: A Single Center Experience in Japan

Shirasugi, Nozomu; Horiguchi, Sadaaki; Shirato, Hiroyuki; Kawakami, Toshimitsu; Ono, Hisako; Yabuki, Shiho; Jojima, Kumiko; Niimi, Masanori

doi:10.3400/avd.oa.15-00124

Cited by 4 publications

(10 citation statements)

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“…We previously showed that 4.64% of VV patients had IDDVT. 1 ) Tamura and Nakahara assessed the performance of magnetic resonance venography and reported that it revealed two cases of DVT (2.8%) in 72 VV patients. 6 ) Müller-Bühl et al reported that there were 132 (5.6%) DVT cases among 2,357 VV patients in outpatient clinics.…”

Section: Discussionmentioning

confidence: 99%

“…Screening for deep vein thrombosis (DVT) is necessary prior to varicose vein (VV) surgery. Formerly, venography was the gold standard to investigate the venous system in lower extremities 1 ) ; however, nowadays duplex ultrasonography (DUS) is used for initial examination imaging of the venous system, as it is less invasive and more useful for detecting DVT in the soleal veins than venography. 2 ) The increasing number of cases with asymptomatic DVT, especially distal DVT, was incidentally recognized during use of DUS to investigate the venous system.…”

Section: Introductionmentioning

confidence: 99%

“…3 , 4 ) However, no consensus has been reached on whether or not indications for VV surgery include the presence of incidental distal DVT (IDDVT). 1 ) When venography was the gold standard for DVT screening, VV surgery was contraindicated in patients with DVT. 1 ) Current guidelines in Japan define treatment with endovenous ablation as a contraindication for patients with VVs when DVT are detected, even incidentally.…”

Section: Introductionmentioning

confidence: 99%

“… 1 ) When venography was the gold standard for DVT screening, VV surgery was contraindicated in patients with DVT. 1 ) Current guidelines in Japan define treatment with endovenous ablation as a contraindication for patients with VVs when DVT are detected, even incidentally. 5 ) On the other hand, indication for VV surgery involving high ligation of the junction between the saphenous veins (SVs) and deep veins, either with or without stripping, remains unclear in VV patients with IDDVT.…”

Section: Introductionmentioning

confidence: 99%

“…5 ) On the other hand, indication for VV surgery involving high ligation of the junction between the saphenous veins (SVs) and deep veins, either with or without stripping, remains unclear in VV patients with IDDVT. 1 ) Therefore, we carefully selected VV patients with IDDVT using the following criteria and performed high ligation of the SV junction with or without stripping. The criteria included: (1) patients with VVs with incompetent SVs, (2) stability and clinical insignificance of IDDVT confirmed by serial DUS, (3) patients without risk factors for DVT, (4) VV surgery possible under local anesthesia, and (5) patients able to understand the concept of IDDVT.…”

Section: Introductionmentioning

confidence: 99%

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Asymptomatic Isolated Calf Deep Vein Thrombosis: Does It Worsen after Varicose Vein Surgery?

Horiguchi¹,

Ono²,

Shirato³

et al. 2017

Annals of Vascular Diseases

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In our varicose vein center, on a trial basis, among the patients with asymptomatic calf deep vein thrombosis (CDVT) we carefully selected the patients for varicose vein surgery using the requirements as follows; 1) the patients had varicose veins with incompetent saphenous veins, 2) sequential examination including DUS confirmed stability and clinical insignificance of asymptomatic CDVT, 3) the patients do not have any risk factors for DVT such as a coagulation profile disorder (antithrombin deficiency, protein C deficiency, protein S deficiency, or antiphospholipid syndrome) or malignancies, 4) surgery is possible under local anesthesia alone, and 5) the patients can understand the concept of asymptomatic CDVT and undergo the surgery on their own will and informed consent. The patients who fulfilled these conditions underwent the varicose vein surgery. Twenty-eight patients with 30 limbs with varicose veins had asymptomatic CDVT, found by preoperative duplex ultrasonography (DUS). Among CDVT, 91% of CDVT existed in the soleal veins. After the diagnosis of the asymptomatic CDVT, serial DUS was performed and showed no changes in the status of the thrombus. Then varicose vein surgery (high ligation of the saphenous junctions either with or without stripping of the saphenous veins) was performed. After the surgery, the CDVT was re-evaluated by DUS. In 27 limbs, CDVT did not show any changes in the status of the thrombus, and in 3 limbs the CDVT was partially resolved. These data suggest that, at least, as far as the patients fulfilled these conditions, varicose vein surgery did not worsen the asymptomatic CDVT. (This is a translation of Jpn J Phlebol 2016; 27: 405–412.)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%