Risk factors for superficial vein thrombosis in patients with primary chronic venous disease

Abstract

Summary:Background: Primary chronic venous disease (CVD) is associated with an increased risk of superfi cial vein thrombosis (SVT). While CVD is a predominant factor in SVT, there is a range of additional predisposing factors. The objective was to investigate the association between age, gender, BMI, smoking, oestrogen hormone therapy, family history of venous thromboembolism (VTE) and CEAP clinical classifi cation in patients with CVD and a history of SVT. Patients and methods: In a retrospective observational study on consecutive patients with primary CVD, 641 outpatients were enrolled (152 men, 23.7 %; 489 women, 76.3 %). The prevalence of SVT was evaluated according to age, BMI, smoking, presence of family history of VTE, use of hormone therapy, and clinical class of CVD. Results: Risk of SVT was signifi cantly increased in women (OR 1.68, 95 % CI = 1.02 -2.76; p = 0.041), older patients (46 -69 years, OR 1.57, 95% CI = 1.03 -2.4; p = 0.036, ≥ 70 years, OR 2.93, 95 % CI = 1.5 -5.76; p = 0.001), smokers (OR 1.69, 95 % CI = 1.1 -2.58; p = 0.015) and in persons with fi rst-degree siblings diagnosed with VTE (OR 2,28, 95 % CI = 1.28 -4.05; p = 0.004). The risk was signifi cantly increased in older male smokers (p -0.042). In women, smoking and oestrogen therapy (p = 0.495) did not increase the risk of SVT even older women or in those with increased BMI. In CVD (C0 -C3), a history of episodes of SVT was found in 103/550 (18.7 %), in chronic venous insuffi ciency (CVI) in 27/91 (29.7 %). There was a signifi cantly higher prevalence of SVT in patients with CVI (OR 1.70, 95% CI = 1.1 -2.5; p = 0.016). Conclusions: In patients with primary CVD, SVT was signifi cantly associated with female gender. In men, older age, smoking and positive family history of VTE were relevant SVT risk factors. In women, risk factors were older age, BMI ≥ 25 kg/m 2 and positive family history of VTE. Compared with C0 -C3 clinical classes, CVI signifi cantly increases the risk of SVT.

Women and Venous Disease of the Lower Limbs

“…In the Calisto trial, for example, almost 90% of patients with acute, symptomatic SVT suffered from varicose veins [11]. Our study revealed that the risk of SVT in primary CVD was associated with female gender and in both genders to the same extent, age-related [12].…”

Chronic venous insufficiency – a review of pathophysiology, diagnosis, and treatment

“…Acute complications of CVI include thromboembolic events. In rare cases, superficial thrombophlebitis may develop, presenting as erythematous, tender, indurated, and warm cord or nodule . It can be associated with deep vein thrombosis (DVT) in about 18–25 % of patients and with pulmonary embolism in about 7 % .…”

Die chronische venöse Insuffizienz – Eine Zusammenfassung der Pathophysiologie, Diagnostik und Therapie

“…Als akute Komplikation der CVI sind thromboembolische Ereignisse zu nennen. In seltenen Fällen kann es zu einer oberflächlichen Venenthrombose (OVT) kommen, welche sich als geröteter, schmerzhafter, verhärteter und überwärmter Strang oder Knoten präsentiert und bei etwa 18–25 % der Patienten mit einer tiefen Beinvenenthrombose (TVT) und bei etwa 7 % mit einer Lungenembolie einhergehen kann . In Folge einer tiefen Beinvenenthrombose kann es bei 20–50 % der Patienten zu einem postthrombotischen Syndrom kommen (PTS) .…”