FROM THE ANNALS OF VASCULAR SURGERY

Isolated greater saphenous vein thrombosis is not as benign as generally thought, according to the results of a single institution retrospective study of 61 patients (67 limbs) with isolated GSVT.

Instead, patients had a significant risk of persistent symptoms, recurrence, deep vein thrombosis (DVT), and pulmonary embolism (PE), according to a report published in the Annals of Vascular Surgery by Elizabeth Kudlaty, MD , Ohio State University, Columbus, and her colleagues.

The average age of the patients was 55.5 years and 52.5% of the patients were women.

Location of the GSVT within 5 cm of the saphenous vein junction (SVJ; 32 patients) as compared with GSVT greater than 5 cm from the SVJ (29 patients) was significantly associated with malignancy (37.5% vs. 6.9%, respectively; P = .01), in-patient status (71.9% vs. 41.4%; P = .02), and diabetes (37.5% vs. 10.3%; P = .02). PE also was significantly greater in patients with GSVT within 5 cm of the SVJ (18.8% vs. 0.0%; P = .02). Patients with GSVT greater than 5 cm from the SVJ showed significantly more GSVT propagation/new saphenous vein thrombosis (0% vs. 31.3%, P = .048). There was a nonsignificant trend toward greater mortality for patients with GSVT within 5 cm of the SVJ (P = .052).

Dr. Kudlaty and her colleagues found that the different management options used, including anticoagulation, observation, and aspirin use, did not significantly affect outcomes ( Ann Vasc Surg. 2017 Nov;45:154-9 ).

“Isolated GSVT can be viewed as a marker of more serious systemic diseases, notably diabetes and cancer, and leaves patients at high risk for thromboembolic events, recurrence, and persistent symptoms, despite a variety of managements,” the researchers concluded.

The authors reported that they had no conflicts of interest and that there were no outside funding sources.

mlesney@frontlinemedcom.com

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