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Management of superficialis thrombophlebitis. Guidelines of the Angiologiy Section of the Slovak Medical Chamber (2013)


Authors: P. Gavorník  1 3;  A. Dukát 1,3;  Ľ. Gašpar 1,3
Authors place of work: II. interná klinika Lekárskej fakulty UK a UN Bratislava, Slovenská republika, prednosta doc. MU Dr. Ľudovít Gašpar, PhD. 1;  Prvé angiologické pracovisko (PAP) II. internej kliniky Lekárskej fakulty UK a UN Bratislava, Slovenská republika, vedúci lekár doc. MU Dr. Peter Gavorník, PhD., mim. prof. 2;  Angiologická sekcia Slovenskej lekárskej komory Bratislava, Slovenská republika, predseda doc. MU Dr. Peter Gavorník, PhD., mim. prof. 3
Published in the journal: Vnitř Lék 2013; 59(11): 1009-1016
Category: Guidelines

Summary

The aim of Guidelines of the Angiology Section of the Slovak Medical Chamber (AS SMC) is to address a last european guidelines for the management of thrombophlebitis superficialis, as well as results in evidence‑based‑ medicine (EBM) in order to assess their contribution to our expanding knowledge on rational management of thrombophlebitis superficialis.

Discussion:
Superficial thrombophlebitis is a common disease, usually considered to be benign. However, the practice of systemic duplex ultrasonography has revealed a large number of cases of deep vein thrombosis concomitant with superficial thrombophlebitis. Assessment of clinical probability of deep vein thrombosis and venous tromboembolism and systematic duplex ultrasound investigation has been proposed in the initial management of superficial thrombophlebitis, to detect the presence of any underlying deep vein thrombosis. In contrast with extensive information on the management of deep vein thrombosis, there is little knowledge about the most appropriate treatment of the superficial thrombophlebitis.

Conclusion:
The treatment of superficial thrombophlebitis should improve local symptoms while preventing the development of complications such as venous thromboembolism. The most effective therapeutic approach to superficial thrombophlebitis seems to be represented by fondaparinux (a synthetic selective indirect inhibitor of factor Xa) which have been shown to prevent VTE events and the extension and/ or recurrence of superficial thrombophlebitis.

Key words:
superficial thrombophlebitis –  CEAP classification –  dia­gnosis –  treatment


Zdroje

1. Gavorník P. Všeobecná angiológia. Angiologická propedeutika. Cievne choroby. Bratislava: Univerzita Komenského‑ Vydavateľstvo UK 2001.

2. Blättler W, Schwarzenbach B, Largiader J. Superficial vein thrombophlebitis –  serious concern or much ado about little? Vasa 2008; 37: 31– 38.

3. Decousus H, Quéré I, Presles E et al. Superficial Venous Thrombosis and Venous Thromboembolism. A Large, Prospective Epidemiologic Study. Ann Intern Med 2010; 152: 218– 224.

4. Leon L, Giannoukas AD, Dodd D et al. Clinical significance of superficial vein thrombosis. Eur J Vasc Endovasc Surg 2005; 29: 10– 17.

5. Kalodiki E, Stvrtinova V, Allegra C et al. Superficial vein thrombosis: a consensus statement. Int angiol 2012; 31: 203– 216.

6. Ramelet AA, Perrin M, Kern P et al. Phlebology. Issy‑ les‑ Moulineaux: Elsevier Masson SAS 2008.

7. Broulíková A, Bulvas M, Karetová D. Angiologie 2007. Trendy soudobé angiologie. 2. zväzok. Praha: Galén 2007.

8. Herman J, Musil D. Žilní onemocnění v klinické praxi. Praha: Grada Publishing 2011.

9. Remková A et al. Žilová trombóza a pľúcna embólia. Bratislava: Samedi 2013.

10. Puchmayer V, Roztočil K et al. Praktická angiologie. Praha: Triton 2003.

11. Grüne S, Orlik J, Von Korn H. Clinical signs in the dia­gnosis of deep vein thrombosis. Int Angiol 2011; 30: 64– 70.

12. Gillet JL, Allaert FA, Perrin M. Superficial thrombophlebitis in non varicose veins of the lower limbs. A prospective analysis in 42 patients. J Mal Vasc 2004; 29: 263– 272.

13. Beebe HG, Bergan JJ, Bergqvist D et al. Classification and grading of chronic venous disease in the lower limbs. A consensus statement. Int Angiol 1995; 14: 197– 201.

14. Eklof B, Rutherford RB, Bergan JJ et al. Revision of the CEAP classification for venous disorders: consensus statement. J Vasc Surg 2004; 40: 1248– 1252.

15. Gavorník P. Choroby ciev všeobecne a havajská „CEAP“ klasifikácia chronickej vénovej choroby dolných končatín. In: Klyscz T, Jünger M Aktívne proti ochoreniam žíl (z nemeckého originálu Aktiv gegen venenleiden. Falken‑ Verlag GmbH, Niederhausen 1996). Frýdek‑ Místek/ Bratislava: Alpress/ Motýľ 1998, 6– 9.

16. Sarica‑ Kucukoglu R, Akdag‑ Kose A, Kayabal IM et al. Vascular involvement in Behcet’s disease: a retrospective analysis of 2,319 cases. Int J Dermatol 2006; 45: 919– 921.

17. Gavorník P, Gašpar Ľ, Dukát A. Kombinovaná kinezio‑ flebotromboemboloprofylaxia, mechano‑ flebotromboemboloprofylaxia a farmako‑ flebotromboemboloprofylaxia vénovej tromboembólie v internej medicíne. Odporúčania Sekcie angiológov Slovenskej lekárskej komory (SA SLK). Vnitř Lék 2012; 58: 851– 855.

18. Wells PS, Anderson DR, Bormanis J et al. Value of assessment of pretest probability of deep‑ vein thrombosis in clinical management. Lancet 1997; 350: 1795– 1798.

19. Wells PS, Anderson DR, Rodger M et al. Derivation of a simple clinical model to categorize of patients probability of pulmonary embolism: increasing of models utility with the SimpliRED D‑dimer. Thromb Haemost 2000; 83: 416– 420.

20. Le Gal G, Righini M, Roy PM et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med 2006; 144: 165– 171.

21. Antignani PL, Benedetti‑ Valentini F, Aluigi L et al. Dia­gnosis of vascular diseases. Ultrasound investigations –  Guidelines. Int angiol 2012; 31 (Suppl 1): 1– 77.

22. Malgor RD, Labropoulos N. Dia­gnosis of venous disease with duplex ultrasound. Phlebology 2013; 28 (Suppl 1): 158– 161.

23. De Maeseneer MG. Superficial thrombophlebitis of the lower limb: Practical recommendations for dia­gnosis and treatment. Acta Chir Belg 2005; 105: 145– 147.

24. Di Nisio M, Middeldorp S, Wichers I. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev 2007; 24: CD004982.

25. Ramelet AA, Kern P, Perrin M. Varicose veins and telangiectasias. Paris: Elsevier 2004.

26. Gavorník P. Kompresívna terapia v prevencii a liečbe chorôb vénového a lymfového cievneho systému dolných končatín. Gen Angiol 2002; 2: 83– 87.

27. Partsch H, Rabe E, Stemmer R. Compression therapy of the extremities. Paris: Editions Phlebologiques Francaises 2000.

28. Mosti G, Pecerni P, Partsch H. Compression stockings with moderate pressure are able to reduce chronic leg oedema. Phlebology 2012; 27: 289– 296.

29. Mosti G. Post‑treatment compression: duration and technique. Phlebology 2013; 28 (Suppl 1): 21– 24.

30. MacLean S, Mulla S, Akl E et al. Antithrombotic Therapy and Prevention of Thrombosis. American College of Chest Physicians (ACCP) evidence‑based clinical practice guidelines. Chest 2012; 141 (Suppl 2): e1S‑ e23S.

31. Prandoni S, Tormene D, Pesavento R et al.High vs. low doses of low molecular weight heparin for the treatment of superficial vein thrombosis of the legs: a double blind, randomized trial. J Thromb Haemost 2005; 3: 1152– 1157.

32. Hirsch J. Guidelines for antithrombotic therapy. Hamilton: BC Decker Inc 2008.

33. Decousus H, Prandoni P, Mismetti P et al.CALISTO Study group. Fondaparinux for the Treatment of Superficial‑ Vein Thrombosis in the legs. N Engl J Med 2010; 363: 1222– 1232.

34. Welzel D, Hull R, Fareed J. Prophylaxis of venous thromboembolism: low molecular weightheparin compared to the selective anticoagulants rivaroxaban, dabigatran and fondaparinux. Int Angiol 2011; 30: 199– 211.

35. Torbicki A, Perrier A, Konstantinides S et al.Guidelines on the dia­gnosis and management of acute pulmonary embolism: The Task Force for the Dia­gnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 2008; 29: 2276– 2315.

36. Nicolaides AN, Fareed J, Kakkar AK et al. Prevention and treatment of venous thromboembolism. International Consensus Statement (guidelines according to scientific evidence). Int Angiol 2006; 25: 101– 161.

37. Malý J, Pecka M, Malý R. Nová an­ti­trom­botika v prevenci žilní tromboembolie a nové protidestičkové léky. Vnitř Lék 2011; 57: 733– 739.

38. Górski G, Szopinski P, Michalak J et al. Liposomal heparin spray: a new formula in adjunctive treatment of superficial venous thrombosis. Angiology 2005; 56: 9– 17.

39. Hirmerová J. Povrchová tromboflebitida, neprávem podceňovaná choroba –  je čas změnit názor? Vnitř Lék 2012; 58: 647– 653.

40. Prevention and treatment of venous thromboembolism – International Consensus Statement. Int Angiol 2013; 32: 111–260.

Štítky
Diabetology Endocrinology Internal medicine

Článok vyšiel v časopise

Internal Medicine

Číslo 11

2013 Číslo 11
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