Pathways for lower extremity superficial vein thrombosis management in an academic medical center
There is currently no established management pathway for lower extremity superficial vein thrombosis (SVT), leading to significant uncertainty among front-line providers. This study aimed to assess prescribing practices and patient outcomes for the initial treatment of lower extremity SVT. This des...
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| Language: | English |
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PAGEPress Publications
2025-03-01
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| Series: | Bleeding, Thrombosis and Vascular Biology |
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| Online Access: | https://www.btvb.org/btvb/article/view/155 |
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| author | Gisoo Imani Aaron Wilson Sara Vazquez Daniel M. Witt |
| author_facet | Gisoo Imani Aaron Wilson Sara Vazquez Daniel M. Witt |
| author_sort | Gisoo Imani |
| collection | DOAJ |
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There is currently no established management pathway for lower extremity superficial vein thrombosis (SVT), leading to significant uncertainty among front-line providers. This study aimed to assess prescribing practices and patient outcomes for the initial treatment of lower extremity SVT. This descriptive retrospective cohort study in a single center included consecutive patients with radiographically diagnosed acute lower extremity isolated SVT between January 1, 2016 and December 31, 2021. Exclusions were chronic SVT, concomitant deep vein thrombosis or pulmonary embolism, required anticoagulation for another indication, or no documented SVT treatment plan. This 6-year study included 265 patients. The majority received conservative therapy as the SVT management strategy (n=188, 70.9%), while 23% (n=61) received anticoagulation therapy. Few patients received no treatment (n=13, 4.9%) or surgery (n=3, 1.1%). The most common strategy in those utilizing anticoagulation was a VTE treatment-dose DOAC, but the duration varied considerably (11.5% 30 days or less, 37.7% 31-45 days, 21.3% for 46-90 days, and 24.6% >90 days). Ninety-day progression to VTE occurred in 8 patients (3.1%, 2 in the anticoagulation therapy group and 6 in the conservative therapy group). Bleeding occurred in 6 patients (2.3%, 4 in the conservative therapy group and 2 in the anticoagulation group). Over a six-year period, there were varying pathways of managing acute lower extremity SVT without a concerning signal in adverse events with any single treatment approach. Future study should focus on which patients benefit from anticoagulation therapy vs conservative therapy and clarifying the optimal anticoagulation treatment intensity and duration.
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| format | Article |
| id | doaj-art-547320cda77245ce86e133f82a10dff6 |
| institution | OA Journals |
| issn | 2785-5309 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Bleeding, Thrombosis and Vascular Biology |
| spelling | doaj-art-547320cda77245ce86e133f82a10dff62025-08-20T02:08:40ZengPAGEPress PublicationsBleeding, Thrombosis and Vascular Biology2785-53092025-03-0141Pathways for lower extremity superficial vein thrombosis management in an academic medical centerGisoo Imani0https://orcid.org/0009-0005-2548-9601Aaron Wilson1https://orcid.org/0000-0002-0870-7874Sara Vazquez2https://orcid.org/0000-0002-9267-8980Daniel M. Witt3https://orcid.org/0000-0002-3930-8358Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UTDepartment of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT; Health Thrombosis Service, University of Utah, Murray, UTDepartment of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT; Health Thrombosis Service, University of Utah, Murray, UTDepartment of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT; Health Thrombosis Service, University of Utah, Murray, UT There is currently no established management pathway for lower extremity superficial vein thrombosis (SVT), leading to significant uncertainty among front-line providers. This study aimed to assess prescribing practices and patient outcomes for the initial treatment of lower extremity SVT. This descriptive retrospective cohort study in a single center included consecutive patients with radiographically diagnosed acute lower extremity isolated SVT between January 1, 2016 and December 31, 2021. Exclusions were chronic SVT, concomitant deep vein thrombosis or pulmonary embolism, required anticoagulation for another indication, or no documented SVT treatment plan. This 6-year study included 265 patients. The majority received conservative therapy as the SVT management strategy (n=188, 70.9%), while 23% (n=61) received anticoagulation therapy. Few patients received no treatment (n=13, 4.9%) or surgery (n=3, 1.1%). The most common strategy in those utilizing anticoagulation was a VTE treatment-dose DOAC, but the duration varied considerably (11.5% 30 days or less, 37.7% 31-45 days, 21.3% for 46-90 days, and 24.6% >90 days). Ninety-day progression to VTE occurred in 8 patients (3.1%, 2 in the anticoagulation therapy group and 6 in the conservative therapy group). Bleeding occurred in 6 patients (2.3%, 4 in the conservative therapy group and 2 in the anticoagulation group). Over a six-year period, there were varying pathways of managing acute lower extremity SVT without a concerning signal in adverse events with any single treatment approach. Future study should focus on which patients benefit from anticoagulation therapy vs conservative therapy and clarifying the optimal anticoagulation treatment intensity and duration. https://www.btvb.org/btvb/article/view/155Superficial vein thrombosisdirect oral anticoagulantsanticoagulation |
| spellingShingle | Gisoo Imani Aaron Wilson Sara Vazquez Daniel M. Witt Pathways for lower extremity superficial vein thrombosis management in an academic medical center Bleeding, Thrombosis and Vascular Biology Superficial vein thrombosis direct oral anticoagulants anticoagulation |
| title | Pathways for lower extremity superficial vein thrombosis management in an academic medical center |
| title_full | Pathways for lower extremity superficial vein thrombosis management in an academic medical center |
| title_fullStr | Pathways for lower extremity superficial vein thrombosis management in an academic medical center |
| title_full_unstemmed | Pathways for lower extremity superficial vein thrombosis management in an academic medical center |
| title_short | Pathways for lower extremity superficial vein thrombosis management in an academic medical center |
| title_sort | pathways for lower extremity superficial vein thrombosis management in an academic medical center |
| topic | Superficial vein thrombosis direct oral anticoagulants anticoagulation |
| url | https://www.btvb.org/btvb/article/view/155 |
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