|Saphenous vein thrombophlebitis (SVT): a deceptively benign disease.|
|PMID: 9576081 Owner: NLM Status: MEDLINE|
|PURPOSE: The association between deep vein thrombosis (DVT) and the hypercoagulable state is a well-established entity. However, the association between saphenous vein thrombophlebitis and coagulation abnormalities has not been investigated. Although thrombosis of varicose veins typically runs a benign course, phlebitis of the saphenous system may propagate to the deep system or saphenofemoral junction that requires more aggressive therapy. Given the potential similarity in clinical outcome between saphenous vein thrombophlebitis (SVT) and DVT, we have investigated the coagulation profile of patients presenting with isolated SVT.
METHODS: Seventeen consecutive patients who presented to our vascular laboratory with isolated SVT had a coagulation profile performed that included antithrombin III (AT III), protein C (PC), protein S (PS) antigen and activity levels, activated protein C (APC) resistance, factor V DNA mutation, and coagulation factors II and X. All patients had duplex scans performed on both the superficial and deep venous systems. Patients with SVT only were treated with nonsteroidal antiinflammatory drugs (NSAIDs) and warm soaks as outpatients, whereas those patients found to have DVT or a clot at the saphenofemoral junction were fully anticoagulated with heparin and coumadin therapy. All 17 patients had at least one repeat coagulation profile performed up to 5 months after their SVT occurrence to ensure that the results of hypercoagulability were not transient.
RESULTS: Ten (59%) of the 17 patients with SVT had abnormal coagulation profiles on initial presentation. All 10 patients who were hypercoagulable had repeat tests and 6 (35%) remained abnormal. Four patients who had abnormal results converted to normal values. Seven patients with normal coagulation profiles on initial presentation had repeat tests and all remained normal.
CONCLUSION: The incidence of the hypercoagulable state in patients with SVT is high. Thirty-five percent of patients with isolated SVT had consistently abnormal coagulation profiles. Patients with SVT may be prone to the development of DVT or saphenofemoral junction thrombophlebitis and should be closely followed after the initial diagnosis of hypercoagulability.
|J N Hanson; E Ascher; P DePippo; E Lorensen; M Scheinman; W Yorkovich; A Hingorani|
|Type: Journal Article|
|Title: Journal of vascular surgery Volume: 27 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 1998 Apr|
|Created Date: 1998-05-28 Completed Date: 1998-05-28 Revised Date: 2012-10-03|
Medline Journal Info:
|Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: UNITED STATES|
|Languages: eng Pagination: 677-80 Citation Subset: IM|
|Maimonides Medical Center, Brooklyn, NY 11219, USA.|
|APA/MLA Format Download EndNote Download BibTex|
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Anticoagulants / blood, therapeutic use
Antigens / blood
Antithrombin III / analysis
Blood Coagulation Disorders / blood, complications, physiopathology
DNA / genetics
Factor V / analysis, genetics
Factor X / analysis
Femoral Vein / physiopathology
Fibrinolytic Agents / blood
Heparin / therapeutic use
Mutation / genetics
Phlebitis / physiopathology
Postphlebitic Syndrome / etiology, physiopathology
Protein C / analysis
Protein S / analysis, immunology
Prothrombin / analysis
Saphenous Vein / physiopathology*, ultrasonography
Serine Proteinase Inhibitors / blood
Thrombophlebitis / etiology
Thrombosis / blood, etiology, physiopathology*, therapy, ultrasonography
Ultrasonography, Doppler, Duplex
Varicose Veins / physiopathology
Warfarin / therapeutic use
|0/Anti-Inflammatory Agents, Non-Steroidal; 0/Anticoagulants; 0/Antigens; 0/Fibrinolytic Agents; 0/Protein C; 0/Protein S; 0/Serine Proteinase Inhibitors; 81-81-2/Warfarin; 9000-94-6/Antithrombin III; 9001-24-5/Factor V; 9001-26-7/Prothrombin; 9001-29-0/Factor X; 9005-49-6/Heparin; 9007-49-2/DNA|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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