Abstract
This review presents the current literature regarding the epidemiology, diagnosis, conservative and surgical treatment
of patients with acute subcutaneous venous thrombosis (ASVT). ASVT is one of the most common in clinical practice
of acute diseases of the vascular system. The consequences of the disease, with untimely treatment, can lead to
long-term and persistent disability of patients due to the spread of the process to the deep venous system and the
development of pulmonary embolism. Analysis of the literature data shows that despite the long-standing interest in
the problem of ASVT, to date, no single approach has been formed regarding the strategy and tactics of treatment for
this pathology. There are still debatable issues of conservative or surgical treatment, radicality and timing of surgical
intervention, the use of new minimally invasive technologies.
References
- Cosmi B. Management of superficial vein thrombosis.J. Thromb. Haemost.2015; 13: 7. DOI: 10.1111/jth.12986
- Studennikova V.V., Severgina L.O., Dzyundzya А.N.,Korovin I.А. Mechanisms of development and featuresof varicose veins of the lower extremities in childhoodand young age. Аrkhiv Patologii (Archive of Pathology).2017; 79 (4): 56–60 (in Russ.). DOI: 10.17116/patol201779456-60
- Perepelkina N.Yu., Bizmenov I.M. Medico-social char-acteristics and prevalence of risk factors among patientswith varicose veins of the lower extremities. IzvestiyaSamarskogo Nauchnogo Tsentra Rossijskoj Akademii Nauk(News of the Samara Scientific Center of the RussianAcademy of Sciences).2014; 5 (2): 798–800 (in Russ.)
- Bogachev V.Yu., Kaperiz K.A., Lobanov V.N. Effective-ness of multicomponent topical preparations in patientswith acute thrombophlebitis of the veins of the lowerextremities. Russkij Meditsinskij Zhurnal (RussianMedical Journal).2017; 28: 2035–8 (in Russ.)
- Nasr H. Superficial thrombophlebitis (superficial venous
thrombosis). BMJ. 2015; 350: 2039. DOI: 10.1136/bmj.h2039
- Décousus H., Bertoletti L., Frappé P. Spontaneous
acute superficial vein thrombosis of the legs: do we really
need to treat? J. Thromb. Haemost. 2015; 13: 230–7.
DOI: 10.1111/jth.12925.
- Frappé P., Buchmuller-Cordier A., Bertoletti L., Bonithon-
Kopp C., Couzan S., Lafond P. et al. STEPH Study
Group. Annual diagnosis rate of superficial vein thrombosis
of the lower limbs: the STEPH community-based
study. J. Thromb. Haemost. 2014; 12 (6): 831–8.
DOI: 10.1111/jth.12575
- Décousus H., Quéré I., Presles E., Becker F., Barrellier
M.T., Chanut M. et al. POST Study Group.
Superficial venous thrombosis and venous thromboembolism:
a large, prospective epidemiologic study. Ann.
Intern. Med. 2010; 152 (4): 218–24. DOI: 10.7326/0003-4819-152-4-201002160-00006
- Galanaud J.P., Genty C., Sevestre M.A., Brisot D.,
Lausecker M., Gillet JL. et al. OPTIMEV SFMV
Investigators. Predictive factors for concurrent deep vein
thrombosis and symptomatic venous thromboembolic
recurrence in case of superficial venous thrombosis.
Thromb. Haemost. 2011; 105 (1): 31–9. DOI: 10.1160/TH10-06-0406
- Clement D.L. Superficial vein thrombosis: more dangerous
than anticipated. Phlebolymphology. 2013; 20 (4): 188.
- Nuzova O.B., Demin D.B., Avchenko M.T., Kondra-shov N.N., Lisitskij N.N., Soldatov Yu.N. et al. Impro-ving the efficiency of diagnosis and treatment of acutevaricothrombophlebitis.Orenburgskij Meditsinskij Vestnik(Orenburg Medical Bulletin). 2013; 1 (3): 23–5 (in Russ.).
- Orel M.G. The frequency of detection of deep veinthrombosis of the lower extremities in thrombotic lesionsof the subcutaneous veins. Novosti Khirurgii (SurgeryNews).2015; 23 (1): 63–8 (in Russ.). DOI: 10.18484/2305-0047.2015.1.63
- Scott G., Mahdi A.J., Alikhan R. Superficial vein thrombosis:
a current approach to management. Br. J.
Haematol. 2015; 168: 639–45. DOI: 10.1111/bjh.13255
- Chernyakov А.V. Modern aspects of treatment of patientswith acute thrombophlebitis of superficial veins of thelower extremities. Russkij Meditsinskij Zhurnal (RussianMedical Journal).2016; 9: 519–22 (in Russ.).
- Givirovskaya N.E., Mikhal'skij V.V. Thrombosis andthrombophlebitis of lower extremity veins: etiology,diagnosis and treatment. Russkij Meditsinskij Zhurnal(Russian Medical Journal).2009; 25: 1663 (in Russ.).
- Kalodiki E., Stvrtinova V., Allegra C., Andreozzi G.M.,
Antignani P.L., Avram R. et al. Superficial vein thrombosis:
a consensus statement. Int. Angiol. 2012; 31:
203–16.
- Shevchenko Yu.L., Stoyko Yu.M. Fundamentals of clini-cal phlebology. 2nd edn. Moscow; 2013 (in Russ.).
- Bauersachs R.M. Diagnosis and treatment of superficial
vein thrombosis. Hamostaseologie. 2013; 33 (3): 232–40.
DOI: 10.5482/HAMO-13-04-0027
- Ascher E., Hanson J.N., Salles-Cunha S., Hingorani A.
Lesser saphenous vein thrombophlebitis: its natural history
and implications for management. Vasc. Endovas. Surg.
2003; 37 (6): 421–7. DOI: 10.1177/ 153857440303700606
- Tsarev O.А., Аnisimov А.Yu., Zakharov N.N., Korobov А.V.Surgical tactics in patients with varicothrombophlebitiswith undifferentiated connective tissue dysplasia. Sara-tovskij Nauchno-Meditsinskij Zhurnal (Saratov ScientificMedical Journal).2016; 12 (1): 66–9 (in Russ.).
- Quéré I., Leizorovicz A., Galanaud J.P., Presles E.,
Barrellier M.T., Becker F. Superficial venous thrombosis
and compression ultrasound imaging. J. Vasc. Surg. 2012;
56 (4): 1032–8. DOI: 10.1016/j.jvs.2012.03.014
- Marushchak E.А., Zubarev А.R., Demidova А.K.Methodology of venous thrombosis ultrasound research.Statsionarozameshchayushchie Tekhnologii: Аmbulator-naya Khirurgiya (Hospital Replacement Technologies:Outpatient Surgery).2016; 1 (2): 78–87 (in Russ.).
- Bychkova T.V., Аndriyashkin V.V., Zolotukhin I.А.,Leont'ev S.G., Kirienko А.I. Surgery for acute thrombo-sis of the femoral vein. Flebologiya (Phlebology).2010;4 (2): 13–6 (in Russ.).
- Hirmerova J., Seidlerova J., Subrt I. Deep vein thrombosis
and/or pulmonary embolism concurrent with superficial
vein thrombosis of the legs: cross-sectional single
center study of prevalence and risk factors. Int. Angiol.
2013; 32 (4): 410–6.
- Nisio M., Wichers I.M., Middeldorp S. Treatment for
superficial thrombophlebitis of the leg. Cochrane Database
Syst. Rev. 2013; 30 (4): CD004982. DOI: 10.1002/14651858.CD004982.pub5.
- Gillet J.L., French P., Hanss M., Allaert F.A., Chleir F.
Predictive value of D-dimer assay in superficial thrombophlebitis
of the lower limbs. J. Mal. Vasc. 2007; 32:
90–5. DOI: 10.1016/j.jmv.2007.01.111
- Sobreira M.L., Rogatto S.R., Dos Santos R.M., Santos
I.T., Ferrari I.C., Yoshida W.B. An unexpectedly high
rate of thrombophilia disorders in patients with superficial
vein thrombosis of the lower extremities. Ann. Vasc.
Surg. 2017; 43: 272–7. DOI: 10.1016/j.avsg.2017.02.022
- Vasil'ev S.А., Vinogradov V.L., Smirnov А.N., Pogorel's-kaya E.P., Markova M.L. Thrombosis and thrombophilia:classification, diagnosis, treatment, prevention. RusskijMeditsinskij Zhurnal (Russian Medical Journal).2013; 17:896 (in Russ.)
- Marcone L.S. Complications and treatment of superficial
thrombophlebitis. J. Vasc. Bras. 2015; 14 (1): 1–3.
DOI: 10.1590/1677-5449.20151401
- Supil'nikov А.А., Pribytkov D.L., Starostina А.А. Theoptimal method of choice of operation in acute ascend-ing thrombophlebitis of the superficial veins of the lowerextremities. Vestnik Meditsinskogo Instituta «REАVIZ»(Bulletin of the Medical Institute “REAVIZ”).2017; 5 (29):65–8 (in Russ.).
- Boehler K., Kittler H., Stolkovich S., Tzaneva S.
Therapeutic effect of compression stockings versus no
compression on isolated superficial vein thrombosis of
the legs: a randomized clinical trial. Eur. J. Vasc.
Endovasc. Surg. 2014; 48 (4): 465–71. DOI: 10.1016/j.ejvs.2014.06.047
- Belcaro G., Cesarone M.R., Dugall M., Feragalli B.,
Ippolito E., Corsi M. et al. Topical formulation of
heparin is effective in reducing the symptoms of superficial
venous thrombosis: a monocenter, observer-blind,
placebo-controlled randomized study. Panminerva Medica.
2011; 53 (3 Suppl. 1): 3–11.
- Szopiński P., Michalak J., Marianowska A., Borkowski M.,
Geremek M., Trochimczuk M. et al. Liposomal heparin
spray: a new formula in adjunctive treatment of superficial
venous thrombosis. Angiology. 2005; 56 (1): 9–17.
DOI: 10.1177/000331970505600102
- Becherucci A., Bagilet D., Marenghini J., Diab M.,
Biancardi H. et al. Effect of topical and oral diclofenac
on superficial thrombophlebitis caused by intravenous
infusion. Med. Сlin. 2000; 114 (10): 371–3. DOI: 10.1016/s0025-7753(00)71300-5
- The superficial thrombophlebitis treated by enoxaparin
Study, G., A pilot randomized double-blind comparison
of a low-molecular-weight heparin, a nonsteroidal antiinflammatory
agent, and placebo in the treatment of
superficial vein thrombosis. Arch. Int. Med. 2003;
163 (14): 1657–63. DOI: 10.1001/archinte.163.14.1657
- Uncu H. A comparison of low-molecular-weight heparin
and combined therapy of low-molecular-weight heparin
with an anti-inflammatory agent in the treatment of
superficial vein thrombosis. Phlebology. 2009; 24 (2):
56–60. DOI: 10.1258/phleb.2008.008025
- Lane T.R., Sritharan K., Herbert J.R., Franklin I.J., Davies
A.H. The disparate management of superficial venous
thrombosis in primary and secondary care. Phlebology.
2015; 30: 172–9. DOI: 10.1177/0268355514521184
- Dua A., Heller J.A., Patel B., Desai S.S. Variability in the
management of superficial venous thrombophlebitis
across practitioners based in North America and the
global community. Thrombosis. 2014; 2014: 306018.
DOI: 10.1155/2014/306018
- Maddox R.P., Seupaul R.A. What is the most effective
treatment of superficial thrombophlebitis? Ann. Emerg.
Med. 2016; 67 (5): 671–2. DOI: 10.1016/j.annemergmed.2015.10.018
- Shabunin A.V., Gavrilov S.G., Pustovait A.A., Bychko-va T.V., Karalkin A.V., Zolotukhin I.A. Comparativestudy of surgical and conservative tactics in patients withsuperficial thrombophlebitis of great saphenous vein.Phlebologia (Phlebology). 2013; 7 (2): 10–4 (in Russ.).
- Tsukanov Yu.T., Nikolajchuk А.I. The results of the treat-ment of patients with thrombosis of the subcutaneous veins.Journal of Siberian Medical Sciences.2015; (2): 12 (in Russ.).
- Tsukanov Yu.T., Nikolajchuk А.I. The immediate resultsof the use of anticoagulants as the component of thecombined therapy of superficiac. Flebologiya (Phlebology).2015; 9 (2): 42–7 (in Russ.). DOI: 10.17116/flebo20159242-46
- Beyer-Westendorf J., Controversies in venous thromboembolism:
to treat or not to treat superficial vein
thrombosis. ASH Education Program Book, 2017. 2017 (1):
223–30. DOI: 10.1182/asheducation-2017.1.223
- Décousus H., Prandoni P., Mismetti P., Bauersachs R.M.,
Boda Z., Brenner B. et al. Fondaparinux for the treatment
of superficial-vein thrombosis in the legs. N. Engl.
J. Med. 2010; 363 (13): 1222–32. DOI: 10.1056/NEJMoa0912072
- Beyer-Westendorf J., Schellong S.M., Gerlach H.,
Rabe E., Weitz J.I., Jersemann K. et al. Prevention of
thromboembolic complications in patients with superficial-
vein thrombosis given rivaroxaban or fondaparinux:
the open-label, randomised, non-inferiority SURPRISE
phase 3b trial. Lancet Haematol. 2017; 4 (3): 105–13.
DOI: 10.1016/S2352-3026(17)30014-5
- Rathbun S.W., Aston C.E., Whitsett T.L. A randomized
trial of dalteparin compared with ibuprofen for the treatment
of superficial thrombophlebitis. J. Thromb. Haemostas.
2012; 10 (5): 833–9. DOI: 10.1111/j.1538-7836.2012.04669.x
- Cosmi B., Filippini M., Tonti D., Avruscio G., Ghirarduzzi
A., Bucherini E. et al. A randomized double-blind
study of low-molecular-weight heparin (parnaparin) for
superficial vein thrombosis: STEFLUX (Superficial
ThromboEmbolism and Fluxum). J. Thromb. Haemostas.
2012; 10 (6): 1026–35. DOI: 10.1111/j.1538-7836.2012.04727
- Russian clinical guidelines for the diagnosis, treatmentand prevention of venous thromboembolic complications(VTEC). Flebologiya (Phlebology).2015; 9: 2–4 (in Russ.)
- Borsov M.Kh., Mikhailichenko M.V. Surgical treatmentof patients with acute varicose thrombosis. NovyeTekhnologii (New Technologies).2014; 2: 45–8 (in Russ.).
- Kalinin R.E., Narizhnyj M.V., Suchkov I.А. Embolismof acute ascending thrombophlebitis of superficial veinsof lower extremities. Rosiyskij Mediko-BiologycheskijVestnik im. Akademika I.P. Pavlova (Russian Medical Bio-logical Bulletin named after Academician I.P. Pavlov).2011;2: 19 (in Russ.). DOI: 10.17816/PAVLOVJ2011219-19
- Lozano F.S., Almazan A. Low-molecular-weight heparin
versus saphenofemoral disconnection for the treatment
of above-knee greater saphenous thrombophlebitis:
a prospective study. Vasc. Endovasc. Surg. 2003; 37 (6):
415–20. DOI: 10.1177/153857440303700605
- Dubrovshhik O.I., Dovnar I.S., Sytyj А.А., Rakovich D.Yu.,Zhuk D.А., Gerasimovich А.Yu., Khil'monchik Ya.I.Tactics of treatment of acute thrombosis of deep andthrombophlebitis of superficial veins of the lower extre-mities. In: Actual problems of medicine: materials of theannual final scientific-practical conference (26–27 janu-ary's 2017). Grodno; 2017: 285–9 (in Russ.).
- Pustovoit А.А., Gavrilov S.G., Zolotukhin I.А. Tacticsof treatment of acute ascending thrombophlebitis.Flebologiya (Phlebology). 2011; 5 (3): 46–52 (in Russ.).
- Gradman W.S. Endovenous saphenous vein ablation
in patients with acute isolated superficial-vein thrombosis.
Phlebology. 2015; 30 (3): 204–9. DOI: 10.1177/0268355513514047
- Enzler M.A. Russell D., Schimmelpfennigc J. Thermal
ablation in the management of superficial thrombophlebitis.
Eur. J. Vasc. Endovasc. Surg. 2012; 43 (6):
726–8. DOI: 10.1016/j.ejvs.2012.02.012
- Bishara R.A., Taha W., Grace A.I. Great saphenous vein
ablation for the treatment of superficial thrombophlebitis
complicated by pulmonary embolism. Eur. J. Vasc.
Endovasc. Surg. 2014; 27 (2): 10–2. DOI: 10.1016/j.ejvsextra.2013.11.007
- Burleva E.P., Smirnov O.A., Tyurin S.A. Stripping of thegreat saphenous vein. Phlebologia (Phlebology). 2017; 2:76–82 (in Russ.). DOI: 10.17116/flebo201711276-82
- Shaidakov E.V., Petukhov А.V., Iliukhin E.А. Chronicvenous diseases related quality of life. Flebologiya(Phlebology).2011; 3: 64–8 (in Russ.).
- Аgapov А.B. Quality of life assessment using question-naires in patients with lower limb vein disease. RossijskijMediko-Biologicheskij Vestnik imeni Akademika I.P. Pav-lova (Russian Medical Biological Bulletin named afterAcademician I.P. Pavlov).2015; 3: 126–32 (in Russ.).
DOI: 10.17816/PAVLOVJ20153126-133
About the authors
- Sergey I. Pryadko, Cand. Med. Sc., Chief of Department; orcid.org/0000-00019478-8414
-
Sup’yan S. Atuev, Postgraduate; orcid.org/0000-0003-2390-8962
-
Aleksandr A. Malinin, Dr. Med. Sc., Leading Researcher; orcid.org/0000-0003-4652-4590