UOTW #77 Answer

ANSWER:  Anticoagulation

  • This patient presents with a superficial venous thrombosis of >5cm in length
  • Further evaluation of the SVT demonstrates extension into the common femoral vein (A deep vein)
  • A superficial venous thrombosis (SVT) often presents with an area of redness, pain, warmth along the distribution of a superficial vein, often with a palpable cord.
  • SVT is estimated to occur at a rate of 4 per 1000 per year in the US.1
  • SVT’s have traditionally thought to be a benign disease, and treated with NSAIDS and warm compresses.2
  • However, recent literature shows that the rate of concomitant DVT and PE can be as high as 25% and 5%, respectively. 3
  • Current ACCP guidelines recommend treatment with fondaparinux or LMWH if the SVT is >5cm in length.4

REFERENCES

  1. Blumenberg RM, Barton E, Gelfand ML, Skudder P, Brennan J. Occult deep venous thrombosis complicating superficial thrombophlebitis. Journal of vascular surgery. 27(2):338-43. 1998. [pubmed]
  2. Cosmi B. Management of superficial vein thrombosis. Journal of thrombosis and haemostasis : JTH. 13(7):1175-83. 2015. [pubmed]
  3. Frappé P, Buchmuller-Cordier A, Bertoletti L. Annual diagnosis rate of superficial vein thrombosis of the lower limbs: the STEPH community-based study. Journal of thrombosis and haemostasis : JTH. 12(6):831-8. 2014. [pubmed]
  4. Kearon C, Akl EA, Comerota AJ. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 141(2 Suppl):e419S-94S. 2012. [pubmed]

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