I have just attended an interesting talk about superficial vein thrombosis at the European Haematology Association meeting in Copenhagen.
First a bit about the meeting.
- 10,000 delegates; doctors, nurse and scientists
- Held each year in a different city in Europe
- Over 250 sessions covering all aspects of haematology from basic science to the latest clinical research.
Why I attend?
I find these conferences a great way to get up to date information about the latest development and to see what new treatments are just around the corner.
Thrombophlebitis or Superficial vein clots – What you should know
- Not as common as a DVT. Only about 6 in every 10,000 people per year whereas DVT are 20 in every 10,000. Blood clots in the superficial veins of the leg give symptoms very similar to a deep vein thrombosis, but often a firm lump can be felt over the veins in the leg. They commonly occur with varicose veins.
- The size of the clot is important. Most superficial clots are very small (less than 5cm) and localised to a varicose vein, but a clot larger than 5cm is more likely to extend to the deep veins.
- They can be associated with a DVT. One study showed that approximately 20% of people with a large superficial vein clot also had a DVT on ultrasound and a very small number had a PE.
- They can be hard to diagnose. There are several causes of a painful red leg and a superficial clot is not always obvious. A condition called cellulitis can look similar and is treated in a different way. We often use a test called the d-dimer to diagnose a DVT but this test is not so reliable for superficial clots, it is negative in 20% of cases. An ultrasound may be necessary.
- Treatment is different for different size clots. Small clots often only need treatment with an anti-inflammatory, like diclofenac or ibuprofen, however larger clots need treatment with an anticoagulant, and clots in a vein called the long saphenous vein need to be treated like a DVT if they extend to within 3 cm of the deep veins.
Conferences help to answer some questions but the discussion often raises other issues. In the case of superficial clots, it is still not clear for how long treatment should be given or what is the correct dose. Perhaps we will have sorted that by the next conference.
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