OC 14.2 - Long-term outcomes of superficial vein thrombosis in daily practice: 12-month data from the INSIGHTS-SVT study

Sunday, July 10, 2022

11:00 AM – 11:15 AM

Location: ExCel Center, ICC Capital Suite Room 7&12

Presentation Format: In-Person

Co-Author(s)

ER

Eberhard Rabe, MD

Professor (emeritus)
University of Bonn
Bonn, Nordrhein-Westfalen, Germany
UH

Ulrich Hoffmann

Division of Vascular Medicine, Medical Clinic and Policlinic IV
Ludwig-Maximilians-University
Munich, Bayern, Germany
AS

Alexandra Schimke

Mediical Department
Mylan Pharmaceuticals GmbH
Bad Homburg, Hessen, Germany
AH

Andreas Heinken

Medical Department
Aspen GmbH
Munich, Bayern, Germany
FL

Florian Langer

Medical Specialist in Internal Medicine
Universitätsklinikum Eppendorf, II. Medizinische Klinik und Poliklinik, Hubertus Wald Tumorzentrum, Universitäres Cancer Center Hamburg (UCCH), Hamburg, Germany
Hamburg, Hamburg, Germany
TN

Thomas Noppeney

Department for Vascular and Endovascular Surgery
Martha-Maria Hospital Nuremberg
Nuremberg, Bayern, Germany
DP

David Pittrow

Consultant
Institute for Clinical Pharmacology
Dresden, Bayern, Germany
JK

Jens Klotsche

Epidemiology
German Rheumatism Research Center Berlin (DRFZ)
Berlin, Berlin, Germany
HG

Hort Gerlach

Private Office
Office for Vascular Diseases
Mannheim, Hessen, Germany

Presenting Author(s)

Rupert Bauersachs, MD

Professor
University Medical Center Mainz
Mainz, Rheinland-Pfalz, Germany

Background: Information about the long-term course of superficial vein thrombosis (SVT) in daily practice is limited.

Aims: The INvestigating SIGnificant Health TrendS in the management of SVT study investigated venous thromboembolic events (VTE) and bleeding events over 12 months.

Methods: Prospective observational study, with objectively confirmed acute isolated SVT. Outcomes of interest were deep venous thrombosis (DVT), pulmonary embolism (PE), extension or recurrence of SVT, and, as safety outcome linked to antithrombotic treatment, bleeding events. NCT02699151.

Results: 872 patients with acute SVT as index event with 12-month follow-up were 60.6 ±14.5 years old, 42.4% were women. The majority had varicose veins (76.4%) and often chronic venous insufficiency /ulceration (49.8%), or history of venous thrombosis (41.9%). 62.2% were treated with fondaparinux, 25.0% with low molecular weight heparin, 6.2% with other anticoagulation and 6.6% had no anticoagulation. At 12 months of follow-up, the primary efficacy outcome (symptomatic VTE consisting of DVT, PE, recurrent or extending SVT) had occurred in 108 (14.3%) of patients. The most frequent VTE event was recurrent or extending SVT in 11.0%, followed by DVT in 2.7% and PE in 2.4%. Twelve patients (1.1%) died, and eight (1.8%) were hospitalized due to VTE. Bleeding events occurred in 2.2% of patients, however only 3 cases (0.3%) were major. The rate of primary efficacy outcome was highest in the LMWH group (22.4%) and lowest in the fondaparinux group (10.4%). In a multivariate model, factors associated with “late events”, i.e. those between 3 months and 12 months were: BMI, previous VTE, SVT in the saphenous veins, major surgery, severe systemic infection at entry.

Conclusion(s): Isolated SVT is a common but underrated condition. While the majority of events occurred within 3 months, the risk of symptomatic VTE remained elevated up to 12 months. Thus, in patients with risk factors, prolonged rather than short-term anticoagulation therapy should be considered.