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

1University of Bonn, Bonn, Nordrhein-Westfalen, Germany, 2Ludwig-Maximilians-University, Munich, Bayern, Germany, 3Mylan Pharmaceuticals GmbH, Bad Homburg, Hessen, Germany, 4Aspen GmbH, Munich, Bayern, Germany, 5II. Medizinische Klinik und Poliklinik, Zentrum für Onkologie, UKE, Hamburg, Germany, Hamburg, Hamburg, Germany, 6Martha-Maria Hospital Nuremberg, Nuremberg, Bayern, Germany, 7Institute for Clinical Pharmacology, Dresden, Bayern, Germany, 8German Rheumatism Research Center Berlin (DRFZ), Berlin, Berlin, Germany, 9Office for Vascular Diseases, Mannheim, Hessen, Germany, 10Standort AGAPLESION Bethanien Krankenhaus, Frankfurt, Hessen, Germany

Abstract Number: OC 14.2

Meeting: ISTH 2022 Congress

Theme: Venous Thromboembolism » VTE Treatment

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.

To cite this abstract in AMA style:

Rabe E, Hoffmann U, Schimke A, Heinken A, Langer F, Noppeney T, Pittrow D, Klotsche J, Gerlach H, Bauersachs R. Long-term outcomes of superficial vein thrombosis in daily practice: 12-month data from the INSIGHTS-SVT study [abstract]. https://abstracts.isth.org/abstract/long-term-outcomes-of-superficial-vein-thrombosis-in-daily-practice-12-month-data-from-the-insights-svt-study/. Accessed September 27, 2023.

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