DVT occurred in 2.7% of all SVTP patients as compared with 0.2% in the controls (OR=10.2; 95% confidence interval [CI], 2.0-51.6).
Discussion Spontaneous SVTP in the leg is a risk factor for DVT, but is less predictive in patients with prior DVT.
The association between spontaneous superficial venous thrombophlebitis (SVTP) and subsequent venous or arterial thromboembolic events has been studied among referred populations, but not in the primary care setting.
We found that, although the risk of developing a deep venous thrombosis (DVT) following SVTP is real, the absolute risk is quite low.
Until the early 1990s, no relationship had been established between SVTP and either DVT or pulmonary embolism (PE).
(4-7) In a prospective hospital-based study, DVT occurred in approximately 2% of the patients with SVTP during 3 months of follow-up.
This perceived increased risk led to trials that showed a significant reduction within 12 days in the incidence of recurrent or extended SVTP among patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or low-molecular-weight heparins, compared with those receiving placebo.
The primary objective of the present study was to determine the association between a history of SVTP and subsequent venous or arterial thromboembolic events in patients, presenting in a primary care setting with a spontaneous episode of SVTP of the leg.
The exposed cohort consisted of patients who had presented to their family physician with an uncomplicated and spontaneous SVTP. Nonexposed patients had no history of SVTP, but were matched for practice, age (within 1 year), and sex.
In the central electronic medical database, possible consultations concerning SVTP were identified using truncated keywords.
(7) A randomized trial of infusion-related SVTP (n=100) found that 2% nitroglycerin gel eliminated pain in 50 hours vs 72 hours with topical heparin (P<.05).
For SVTP of the leg that does not include the proximal saphenous vein, Up To Date recommends compression and oral NSAIDs, noting that NSAIDs are inexpensive, help with symptom control, and appear comparable to low-molecular-weight heparin in limiting complications.