Superficial vein thrombosis associated with higher risk for DVT in lower extremities

About one-fourth of patients with superficial vein thrombosis also suffered from concomitant, asymptomatic deep vein thrombosis, according to data from a prospective study. According to the researchers, the data indicate that concurrent DVT is more likely when superficial vein thrombosis occurs in the lower leg.

The study included 46 patients who presented with superficial vein thrombosis to the outpatient department of the Medical University of Graz in Austria; median age was 65. Upon presentation, all patients underwent color-coded duplex sonography of both lower extremities to confirm diagnosis, and detect or exclude DVT.

The researchers reported a concomitant, mostly asymptomatic DVT in 24% of patients. DVT occurred in the affected leg in 73% of patients, the contralateral leg in 9% and in both legs in 18%. Among patients with DVT, only calf muscles were affected in 36%, thrombosis of perforating veins occurred in 45% and thrombi in posterior tibial veins occurred in 18%.

The median age of patients with DVT was 73 and the median age of those without DVT was 65, but the difference was not statistically significant. DVT was found in the lower leg and calf muscle veins in three patients younger than 60 and in the calf muscle veins and perforating veins in eight patients older than 60.

Superficial vein thrombosis affected the lower leg in all patients with DVT; superficial vein thrombosis affected only the thigh in one-third of patients without DVT. According to the researchers, lower leg superficial vein thrombosis was associated with a higher frequency of DVT (P=.02). D-dimer levels were elevated among patients with DVT; normal levels were only found in patients without DVT (P=.06).

The researchers recommend assessing deep veins with color-coded duplex sonography to exclude or confirm acute DVT in cases where superficial vein thrombosis affects the lower leg.

Binder B. Arch Dermatol. 2009;145:753-757.