Varicose vein surgery after acute isolated superficial vein thrombosis in daily practice: INSIGHTS-SVT study
Creators: name: Noppeney, Thomas
name: Rabe, Eberhard
name: Hoffmann, Ulrich
name: Schimke, Alexandra
name: Heinken, Andreas
name: Langer, Florian
name: Pittrow, David
name: Klotsche, Jens
name: Gerlach, Horst E.
name: Bauersachs, Rupert
name: Schnabl, Christian
name: Winterbauer, Tina
name: Schön, Norbert Harriet
name: Werno, Simone
name: Herman, Georg
name: Schmidt, Oliver
name: Dietrich, Beate
name: Schünemann, Martin
name: Rieker, Eberhard
name: Ruppe, Ulrich
name: Betzl, Gabriele
name: Noppeney, Thomas
name: Heilberger, Peter
name: Tsantilas, Dimitrios
name: Köpp, Andreas
name: Forkmann, Lutz
name: Willeke, Andreas
name: Rothenbücher, Gabriele
name: Förster, Karl
name: Kießling, Jeanette
name: Junge, Gesche
name: Wittig, Ina
name: Wilms, Dagmar
name: Schulte, Christoph
name: Flüchter, Stephan
name: Kneist, Martina
name: Kirsch, Ulrike
name: Herrmann, Thomas
name: Turowski, Alexandra
name: Hartmann, Karsten
name: Oettler, Wolfram
name: Nelles, Heike
name: Frank, Jürgen
name: Apostolidis, Savvas
name: Keilhau, Dag-Alexander
name: Murena Schmidt, Renate
name: Rivera-Reuver, Iris Rocha
name: Augustin, Kerstin
name: Predel, Diethard
name: Hertel, Thomas
name: Schmeink, Ursula
name: Seibt, Simone
name: Schreiner, Jürgen
name: Zollmann, Christine
name: Möbius, Eckart
name: Vollmer, Thomas
name: Brettschneider, Roswitha
name: Raulin, Sabine
name: Pourhassan, Siamak
name: Läger, Gerlind
name: Brandl, Robert
name: Schmiedel, Rainer
name: Jager, Karoline
name: Mendoza, Erika
name: Schwuchow, Jörg
name: Siegers, Jan-Peter
name: Gätzschmann, Peter
name: Zgouras, Dimitrios
name: Lang, Werner
name: Clasing, Arne
name: Ananin, Anatoli
name: Rutkowski, Jörg
name: Kalka, Christoph
name: Ackermann, Frank
name: Peter, Fred
name: Schaub, Patricia
name: Beyer-Westendorf, Jan
name: Brado, Bernadette
name: Schöniger, Mario
name: Köpnick, Sven
name: Biro, Ferenc
name: Linnemann, Birgit
Publisher: name: Universität Regensburg
Year: 2024
Subjects: subject: Fondaparinux; Low-molecular weight heparin; Prognosis; Risk assessment; Superficial vein thrombosis; Surgical intervention; Venous thrombosis
subject: 610 Medizin

description: Objective
The aim of this study was to assess the utilization of surgical interventions in patients diagnosed with superficial vein thrombosis (SVT) and its potential association with the occurrence of venous thromboembolism (VTE) and bleeding events.
Methods
INSIGHTS-SVT, a prospective, non-interventional, multicenter study in Germany, investigated the management and outcomes of patients with acute SVT who received conservative and/or invasive treatments at the discretion of the treating physician.
Results
Among the 872 patients with 12-month data, 657 had medical therapy only, and 215 patients underwent vascular surgery (70 within 3 months of SVT diagnosis, 136 between months 4 and 12, and nine had an intervention in both periods). The most commonly performed procedures included endovenous thermal ablation, ligation of the saphenofemoral or saphenopopliteal junction, and vein stripping. The primary outcome of symptomatic VTE was observed in 5.8% of conservatively treated patients and 6.3% of those who underwent surgical intervention. Additionally, the secondary outcome of recurrent or extended SVT was documented in 4.7% of conservatively treated patients and 5.3% of invasively treated patients. Bleeding events occurred in 1.4% of conservatively treated patients and 2.1% of surgically treated patients. These differences were statistically not significant. Furthermore, our analysis indicated a potential protective effect associated with surgical treatments, such as ligation of the saphenofemoral or saphenopopliteal junction, stripping and endovenous thermal ablation, concerning the endpoint of VTE for patients when applied after 3 months from the index SVT event.
Conclusions
In line with previous research, our study suggests that surgical interventions are not frequently employed in the management of SVT, although they may be warranted in select cases. Nevertheless, additional research is essential to gain a deeper understanding of the indications, criteria, and benefit of surgical interventions in the treatment of SVT.