Risk factors of superficial vein thrombosis in patients with varicose veins

Abstract

Introduction Varicose veins are the main risk factor for the development of superficial vein thrombosis (1). However, the role of additional factors, which are typically associated with venous thromboembolism, is insufficiently studied in patients with acute varicothrombophlebitis (AVTPh). Purpose The aim of study was comparison of demographic data and baseline characteristics of varicose veins in two cohorts of patients: with uncomplicated varicose veins of the lower limbs and those with AVTPh. Material and methods The study group included 190 consecutive patients with AVTPh, prospectively enrolled over 4 years. The diagnosis of AVTP was confirmed based on duplex ultrasound. The control group included 860 patients with varicose veins, the data being extracted from a prospective study previously conducted in the clinic. Results Patients with AVTPh had significantly higher: age - 60 (IQR 49-66) vs 50 (IQR 38-58) years; body mass index – 28,6 (IQR 25,4-31,3) vs 24,1 (IQR 22-32) and Charlson comorbidity index - 2 (IQR 0-2) vs 1 (IQR 0-1,8), p <0,0001. The probability of AVTPh was significantly higher after 60 years (OR 4,3 [3-5,9]) and in those with obesity (OR 1,5 [1,1-2,1]). No differences were found regarding patient gender, laterality and duration of varicose veins. In AVTPh group the diameters of the sapheno-femoral and sapheno-popliteal junctions were larger: 12 (IQR 10-13,7) vs 9,5 (IQR 8-11,3) mm and 10 (IQR 9,2- 12) vs 8,5 (IQR 6,8-10) mm, p <0,05. Conclusions Age, obesity and comorbidities have an important role in development of AVTPh. Risk factors of AVTPh are similar with those of venous thromboembolism in general. Pronounced dilation of incompetent junctions can contribute to severity of venous stasis and development of thrombosis.