Jan Sloves Applaudes Gregory Piazza and Colleagues: Excellent Review Paper on SVT
Jan Sloves, President and Consultant at Vascular Imaging Professionals LLC, shared on LinkedIn:
”My Top 6 Teaching Points from the JAMA 2025 Review on Superficial Vein Thrombosis by Gregory Piazza and colleagues.
Excellent Review Paper, Congratulations to the Authors
1. Clinical Relevance and Risk of VTE
SVT has a meaningful risk of progression to deep vein thrombosis (DVT) or pulmonary embolism (PE), especially if untreated, up to 10% of patients develop DVT or PE. Approximately 25% present with concomitant DVT, and thromboembolic events can occur in up to 7% within 90 days of SVT diagnosis
2. Diagnosis: Clinical and Imaging Approach
SVT typically presents with a tender, palpable cord and erythema along a superficial vein. While history and physical are often sufficient, duplex US should be performed if there is diagnostic uncertainty, concern for extension, or major risk factors. D-dimer is not sensitive enough to reliably exclude SVT
3. Risk Stratification
Key risk factors for SVT include varicose veins, pregnancy, cancer, indwelling catheters (for upper extremity SVT), immobilization, obesity, and history of VTE. Prognosis is worse for patients with cancer, male sex, absence of varicose veins, or involvement of the saphenofemoral/popliteal junction
4. Indications for Anticoagulation
Anticoagulation is strongly recommended for:
• SVT ≥ 5 cm in length,
• SVT with symptoms refractory to conservative therapy,
• SVT within 3 cm of a deep vein (should be treated as DVT with therapeutic anticoagulation).
First-line therapy is fondaparinux 2.5 mg daily for 45 days; alternatives include rivaroxaban 10 mg daily or enoxaparin 40 mg daily
5. Conservative Measures and Other Therapies
Elastic compression stockings and NSAIDs offer symptomatic relief and are appropriate in select low-risk cases. Topical therapies (such as heparin ointment) may add symptom benefits, but surgical/ablative intervention is not routinely advised unless significant venous reflux is confirmed
6. Follow-Up and Outcomes
Patients should be counseled to seek further evaluation if symptoms worsen or fail to improve within 7 days. Early follow-up duplex US is advised for proximal progression or new symptoms. Residual reflux is common after SVT and may lead to chronic venous insufficiency, but evidence for reducing post-SVT ulceration is still lacking.
Subscribe to the only newsletter built for vascular pros”
Read the full article in JAMA.
Article: Superficial Vein Thrombosis. A Review
Authors: Gregory Piazza, Darsiya Krishnathasan, Nada Hamade, Francisco Ujueta, Giovanni Scimeca, Marcos Ortiz-Rios, Bridget McGonagle, Jean-Philippe Galanaud, David Jiménez, Manuel Monreal, John Fanikos, Anahita Dua, Leben Tefera, Raghu Kolluri, Sahil Parikh, Walter Ageno, Samuel Goldhaber, Jeffrey Weitz, Lisa Moores, Isabelle Quéré, Behnood Bikdeli
Stay updated on all scientific advances in the field of thrombosis with Hemostasis Today.
-
Sep 29, 2025, 12:54Microfluidic Technology Uncovers Ongoing TTP Disease Activity
-
Sep 29, 2025, 12:43Advancing Thrombosis Research: MRI-Based Methodology for Studying Thrombus Resolution
-
Sep 29, 2025, 05:58Samwel Mikaye on Understanding, Diagnosing, and Managing Deep Venous Thrombosis (DVT)
-
Sep 28, 2025, 14:08Mary Cushman: Dr Warkentin Is a Giant in Hematology
-
Sep 28, 2025, 13:31Michael Makris Highlights Vaccine Misinformation and Its Risks
-
Sep 29, 2025, 12:33Allison Wheeler: Some Days I Love Science a Little Bit More
-
Sep 29, 2025, 06:23Yudi Hardianto and Colleagues Give a Review on Stroke Rehabilitation in LMICs
-
Sep 29, 2025, 04:42Wolfgang Miesbach on the Bi8 Study: A Novel FVIII-Mimetic Antibody Gene Therapy for Haemophilia A
-
Sep 29, 2025, 04:16Salvador Payán Pernía on Equity Challenges in Access to Gene Therapy for Hemoglobinopathies
-
Sep 29, 2025, 04:02Nicolas Gendron: A Very Nice Demonstration by The Authors - Coffee is Associated with Reduced Risk of VTE
-
Sep 29, 2025, 05:06Sue Bacon on the Importance of Addressing Hospital-Acquired DVT and PE
-
Sep 24, 2025, 11:06Wolfgang Miesbach Reports Promising Results for New Subcutaneous von Willebrand Disease Therapy VGA039
-
Sep 23, 2025, 06:40Richard Buka: CSL Behring Have Announced a Collaboration with Dutch Biotech, VarmX
-
Sep 22, 2025, 07:10Aspirin Beyond the Heart․ Targeting PI3K-Altered Colorectal Cancer
-
Sep 22, 2025, 06:04ClearPlasma: A New Filter Technology to Enhance Clot Stability in Donated Plasma
-
Sep 29, 2025, 07:02Kambua Manundu: We Walked to Protest the Countless Lives of Women We Have Lost to Post Partum Hemorrhage
-
Sep 29, 2025, 06:41Ouma Oluga Unveiled Plans to Make Sickle Cell Screening Mandatory in Kenya at 80th UN General Assembly
-
Sep 29, 2025, 04:51Nathan Connell on Breakthrough Gene Therapy Advancing Care for People with Hemophilia
-
Sep 29, 2025, 04:28Emmeran Hauser: Fantastic to See First Results of Our Work in Europe
-
Sep 28, 2025, 10:33Côme Bommier: Burnout Is Common Among Hematology Professionals