Bertoletti Laurent, Frappé Paul, Leizorovicz Alain, Quéré Isabelle, Becker François, Moulin Nathalie, Decousus Hervé
Groupe de recherche sur la thrombose, université Jean-Monnet, Saint-Etienne.
Rev Prat. 2011 Nov;61(9):1244-8.
Thromboses affecting venous superficial system have been considered as benign diseases. Recent studies demonstrate that they might be associated with more severe venous events (as deep venous thrombosis [DVT] or pulmonary embolism [PE]), initially or during 3-month followup. The POST study presents clinical evolution of 844 patients with superficial venous thrombosis (SVT) of lower limbs. Of note, concomitant DVT and/or symptomatic PE were initially found in one quarter of them. Among the 586 patients with isolated SVT (i. e. without DVT or symptomatic PE, and at more than 3 cm of the saphenofemoral junction), 10% presented with DVT, PE, recurrent or extensive SVT during the 3-month follow-up. These results, as the heterogeneous therapeutic management, were confirmed by another cohort study (OPTIMEV). In the CALISTO study, Fondaparinux, at a dose of 2.5 mg once a day for 45 days was effective in the treatment of patients with isolated SVT of the legs and did not have serious side effects. In absence of contra-indication, this treatment may be preferred in patients with confirmed isolated SVT of lower limb.
影响静脉浅表系统的血栓形成曾被视为良性疾病。近期研究表明，它们可能与更严重的静脉事件（如深静脉血栓形成[DVT]或肺栓塞[PE]）相关，无论是在初始阶段还是在3个月的随访期间。POST研究展示了844例下肢浅静脉血栓形成（SVT）患者的临床演变情况。值得注意的是，其中四分之一的患者最初就伴有DVT和/或有症状的PE。在586例孤立性SVT患者（即无DVT或有症状的PE，且距离隐股交界处超过3厘米）中，10%的患者在3个月的随访期间出现了DVT、PE、复发性或广泛性SVT。这些结果，连同治疗管理的异质性，在另一项队列研究（OPTIMEV）中得到了证实。在CALISTO研究中，每天一次给予2.5毫克磺达肝癸钠，持续45天，对腿部孤立性SVT患者的治疗有效，且无严重副作用。在没有禁忌证的情况下，这种治疗方法可能更适合确诊为下肢孤立性SVT的患者。
