Reducing the risk of venous thromboembolism following superficial endovenous treatment: a UK and Republic of Ireland consensus study
File(s)Manuscript Final version.doc (617.5 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
Objectives
Venous thromboembolism is a potentially fatal complication of superficial endovenous treatment. Proper risk assessment and thromboprophylaxis could mitigate this hazard; however, there are currently no evidence-based or consensus guidelines. This study surveyed UK and Republic of Ireland vascular consultants to determine areas of consensus.
Methods
A 32-item survey was sent to vascular consultants via the Vascular and Endovascular Research Network (phase 1). These results generated 10 consensus statements which were redistributed (phase 2). ‘Good’ and ‘very good’ consensus were defined as endorsement/rejection of statements by >67% and >85% of respondents, respectively.
Results
Forty-two consultants completed phase 1. This generated seven statements regarding risk factors mandating peri-procedural pharmacoprophylaxis and three statements regarding specific pharmacoprophylaxis regimes. Forty-seven consultants completed phase 2. Regarding venous thromboembolism risk factors mandating pharmacoprophylaxis, ‘good’ and ‘very good’ consensus was achieved for 5/7 and 2/7 statements, respectively. Regarding specific regimens, ‘very good’ consensus was achieved for 3/3 statements.
Conclusions
The main findings from this study were that there was ‘good’ or ‘very good’ consensus that patients with any of the seven surveyed risk factors should be given pharmacoprophylaxis with low-molecular-weight heparin. High-risk patients should receive one to two weeks of pharmacoprophylaxis rather than a single dose.
Venous thromboembolism is a potentially fatal complication of superficial endovenous treatment. Proper risk assessment and thromboprophylaxis could mitigate this hazard; however, there are currently no evidence-based or consensus guidelines. This study surveyed UK and Republic of Ireland vascular consultants to determine areas of consensus.
Methods
A 32-item survey was sent to vascular consultants via the Vascular and Endovascular Research Network (phase 1). These results generated 10 consensus statements which were redistributed (phase 2). ‘Good’ and ‘very good’ consensus were defined as endorsement/rejection of statements by >67% and >85% of respondents, respectively.
Results
Forty-two consultants completed phase 1. This generated seven statements regarding risk factors mandating peri-procedural pharmacoprophylaxis and three statements regarding specific pharmacoprophylaxis regimes. Forty-seven consultants completed phase 2. Regarding venous thromboembolism risk factors mandating pharmacoprophylaxis, ‘good’ and ‘very good’ consensus was achieved for 5/7 and 2/7 statements, respectively. Regarding specific regimens, ‘very good’ consensus was achieved for 3/3 statements.
Conclusions
The main findings from this study were that there was ‘good’ or ‘very good’ consensus that patients with any of the seven surveyed risk factors should be given pharmacoprophylaxis with low-molecular-weight heparin. High-risk patients should receive one to two weeks of pharmacoprophylaxis rather than a single dose.
Date Issued
2020-10-01
Date Acceptance
2020-06-05
Citation
Phlebology, 2020, 35 (9), pp.706-714
ISSN
0268-3555
Publisher
SAGE Publications
Start Page
706
End Page
714
Journal / Book Title
Phlebology
Volume
35
Issue
9
Copyright Statement
©The Author(s) 2020. The final, definitive version of this paper has been published in Phlebology by Sage Publications Ltd. All rights reserved. It is available at: https://journals.sagepub.com/doi/10.1177/0268355520936420
Subjects
Science & Technology
Life Sciences & Biomedicine
Surgery
Peripheral Vascular Disease
Cardiovascular System & Cardiology
Deep vein thrombosis
varicose veins
venous thromboembolism
VTE management
GREAT SAPHENOUS-VEIN
ABLATION
COMPRESSION
THROMBOSIS
REFERRALS
Deep vein thrombosis
VTE management
varicose veins
venous thromboembolism
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
Publication Status
Published
Date Publish Online
2020-07-01