%0 Journal Article
%T Variability in the Management of Superficial Venous Thrombophlebitis across Practitioners Based in North America and the Global Community
%A Anahita Dua
%A Jennifer A. Heller
%A Bhavin Patel
%A Sapan S. Desai
%J Thrombosis
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/306018
%X Introduction. This study aimed to compare management patterns of patients with SVT among healthcare practitioners based in North America versus those in the global community. Methods. A 17-question, multiple choice survey with questions regarding SVT diagnosis and management strategies was provided to practitioners who attended the American Venous Forum (AVF) meeting in 2011. Results. There were 487 practitioners surveyed with 365 classified as North American (US or Canada) and 122 (56 Europe, 25 Asia, 11 South America, and 7 Africa) representing the global community. The key difference seen between the groups was in the initial imaging study used in patients presenting with SVT () and physicians in the US ordered fewer bilateral duplex ultrasounds and more unilateral duplex ultrasounds (49.6% versus 58.2%, 39.7% versus 34.4%). In the US cohort, phlebologists and vascular surgeons constituted 82% () of the specialties surveyed. In the global community, SVT was managed by phlebologists or vascular surgeons 44% () of the time. Surgical management was highly variable between groups. Conclusion. There is currently no consensus between or among practitioners in North America or globally as to the surgical management of SVT, duration of follow-up, and anticoagulation parameters. 1. Introduction The diagnosis and management of superficial venous thrombophlebitis (SVT) is poorly defined and remains controversial both within practitioners here in the USA and globally [1]. SVT is a relatively common disease with up to an 11% incidence rate [1¨C3]. While SVT used to be considered a self-limiting disease, benign disease studies have confirmed the close correlation between SVT and deep-vein thrombosis (DVT) or pulmonary embolism (PE) [1¨C4]. DVT or PE is diagnosed in up to 20¨C30% of patients with SVT with clinically relevant symptomatic thromboembolic events complicating isolated SVT in 4¨C8% of patients [3, 4]. SVT is managed by a variety of practitioners including family practice physicians, dermatologists, internists, phlebologists, cardiologists, interventional radiologists, general surgeons, and vascular surgeons resulting in further variations in treatment regimes. Different countries have adopted variable practice patterns for this disease and at present no consensus had been reached regarding optimum care. A 2013 Cochrane review attempting to delineate most favorable treatment patterns for SVT concluded that while prophylactic doses of fondaparinux given for six weeks appear to be a valid therapeutic option for SVT of the legs, the current published evidence on
%U http://www.hindawi.com/journals/thrombosis/2014/306018/