Vasc Spec Int.  2020 Jun;36(2):105-111. 10.5758/vsi.200021.

Management of Superficial Vein Thrombosis in Patients with Varicose Veins: A Survey among Members of National Surgical Society from Republic of Moldova

• Bzovii F
• Casian D
• Culiuc V
• Gutu E

• KMID: 2503975
• DOI: http://doi.org/10.5758/vsi.200021

Abstract

Purpose
Management of superficial vein thrombosis (SVT) in patients with varicose veins (VV) is not currently standardized. We performed a survey aimed to demonstrate patterns in the management of SVT in the Republic of Moldova.
Materials and Methods
This was a descriptive study whereby members of the National Surgical Society were asked to complete an online questionnaire. In the questionnaire, multiple-choice questions were supplemented with four clinical vignettes of real patients with SVT.
Results
The questionnaire was completed by 102 participants (31.1% response rate). In the treatment of SVT, duplex ultrasound was routinely used by 74.5% of respondents, and anticoagulants were used by 70.5%. The full therapeutic dose of anticoagulants was recommended by 63.3% of surgeons, intermediate dose by 21.1%, and prophylactic dose by 15.6%. Only 50% of respondents were prescribed anticoagulants for 1 month or more. In case of surgical intervention for SVT, crossectomy and stripping were performed by 84.0% of surgeons, while isolated crossectomy by 10.7%. In all clinical vignettes, the majority of respondents opted for urgent surgical treatment. The rate of proponents of surgery varied from 43% in cases of isolated thrombosis of tributaries, and up to 72.5% in cases of thrombosis up to the sapheno-femoral junction.
Conclusion
Management of patients with SVT and VV in the Republic of Moldova is far from standardized. Prescribed doses of anticoagulants, as well as the duration of anticoagulation are highly variable and often contradict the recommendations of current guidelines. Urgent crossectomy and stripping dominate the pattern of current therapeutic approaches.

Keyword

Superficial vein thrombosis; Varicose veins; Anticoagulation; Surgery; Moldova