The cut-off length of superficial vein thrombosis setted-up in ESVS VTE Guideline (2021) and other publications for anticoagulation is 5 cm. Did this value reffers to the saphenous trunk only or isolated thrombosis of a varicose tributary should be considered also?
I'm sorry Dumitru, for my late reply and thanks for your question.
It would rather make sense that this applies to a saphenous trunk, however I do not think it has been clearly specified in the studies (like the Calixto study on SVT).
Kind regards
Marianne
Dear Marianne, thank you for your valuable opinion. I agree that (most probably) a 5 cm cut-off refers to saphenous trunk thrombosis (Recommendation 44 from ESVS Guideline). However, in my opinion there are two important issues: (1) it should be clearly stated in further Guideline, excluding ambiguous interpretation and any misunderstanding of indication for anticoagulation; (2) refuse from anticoagulation in patients with extensive thrombosis of varicose tributaries (where summar thrombus length can be 30 cm or even more) hard to accept, because it is associated with progression of thrombosis to the trunk in significant proportion of cases. Thus, the clarification of this Recommendation is required to my humble opinion.
Best regards,
Dumitru
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