PMID- 17443561
OWN - NLM
STAT- MEDLINE
DCOM- 20070717
LR  - 20200511
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
IP  - 2
DP  - 2007 Apr 18
TI  - Treatment for superficial thrombophlebitis of the leg.
PG  - CD004982
AB  - BACKGROUND: The optimal treatment of superficial thrombophlebitis (ST) of the 
      legs remains poorly defined. While improving or relieving the local painful 
      symptoms, treatment should aim at preventing venous thromboembolism (VTE), which 
      might complicate the natural history of ST. OBJECTIVES: To assess the efficacy 
      and safety of topical, medical, and surgical treatments in patients presenting 
      with ST of the legs. SEARCH STRATEGY: The Cochrane Peripheral Vascular Diseases 
      Group searched their specialized register (last searched 16 February 2007), and 
      the Cochrane Central Register of Controlled Trials (CENTRAL) (last searched Issue 
      1, 2007. We searched MEDLINE (1966 to January 2006), EMBASE (1980 to January 
      2006), and handsearched reference lists of relevant papers and conference 
      proceedings. SELECTION CRITERIA: Randomized trials evaluating topical, medical, 
      and surgical treatments for ST of the leg including participants with a clinical 
      diagnosis of ST of the legs or objective diagnosis of a thrombus in the 
      superficial vein. DATA COLLECTION AND ANALYSIS: Two authors assessed the trials 
      for inclusion in the review, extracted the data, and assessed the quality of the 
      studies. Data were extracted independently from the included studies and any 
      disagreements resolved by consensus. MAIN RESULTS: Twenty-four studies involving 
      2469 participants with ST of the legs were included in this review. The 
      methodological quality of most of the trials was poor. Treatment ranged from low 
      molecular weight heparin (LMWH), to non-steroidal anti-inflammatory agents 
      (NSAIDs), topical treatment, surgery, oral, intramuscular, and intravenous 
      treatments. Both LMWH and NSAIDs significantly reduced the incidence of ST 
      extension or recurrences by about 70% compared with placebo and both seemed to 
      have a similar efficacy and safety. Overall, topical treatments improved local 
      symptoms. However, no data were provided on the effects of these treatments on 
      VTE and ST extension. Surgical treatment combined with elastic stockings in ST 
      was associated with a lower VTE rate and ST progression, compared with elastic 
      stockings alone. AUTHORS' CONCLUSIONS: Low molecular weight heparin and NSAIDs 
      appear as the current best therapeutic options for ST of the legs. While the 
      available data are too limited to make clear recommendations, an intermediate 
      dose of LMWH for at least a month might be advised. Further research is needed to 
      assess the role of NSAIDs and LMWH, the optimal doses and duration of treatment, 
      and whether a combination therapy may be more effective than single treatment. 
      Adequately designed and conducted studies are required to clarify the role of 
      topical and surgical treatments.
FAU - Di Nisio, M
AU  - Di Nisio M
AD  - Academic Medical Center, Department of Vascular Medicine, F4-138, Meibergdreef, 9 
      -1100 DD, P.O. Box 22660, Amsterdam, Netherlands, 1105 AZ. mdinisio@unich.it
FAU - Wichers, I M
AU  - Wichers IM
FAU - Middeldorp, S
AU  - Middeldorp S
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20070418
PL  - England
TA  - Cochrane Database Syst Rev
JT  - The Cochrane database of systematic reviews
JID - 100909747
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
UOF - Cochrane Database Syst Rev. 2007;(1):CD004982. PMID: 17253533
UIN - Cochrane Database Syst Rev. 2012;3:CD004982. PMID: 22419302
MH  - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
MH  - Anticoagulants/therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Randomized Controlled Trials as Topic
MH  - Thromboembolism/prevention & control
MH  - Thrombophlebitis/drug therapy/surgery/*therapy
RF  - 80
EDAT- 2007/04/20 09:00
MHDA- 2007/07/18 09:00
CRDT- 2007/04/20 09:00
PHST- 2007/04/20 09:00 [pubmed]
PHST- 2007/07/18 09:00 [medline]
PHST- 2007/04/20 09:00 [entrez]
AID - 10.1002/14651858.CD004982.pub3 [doi]
PST - epublish
SO  - Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004982. doi: 
      10.1002/14651858.CD004982.pub3.