From the Guidelines
Varicose vein patients with suspected DVT should seek immediate medical attention and may require anticoagulant therapy, as the risk of symptomatic extension, recurrence, and progression to VTE is significant, with 5.9% of patients experiencing symptomatic extension of SVT, and extension to DVT or PE at 77 days in the absence of anticoagulants 1.
Varicose Veins and DVT Relationship
Varicose veins and deep vein thrombosis (DVT) are related but distinct vascular conditions. Varicose veins themselves do not directly cause DVT, but they can share risk factors. Varicose veins are enlarged, twisted superficial veins that develop when valves weaken, allowing blood to pool. DVT is a serious condition where blood clots form in deep veins, usually in the legs.
Management and Prevention
If you have varicose veins, focus on managing them through:
- Compression stockings (20-30 mmHg)
- Regular exercise
- Leg elevation
- Maintaining a healthy weight These measures improve circulation and reduce symptoms. For severe varicose veins, medical treatments include sclerotherapy, laser therapy, or surgical removal. Regular movement, especially during long periods of sitting, helps prevent both conditions by promoting healthy blood flow.
DVT Risk and Anticoagulation
While having varicose veins slightly increases DVT risk, the connection is not strong enough to warrant anticoagulation solely for varicose veins. However, patients with varicose veins should be aware of the signs and symptoms of DVT, such as sudden leg swelling, pain, warmth, or redness, and seek immediate medical attention if they occur, as prompt treatment with anticoagulants like heparin or warfarin may be necessary 1.
From the Research
Varicose Veins and DVT
- Varicose veins are a potential long-term complication of deep vein thrombosis (DVT) 2
- DVT can lead to post-thrombotic syndrome, characterized by lower-limb pain, varicose veins, oedema, and sometimes skin ulcers 2
Treatment of DVT
- Initial treatment of DVT usually involves a low-molecular-weight heparin (LMWH) 2
- Apixaban, an oral factor Xa inhibitor, has been shown to be effective in treating DVT and reducing the risk of recurrent venous thromboembolism (VTE) 3, 4, 5, 6
- Apixaban has a lower risk of major bleeding compared to warfarin 5, 6
Comparison of Apixaban and Warfarin
- Apixaban has been shown to be more effective than warfarin in reducing the risk of recurrent VTE and major bleeding events 5, 6
- The effectiveness and safety of apixaban compared to warfarin are consistent across subgroups of patients, including those with provoked and unprovoked VTE 6
- Apixaban is associated with a lower risk of clinically relevant non-major bleeding compared to warfarin 5