Abstract
Superficial venous thrombophlebitis (SVT) is a relatively common problem that may yield under-appreciated complications of venous thromboembolism including deep venous thrombosis (DVT) and pulmonary embolism (PE) . Duplex ultrasonography remains the diagnostic gold standard. Treatment considers the extent and location of thrombus burden. Mild forms of SVT may be treated with conservative measures that include nonsteroidal anti-inflammatory drugs (NSAIDs) , elastic compression, and elevation. Anti-coagulation with 2.5 mg fondaparinux favored over prophylactic low-molecular-weight heparin is indicated for moderate thrombus burden, defined as thrombus that measures at least 5 cm in length located at least 3 cm distal to the saphenofemoral junction. Surgical interventions remain indicated for select patients with moderate thrombus burden that cannot tolerate anti-coagulation [i.e., great saphenous vein (GSV) disconnection and ligation] and those with documented venous insufficiency and associated varicose veins (i.e., GSV ablation and phlebectomy). Finally, therapeutic anti-coagulation remains applicable to patients that develop associated DVT or PE.
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Abbreviations
- DVT:
-
Thrombophlebitis, deep venous thrombosis
- GSV:
-
Septic thrombophlebitis, great saphenous vein
- LMWH:
-
Anti-coagulation, low-molecular-weight heparin
- NSAIDs:
-
Heparin, nonsteroidal anti-inflammatory drugs
- PE:
-
Pulmonary embolism
- SVT:
-
Superficial venous thrombophlebitis
- VTE:
-
Venous thromboembolism
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Further Reading
Di Nisio M, Wichers IM, Middeldorp S (2008) Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev 3
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Coleman, D.M. (2015). Superficial Thrombophlebitis. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_163
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DOI: https://doi.org/10.1007/978-3-642-37078-6_163
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