Superficial venous thrombosis is a blood clot in a superficial vein of the upper or lower extremities or, less commonly, in one or more veins of the chest or breast (Mondor disease).
Superficial venous thrombosis in the upper extremity most commonly results from IV infusions or catheterization. Varicose veins seem to be the main risk factor for superficial venous thrombosis in the lower extremity, especially among women. Superficial venous thrombi rarely cause serious complications and rarely become emboli.
Typically, patients present with pain, tenderness, or an indurated cord along a palpable superficial vein. The overlying skin is usually warm and erythematous.
Migratory superficial venous thrombosis, which develops, resolves, and recurs in normal veins of the arms, legs, and torso at various times, is a possible harbinger of pancreatic cancer and other adenocarcinomas (Trousseau syndrome).
Diagnosis is based on history and physical examination. Patients with superficial venous thrombosis above the knee have an increased risk of deep venous thrombosis (DVT) and should probably have ultrasonography (1).
General reference
1. Galanaud JP, Sevestre MA, Pernod G, et al. Long-term risk of venous thromboembolism recurrence after isolated superficial vein thrombosis. J Thromb Haemost 2017;15(6):1123-1131. doi:10.1111/jth.13679
Treatment of Superficial Venous Thrombosis
Warm compresses and nonsteroidal anti-inflammatory drugs (NSAIDs)
Sometimes anticoagulation
Treatment of superficial venous thrombosis traditionally involves warm compresses and NSAIDs.
In patients with extensive superficial venous thrombosis, anticoagulation1). The optimal regimen and duration are unknown, but most experts recommend treating for about 1 month using either a low molecular weight heparinfondaparinux (2.5 mg subcutaneously once a day).
Treatment reference
1. Decousus H, Prandoni P, Mismetti P, et al. Fondaparinux for the treatment of superficial-vein thrombosis in the legs. N Engl J Med 2010;363(13):1222-1232. doi:10.1056/NEJMoa0912072
