Superficial venous thrombophlebitis

Extract

• Thrombophlebitis is a common disease of the superficial veins that most commonly occurs in the lower extremities (especially in the great saphenous vein [vena saphena magna]) and often is connected with varicose veins. It can also occur elsewhere, e.g. on the neck (external jugular vein), on the chest (Mondor’s disease) or in the upper extremities.
• As opposed to deep vein thrombosis (DVT), an inflammatory process of the venous wall is almost always present in addition to thrombosis.
• The prognosis of superficial thrombophlebitis is usually good.
• A more extensive superficial venous thrombosis may spread to the deep veins. Deep venous thrombosis has been described to be associated with about 20% and pulmonary embolism with about 4% of superficial venous thromboses that have been more than 5 cm in length.
• Ultrasonography is helpful in the differential diagnostics and it is recommended to exclude deep vein thrombosis DynaMed PlusE.
• D dimer is not helpful in the differentiation between superficial and deep venous thrombosis.
• A superficial thrombophlebitis of ≥ 5 cm in length in the lower extremity, is according to current guidelines treated with a prophylactic dose of fondaparinux or with a mid-treatment dose of LMWH for 6 weeks. In addition, topically administered NSAIDs may be used if needed. Tentatively, oral rivaroxaban seems to be promising.
• The treatment of superficial thrombophlebitis elsewhere is not equally well established.
• Muscular vein thrombosis and superficial thrombophlebitis are often mixed up. Muscular vein thrombosis is not a superficial thrombophlebitis but a sub-category of deep vein thrombosis, in which the thrombosis is located in the muscular veins of the calf region (plexus soleus or plexus gastrocnemius).

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Buerger's disease, Heparin, Low-Molecular-Weight, I80, I80.0*, O22.2, O87.0, Phlebitis, Pregnancy, Surgery, Vascular surgery, deep venous thrombosis, phlebitis, superficial, superficial venous thrombosis, thrombophlebitis, thrombophlebitis migrans