Superficial vein thrombosis

Superficial vein thrombosis (SVT, also known as superficial vein thrombophlebitis) of the lower limb is most often a complication of varicose veins.

Doppler (duplex) ultrasonography is recommended for all patients with suspected SVT of the lower limb, as concomitant deep vein thrombosis (DVT) may be present.

Underlying prothrombotic conditions should be sought in cases of recurrent SVT and migratory SVT, especially in the absence of varicose veins.

Anticoagulation for 45 days to prevent venous thromboembolic complications (DVT or pulmonary embolism) is warranted, especially in patients with SVT of 5 cm or greater in length.

SVT refers to thrombus formation in a superficial vein, and inflammation in the tissue surrounding the vein.[1]Nasr H, Scriven JM. Superficial thrombophlebitis (superficial venous thrombosis). BMJ. 2015 Jun 22;350:h2039. http://www.ncbi.nlm.nih.gov/pubmed/26099257?tool=bestpractice.com It is generally characterised by pain, tenderness, induration, and/or erythema in a superficial vein. There is often a palpable, sometimes nodular, cord with warmth and erythema, which suggests the presence of thrombus. It most often occurs in the saphenous vein of the lower limbs, and its tributaries. It can also occur in the veins of the upper limbs or neck, but this is less common and usually due to intravenous cannulation and drug administration. This topic focuses on the diagnosis and management of lower-extremity SVT.