Prognosis

Uncomplicated superficial vein thrombosis (SVT) within an axial superficial vein was once considered to be a benign and self-limiting condition. It is now known that even uncomplicated SVT is associated with venous thromboembolism (VTE) at the time of diagnosis and is associated with a future risk of propagation of thrombus, future VTE, and recurrent episodes of SVT.[17][40]​​ Due to this fact, duplex ultrasound at the time of diagnosis is essential and treatment with prophylactic-dose anticoagulation for 45 days is warranted. Isolated thrombus within small tributary varicosities is considered more benign and may be treated without anticoagulation unless there is propagation.[44]​ In uncomplicated SVT, symptoms generally subside in 1-2 weeks, though hardness of the vein may persist for longer. 

Concomitant VTE, such as deep vein thrombosis (DVT) or pulmonary embolism (PE), may prolong the course and anticoagulation may be required for ≥3 months. Complications of DVT or PE include VTE recurrence, as well as chronic venous insufficiency and post-thrombotic syndrome in the case of DVT.

Risk of recurrence

Depending on the presence or absence of underlying risk factors such as varicose veins, malignancy, previous VTE, and/or family history of VTE, the risk of SVT recurrence ranges anywhere between 1.6% to 12.2% in treated patients and 3.3% to 36.7% in untreated patients.[85][86]

The risk for subsequent VTE within the first 3 months following SVT is about 1.5% to 6.2%.[61][87] In the case of recurrent SVT in the setting of axial superficial venous insufficiency with or without varicose veins, interventions such as endovenous thermal or chemical ablation should be considered to decrease the risk of recurrence, after anticoagulation and once the acute thrombotic period has ended.

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