Phlebologie 2018; 47(01): 32-36
DOI: 10.12687/phleb2409-1-2018
Fortbildung in Bildern
Schattauer GmbH

Thrombophlebitis and varicothrombosis: When to treat and how?

Article in several languages: deutsch | English
J. Woitalla-Bruning
1   Krankenhaus Tabea GmbH & Co. KG, Zentrum für Venen- und Dermatochirurgie, Hamburg
› Author Affiliations
Further Information

Publication History

Eingereicht: 29 December 2017

Angenommen: 02 January 2018

Publication Date:
15 March 2018 (online)


Generally, a thrombophlebitis is defined as a thrombosis and inflammation of superficial veins and their environment. Due to the pathophysiological and histological similarities to deep vein thrombosis (DVT), it is recently referred to as superficial vein thrombosis (SVT). A differentiation is made between SVT in healthy veins (referred to as thrombophlebitis) and SVT in varicous veins (referred to as varicothrombosis). SVT is a common disorder with a prevalence rate of 5.3%. In 90% of cases SVT occurs in lower extremities and in up to 30% SVT is associated with a deep vein thrombosis, and less often, with pulmonary embolism. In some instances, deep leg vein thrombosis can be found in different locations at the same time. Therefore initial diagnostics should include duplex ultrasound to localize and define the extent of the thrombosis. Therapeutic options, which include conservative and operative measures, depend on localization and extent of the SVT. Currently Fondaparinux is the only approved drug for treatment. In addition to this low molecular weight heparins appear to be also effective. Since SVT may be caused by a serious underlying condition, particularly in patients with SVT in healthy veins (thrombophlebitis) and in patients with repetitive varicothrombosis, excluding malign processes is recommended. Especially in younger patients a thrombophilic screening should be considered.

  • Literatur

  • 1 Debourdeau P, Farge D, Beckers M, Baglin C, Bauersachs RM, Brenner B, Brilhante D, Falanga A, Gerotzafias GT, Haim N, Kakkar AK, Khorana AA, Lecumberri R, Mandala M, Marty M, Monreal M, Mousa SA, Noble S, Pabinger I, Prandoni P, Prins MH, Qari MH, Streiff MB, Syrigos K, Büller HR, Bounameaux H. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer. J Thromb Haemost 2013; 11: 71-80.
  • 2 Leitlinie der Deutschen Gesellschaft für Angiologie - Gesellschaft für Gefäßmedizin. Diagnostik und Therapie der Venenthrombose und der Lungen embolie 2015. AWMF-Leitlinienregister Nr. 065/002: 35-36.
  • 3 Rabe E, Pannier-Fischer F, Bromen K, Schuldt K, Stang A, Poncar CH, Wittenhorst M, Bock E, Weber S, Jöckel K-H. Bonner Venenstudie der Deutschen Gesellschaft für Phlebologie Epidemiologische Untersuchung zur Frage der Häufigkeit und Ausprägung von chronischen Venenkrankheiten in der städtischen und ländlichen Wohnbe völkerung. Phlebologie 2003; 32: 1-14.
  • 4 Decousus H, Prandoni P, Mismetti P, Bauersachs RM, Boda Z, Brenner B, Laporte S, Matyas L, Middeldorp S, Sokurenko G, Leizorovicz A. Fondaparinux for the treatment of superficial-vein thrombosis in the legs. N Engl J Med 2010; 363: 1222-1232.
  • 5 Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ, Nelson ME, Wells PS, Gould MK, Dentali F, Crowther M, Kahn SR. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141: e419-e494.
  • 6 Cosmi B. Management of superficial vein thrombosis. J Thromb Haemost 2015; 13: 1175-1183.
  • 7 Sullivan V, Denk PM, Sonnad SS, Eagleton MJ, Wakefield TW. Ligation versus anticoagulation: treatment of abov-knee superficial thrombophlebitis not involving the deep venous system. J Am Coll Surg 2001; 193: 556-562.
  • 8 Beyer-Westendorf J, Schellong MS, Gerlach H, Rabe E, Weitz JI, Jersemann K, Sahin K, Bauersachs R. Prevention of thromboembolic complications in patients with superficial-vein thrombosis given rivaroxaban or fondaparinux: the open-label, randomised, non-inferiority SURPRISE phase 3b trial. Lancet Haematol 2017; Mar; 04 (03) e105-e113.
  • 9 Sturm W. Oberflächliche Venenthrombose-Aktuelle Therapieempfehlungen. Zeitschrift für Gefäß medizin 2014; 11 (01) 6-8.