Thrombophlebitis and varicothrombosis: When to treat and how?

Summary

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.

Keywords

Thrombophlebitis - superficial vein thrombosis - varicothrombosis - anticoagulation

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