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Online ISSN 1827-1766
Stvrtinova V. 1, Poredos P. 2, Allegra C. 3
1 Second Clinic of Internal Medicine, Medical Faculty of Comenius University, Bratislava, Slovak Republic
2 Department of Angiology, University Medical Centre, Ljubljana, Slovenia
3 S. Giovanni-Addolorata Hospital, Angiology Department, Rome, Italy
Traditionally superficial thrombophlebitis (ST) has been considered a relatively benign and limited disease or sign of chronic venous disease. In recent years due to systematic ultrasound investigation of the venous system a large number of deep venous thromboses concomitant with ST has been revealed. ST of a varicose vein – varicophlebitis is to be distinguished from ST of a healthy nonvaricose vein. Varicophlebitis is a banal condition in majority of cases. Non-varicose vein superficial thrombophlebitis is a miscellaneous group of disorders, where inflammation is a dominating feature in some conditions, while thrombosis dominates in other cases. As symptoms and signs of ST are overt, the diagnosis is primary clinical. But for precise evaluation of the ST extension compression Duplex ultrasound (DUS) investigation is needed. DUS allows to evaluate not only the length of the thrombosis in the superficial vein but also the extension of the thrombus into the deep venous system. Contrary to the treatment of deep venous thrombosis, only little is known about the most appropriate management of ST. There is no consensus on the optimal treatment of ST in clinical practice. The main therapeutic procedure in all types of ST is compression and mobilization. Non-steroidal anti-inflammatory drugs reduce painful symptoms and perivenous inflammation, but there is no evidence that they reduce the incidence of thromboembolic events. Especially in cases of extensive ST, anticoagulant therapy is a good choice. The most effective approach to ST seems to be represented by fondaparinux or low-molecular-weight-heparin which have been shown to prevent venous thromboembolism events and the extension and/or recurrence of ST.