REVIEW   

Italian Journal of Vascular and Endovascular Surgery 2021 December;28(4):131-5

DOI: 10.23736/S1824-4777.21.01511-4

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Superficial vein thrombosis: controversies on approach and therapy

Chrysanthi P. PAPAGEORGOPOULOU ¹ ✉, Konstantinos. M. NIKOLAKOPOULOS ¹, Ioannis G. NTOUVAS ², Spyros PAPADOULAS ¹

¹ Department of Vascular Surgery, University Hospital of Patras, Patras, Greece; ² Vascular Unit, Department of Surgery, General Hospital of Patras, Patras, Greece

INTRODUCTION: Superficial vein thrombosis has been considered a self-limited and benign disease. Patients with varicose veins are commonly affected, but it can also affect patients with underlying condition such as malignant disease or thrombophilia. Superficial vein thrombosis of the lower extremities shares the same risk factors as deep vein thrombosis; it can propagate into the deep venous system and have a complicated course with pulmonary embolism. Ultrasonography is indicated for both confirmation and evaluation of superficial vein thrombosis extension and recurrence. This study aimed at reviewing the results of different treatment protocols according to the published literature.
EVIDENCE ACQUISITION: Multiple databases (such as MEDLINE/Pubmed, MeSH, EMBASE and Cochrane Library) were systematically searched to identify studies investigating the management and the treatment of patients with superficial vein thrombosis.
EVIDENCE SYNTHESIS: Symptomatic relief and prevention of venous thromboembolism are the main goals for the treatment of the superficial vein thrombosis. Superficial vein thrombosis of the great saphenous vein within 3cm from the saphenofemoral junction is considered to be equivalent to a DVT, and thus deserving therapeutic dose of anticoagulation. Less severe forms of lower-limb thrombosis, not involving the junction, have been included in randomized clinical trials and prospective cohort studies and multiple treatments have been used such as compression therapy, non-steroidal anti-inflammatory drugs, unfractionated heparins and low-molecular weight heparins, with inconclusive results.
CONCLUSIONS: The treatment of choice for the superficial vein thrombosis of the lower extremities is either the intermediate dose of low molecular weight heparin or the prophylactic dose of fondaparinux administered for 45 days. Further studies are needed to define the optimal management strategies for superficial vein thrombosis of the lower extremities.

KEY WORDS: Venous thrombosis; Thrombophlebitis; Heparin; Venous thromboembolism; Anticoagulants