Diagnosis and treatment of superficial thrombophlebitis

JING Yu-chen; XIN Shi-jie

doi:10.19538/j.cjps.issn1005-2208.2023.12.14

Abstract：Superficial thrombophlebitis(SVT)was previously considered a self-limiting disease and received little attention in clinical practice.However recent research findings indicate its potential to cause deep vein thrombosis and even life-threatening pulmonary embolism.The predisposing factors for SVT are complex resembling those of deep vein thrombosis but its clinical manifestations are diverse.predominantly occur-ring in the lower limbs.especially in the great saphenous vein.primarily associated with varicose veins.SVT in the upper limbs is more often related to iatrogenic injuries.Color Dop-pler ultrasound has become the preferred diagnostic method for SVT evaluation.Currently.there is no consensus on the treatment of SVT both domestically and internationally.The primary treatment goals are to alleviate clinical symptoms and prevent the occurrence of complications such as venous throm-boembolism(VTE)and pulmonary embolism(PE).Treatment mo-dalities include pharmacotherapy compression therapy surgi-cal intervention and traditional Chinese medicine treatment.Nonsteroidal anti-inflammatory drugs can alleviate local pain in SVT patients but do not play a significant role in treating su-perficial venous thrombosis or reducing the incidence of deep vein thrombosis and PE.Anticoagulant therapy has become the preferred treatment for SVT.The ACCP guidelines recom-mend the use of prophylactic doses of heparin and low molecu-lar weight heparin for SVT lesions exceeding 5 cm in the lower limbs and anticoagulant therapy is preferred over non-antico-agulant treatment.Additionally,anticoagulant therapy is rec-ommended for other high-risk factors such as lesions involving the saphenofemoral junction lesions occurring in the great sa-phenous vein severe symptoms like pain recent surgeries can-cer patients recurrent SVT and individuals with a recent histo-ry of VTE.Surgical treatment is currently not recommended due to the risk of complications such as pulmonary embolism.