Merck Manual

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Superficial Venous Thrombosis

By

James D. Douketis

, MD, McMaster University

Reviewed/Revised Dec 2023
View PATIENT EDUCATION

Superficial venous thrombosis is a blood clot in a superficial vein of the upper or lower extremities or, less commonly, in one or more veins of the chest or breast (Mondor disease).

Superficial venous thrombosis in the upper extremity most commonly results from IV infusions or catheterization. Varicose veins Varicose Veins Varicose veins are dilated superficial veins in the lower extremities. Usually, no cause is obvious. Varicose veins are typically asymptomatic but may cause a sense of fullness, pressure, and... read more Varicose Veins seem to be the main risk factor for superficial venous thrombosis in the lower extremity, especially among women. Superficial venous thrombi rarely cause serious complications and rarely become emboli.

Typically, patients present with pain, tenderness, or an indurated cord along a palpable superficial vein. The overlying skin is usually warm and erythematous.

Migratory superficial venous thrombosis, which develops, resolves, and recurs in normal veins of the arms, legs, and torso at various times, is a possible harbinger of pancreatic cancer Pancreatic Cancer Pancreatic cancer, primarily ductal adenocarcinoma, accounts for an estimated 64,050 cases and 50,550 deaths in the United States annually ( 1). Symptoms include weight loss, abdominal pain... read more and other adenocarcinomas (Trousseau syndrome).

General reference

Treatment of Superficial Venous Thrombosis

  • Warm compresses and nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Sometimes anticoagulation

Treatment of superficial venous thrombosis traditionally involves warm compresses and NSAIDs.

In patients with extensive superficial venous thrombosis, anticoagulation Anticoagulants Deep venous thrombosis (DVT) is clotting of blood in a deep vein of an extremity (usually calf or thigh) or the pelvis. DVT is the primary cause of pulmonary embolism. DVT results from conditions... read more Anticoagulants (eg, with low molecular weight heparin, fondaparinux) is often beneficial (1 Treatment reference Superficial venous thrombosis is a blood clot in a superficial vein of the upper or lower extremities or, less commonly, in one or more veins of the chest or breast (Mondor disease). Superficial... read more ). The optimal regimen and duration are unknown, but most experts recommend treating for about 1 month using either a low molecular weight heparin (eg, enoxaparin 40 mg subcutaneously once a day) or fondaparinux (2.5 mg subcutaneously once a day).

Treatment reference

Drugs Mentioned In This Article

Drug Name Select Trade
Hepflush-10 , Hep-Lock, Hep-Lock U/P, Monoject Prefill Advanced Heparin Lock Flush, SASH Normal Saline and Heparin
Arixtra
Lovenox
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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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