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Management of Superficial Vein Thrombosis and Thrombophlebitis: Status and Expert Opinion Document

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

G. Belcaro, MD, PhD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy, Cardres{at}abol.it

G. Agus, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

M. Georgiev, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

B.M. Errichi, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

R. Marinucci, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

S. Errichi, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

A. Filippini, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

L. Pellegrini, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

A. Ledda, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

G. Vinciguerra, PhD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

A. Ricci, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

G. Cipollone, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

M. Lania, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

G. Gizzi, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

E. Ippolito, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

P. Bavera, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

F. Fano

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

M. Dugall

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

R. Adovasio, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

L. Gallione, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

G. Del Boccio, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

U. Cornelli, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

R. Steigerwalt, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

G. Acerbi, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

M. Cacchio, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

A. Di Renzo

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

M. Hosoi

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

S. Stuard, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

M. Corsi, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

L. Di Ciano, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

E. Simeone, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

G. Collevecchio, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

M.G. Grossi

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

F. Di Giambattista

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

F. Carestia

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

A. Zukowski, MD

Vascular Lab, Department of Biomedical Science, G D'Annunzio University, Pescara and San Valentino Vascular Screening Project, Italy

Superficial vein thrombosis is characterized by clotting of superficial veins (ie, following direct trauma) with minimal inflammatory components. Superficial thrombophlebitis is a minimally thrombotic process of superficial veins associated with inflammatory changes and/or infection. Treatments generally include analgesics, elastic compression, anti-inflammatory agents, exercise and ambulation, and, in some cases, local or systemic anticoagulants. It is better to avoid bed rest and reduced mobility. Topical analgesia with nonsteroidal, anti-inflammatory creams applied locally to the superficial vein thrombosis/superficial thrombophlebitis area controls symptoms. Hirudoid cream (heparinoid) shortens the duration of signs/symptoms. Locally acting anticoagulants/antithrombotics (Viatromb^®, Lipohep ^®, spray Na-heparin) have positive effects on pain and on the reduction in thrombus size. Intravenous catheters should be changed every 24 to 48 hours (depending on venous flow and clinical parameters) to prevent superficial vein thrombosis/superficial thrombophlebitis and removed in case of events. Low molecular weight heparin prophylaxis and nitroglycerin patches distal to peripheral lines may reduce the incidence of superficial vein thrombosis/superficial thrombophlebitis in patients with vein catheters. In case of superficial vein thrombosis/superficial thrombophlebitis, vein lines should be removed. In neoplastic diseases and hematological disorders, anticoagulants may be necessary. Exercise reduces pain and the possibility of deep vein thrombosis. Only in cases in which pain is very severe is bed rest necessary. Deep vein thrombosis prophylaxis should be established in patients with reduced mobility. Antibiotics usually do not have a place in superficial vein thrombosis/superficial thrombophlebitis unless there are documented infections. Prevention of superficial vein thrombosis should be considered on the basis of patient's history and clinical evaluation.

Key Words: superficial thrombosis • vein thrombosis • thrombophlebitis • phlebitis • anticoagulants • clinical management

Angiology, Vol. 58, No. 1S, 7S-14S (2007)
DOI: 10.1177/0003319706297643


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