Materiały źródłowe

• #1 Thrombophlebitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thrombophlebitis/diagnosis-treatment/drc-20354613

  Superficial thrombophlebitis can be treated by applying heat to the painful area and elevating your leg. You may also take drugs to relieve swelling and irritation and wear compression stockings. From there, it usually improves on its own. For superficial and deep vein thrombosis, or DVT, you might take medications that thin the blood and dissolve clots. You may wear compression stockings that are available by prescription to prevent swelling and prevent complications of DVT. If you can’t take blood thinners, a filter can be placed into the main vein in your abdomen to keep clots from lodging in your lungs. Sometimes varicose veins are removed with surgery. […] For superficial thrombophlebitis, your doctor might recommend applying heat to the painful area, elevating the affected leg, using an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) and possibly wearing compression stockings. The condition usually improves on its own.

• #2 Thrombophlebitis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thrombophlebitis/symptoms-causes/syc-20354607

  Thrombophlebitis is a condition that causes a blood clot to form and block one or more veins, often in the legs. […] Both types of thrombophlebitis can be treated with blood-thinning medications. […] Deep vein thrombosis (DVT) increases the risk of serious health problems. It’s usually treated with blood-thinning medications. Superficial thrombophlebitis is sometimes treated with blood-thinning medications, too. […] If you have one or more risk factors, discuss prevention strategies with your doctor before taking long flights or road trips or if you’re planning to have elective surgery, recovery from which will require you not to move much.

• #3 Superficial vein thrombosis: a current approach to management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/25521017/

  Superficial vein thrombosis (SVT) was considered to be a benign and self-limiting condition. However, it is now appreciated that a significant proportion of those presenting with SVT will have concomitant deep vein thrombosis or pulmonary embolism, or are at significant risk of developing deep venous thromboembolism. Potential therapeutic options include topical preparations, compression therapy (stockings, bandages), medication such as non-steroidal anti-inflammatory drugs (NSAIDs) or anticoagulants (therapeutic or prophylactic doses) and surgery, ligation or stripping, of superficial veins. The treatment of choice is therapeutic/intermediate dose low molecular weight heparin or prophylactic dose fondaparinux administered for 4-6 weeks. The cost-effectiveness of treatment is a concern and more targeted therapy is required.

• #4

  https://www.scielo.br/j/jvb/a/jCwCvPMd8bQFgywdVFQK7Fh/

  Certain clinical characteristics appear to be related to an increased risk of thromboembolic complications, including: male sex, age 60 years, prior history of DVT, bilateral ST and infection. Other characteristics, such as proximity of the thrombotic process to the deep vein system, do not appear to elevate the risk of thromboembolic complications. The association of ST with thromboembolic complications has raised doubts about the benign nature of the condition, and use of vascular ultrasonography to conduct more thorough investigations is recommended more and more. […] Clinical approaches that have been described include: recommending walking and rest in the Trendelemburg position, non-steroidal anti-inflammatories, elastic compression, anticoagulation (prophylactic or therapeutic) and topical treatments. Of these options, those that appear to offer potential benefits are anticoagulant treatment (although there is no consensus whether dosages should be prophylactic or therapeutic) and anti-inflammatories.

• #5 Thrombophlebitis: Causes, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/23311-thrombophlebitis

  In many cases, the treatments mentioned before aren’t necessary. In those cases, your healthcare provider will likely recommend supportive treatments. These include: […] The severity of your case and the treatments you receive determine when you feel better and how long it takes you to recover. In general, you should start to feel better while your symptoms are being treated, especially with medications that treat pain. Most people recover from thrombophlebitis within days, but some may need a little longer (especially if they had complications, the clot was in a critical location or they needed surgery).

• #6 Superficial thrombophlebitis | Healthify

  https://healthify.nz/health-a-z/s/superficial-thrombophlebitis/

  Superficial thrombophlebitis gets better by itself, usually within 2 6 weeks. Your body breaks down the blood clot and the inflammation goes away. […] In the meantime, you can use non-steroidal anti-inflammatory creams or gels which you buy over the counter at a pharmacy. Or you can take pain killers by mouth, eg, paracetamol or non-steroidal anti-inflammatories (if they are safe for you to use.) […] You can get compression stockings to help with pain through a pharmacy or practice nurse at your medical centre. You need to be measured for these to work well and you will need to pay for them yourself. […] If your superficial thrombophlebitis is longer than 8 cm or near your groin, your healthcare provider will talk with you about anticoagulants (medicines that help to stop blood clots forming) because of the risk of the clot extending into your deep veins.

• #7 Phlebitis (superficial thrombophlebitis)

  https://www.nhs.uk/conditions/phlebitis/

  Treatment for phlebitis may not be needed if your symptoms are mild. […] But treatment may be recommended if your symptoms are severe or do not go away. […] Treatments may include: […] anti-inflammatory medicines cream or gel can be used if the affected area is small […] compression stockings these increase blood flow to the legs but are only suitable for some people with phlebitis […] blood-thinning medicine to reduce the risk of blood clots and help stop phlebitis coming back.

• #8 Should I See a Vein Specialist for Superficial Thrombophlebitis? : Center for Varicose Veins: Board Certified Vascular and Interventional Radiologists

  https://www.centerforvaricoseveins.com/blog/should-i-see-a-vein-specialist-for-superficial-thrombophlebitis

  Superficial thrombophlebitis occurs when a blood clot forms near the skins surface, causing the blood vessels to become inflamed. The condition can cause various symptoms, including pain, swelling, tenderness, warmth, and inflammation. […] You should contact a vein specialist at the first sign of symptoms. After evaluating your condition, your provider can create a treatment plan to manage your symptoms and help you recover. […] Your treatment will depend greatly on your risk for developing cellulitis or deep vein thrombosis. If you’re low risk, your doctor might send you home with care instructions that include taking anti-inflammatory medications and using warm or cold compresses to manage the pain. You also might need to wear compression stockings and keep your legs elevated. Walking is also necessary when you are recovering from superficial thrombophlebitis.

• #9 Phlebitis (5 Natural Ways to Improve Symptoms) – Dr. Axe

  https://draxe.com/health/phlebitis/

  People with superficial phlebitis or mild superficial thrombophlebitis are often told to maintain their regular activities. This helps prevent blood clots. […] A randomized, controlled trial found that people with blood clots who wore compression stockings below the knee were half as likely to have complications or another blood clot in the next five years as people who didn’t wear them. […] Treatment for phlebitis usually involves anti-inflammatory drugs and blood thinners. Many natural herbs and supplements can have these effects as well. […] Phlebitis is irritation of the veins lining. Although a supportive diet may not make an immediate difference in your symptoms, over time it may help your blood vessels stay healthy and strong. […] In most cases, superficial phlebitis or superficial thrombophlebitis can be treated quickly and easily.

• #10 Superficial thrombophlebitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/superficial-thrombophlebitis

  To reduce discomfort and swelling, your provider may recommend that you: […] Wear support stockings, if your leg is affected. […] Keep the affected leg or arm raised above heart level. […] Apply a warm compress to the area. […] If you have a catheter or intravenous (IV) line, it will likely be removed if it is the cause of the thrombophlebitis. […] Medicines called nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to reduce pain and swelling. […] If clots in the deeper veins are also present, your provider may prescribe medicines to thin your blood. These medicines are called anticoagulants. Antibiotics are prescribed if you have an infection. […] Surgical removal (phlebectomy), stripping, or sclerotherapy of the affected vein may be needed. These treat large varicose veins or are done to prevent thrombophlebitis in high-risk people.

• #11 Superficial Thrombophlebitis Treatment & Management: Approach Considerations, Compression Stockings, Pharmacologic Therapy

  https://emedicine.medscape.com/article/463256-treatment

  The treatment of superficial venous thrombosis depends on the conditions etiology, extent, and symptoms. Duplex ultrasonography (US) gives an accurate appraisal of the extent of disease and thus allows the administration of a more rational therapy. […] For the superficial, localized, mildly tender area of thrombophlebitis that occurs in a varicose vein, treatment with mild analgesics, such as aspirin, and the use of some type of elastic support usually are sufficient. Patients are encouraged to continue their usual daily activities. If extensive varicosities are present or if symptoms persist, phlebectomy of the involved segment may be indicated. […] More severe thrombophlebitis, as indicated by the degree of pain, redness, and the extent of the abnormality, should be treated with elevation of the extremity and the application of massive hot wet compresses. The latter measure seems to be more effective when a large, bulky dressing, including a blanket and plastic sheeting followed by hot water bottles, is used, taking care to avoid burning the patient.

• #12 Superficial thrombophlebitis

  https://dermnetnz.org/topics/superficial-thrombophlebitis

  Mild cases of superficial thrombophlebitis may not need any treatment. Usually, symptoms will resolve within 34 weeks. You should try to keep up with normal routines and remain active. […] In more severe cases the following treatments may be used. […] Raise the leg and apply warm compresses. This can be done with a hot flannel placed over the vein or using a blanket and hot water bottles. Take care not to burn. […] Elastic supports or compression stockings can help to reduce swelling whilst the inflammation settles. […] Painkilling medication paracetamol, aspirin or non-steroidal anti-inflammatories such as ibuprofen. Always check with your doctor or pharmacist before taking any medication. […] Anti-inflammatory gels or creams such as ibuprofen gel may be useful in mild cases. […] Low molecular weight heparin (LMWH) medications, for example, enoxaparin, may help to reduce swelling and pain and also decrease the chances of blood clots moving further up the vein and causing a DVT.

• #13 Superficial Thrombophlebitis Treatment Adelaide, SA | Duplex Ultrasound Scan Norwood, SA

  https://www.vascularcareadelaide.com.au/superficial-thrombophlebitis.html

  The treatment of superficial thrombophlebitis mainly aims to reduce inflammation and pain and also prevent the complication of deep vein thrombosis. You may be advised the following treatment options depending on the severity of your condition. […] Compression stockings are designed to help reduce the swelling in the legs following DVT and it also improves the drainage of blood from the legs. […] Anti-inflammatory ointments and gels may also be effective in alleviating the pain. […] NSAIDs may be prescribed by your doctor for pain and inflammation. […] Anti-coagulants to promote thinning of blood are recommended if there is extension of the clot towards the junction with the deep veins or in cases of DVT.

• #14 Phlebitis: Symptoms, Causes, Diagnosis, and Treatment

  https://www.verywellhealth.com/thrombophlebitis-7111584

  As painful and distressing as phlebitis can sometimes be, most cases are not serious and will resolve on their own over time. […] Uncomplicated cases will typically respond to the following treatments aimed at easing pain and reducing local inflammation: Heat applications: Applying a heating pad or a hot water bottle to the affected area increases blood circulation and promotes healing. Elevating the leg: Propping up your feet as much as possible reduces blood pressure around the affected vein, easing pain and swelling. Compression stockings: Elastic compression socks, available over the counter or by prescription, prevent blood pooling in the lower limbs, reducing pain and swelling. Oral painkillers: Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen) can also reduce inflammation and pain.

• #15 Superficial Thrombophlebitis Medication: Nonsteroidal Anti-inflammatory Drugs, Anticoagulants, Hematologic, Antibiotics

  https://emedicine.medscape.com/article/463256-medication

  Some anti-inflammatory drugs may be of benefit in the treatment of superficial thrombophlebitis. Salicylates, indomethacin, and ibuprofen have been reported to be effective. In addition, salicylates, ibuprofen, and dipyridamole have been used as antithrombotic agents, but their effectiveness has not been documented in this setting. […] Because thrombophlebitis is primarily due to inflammation and fibrin clot, antithrombotic or antiplatelet-aggregating agents would seem to have little value. Anticoagulants are usually not indicated unless the process extends into the deep venous system. […] Additionally, in rare cases in which persistent inflammation is present in an area of superficial thrombophlebitis, a brief course of low-molecular-weight heparin (LMWH) can be used as an alternative to excision of the vein in order to bring the inflammation under control. This treatment alternative may be necessary for management of superficial thrombophlebitis associated with pregnancy.

• #16 Management of superficial vein thrombosis and thrombophlebitis: status and expert opinion document – PubMed

  https://pubmed.ncbi.nlm.nih.gov/17478877/

  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. […] 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.

• #17 Superficial Thrombophlebitis Treatment & Management: Approach Considerations, Compression Stockings, Pharmacologic Therapy

  https://emedicine.medscape.com/article/463256-treatment

  Current pharmacologic treatment options are aimed at resolving symptoms, preventing recurrence and most importantly, and preventing extension to the deep venous system, which may potentially result in thromboembolism. Previous treatment options were based on a Cochrane review published in 2007 that showed that nonsteroidal anti-inflammatory drugs (NSAIDs) and low-molecular-weight heparin (LMWH) are the first options. […] A second Cochrane review published in 2013 added, among others, a large randomized control study that included more than 3000 patients with superficial thrombophlebitis and compared fondaparinux with placebo. The investigators found fondaparinux to be a good option for treatment of superficial thrombophlebitis and prevention of some of its associated complications. […] A third Cochrane review, published in 2018, found that prophylactic-dose fondaparinux for 45 days appeared to be a valid therapeutic option for most patients.

• #18 What is the best therapy for superficial thrombophlebitis? | MDedge Family Medicine

  https://www.mdedge9-ma1.mdedge.com/familymedicine/article/60248/pain/what-best-therapy-superficial-thrombophlebitis

  One large double-blind randomized controlled trial compared tenoxicam (an NSAID available in Canada, similar to piroxicam), enoxaparin (Lovenox), and placebo for 8 to 12 days in 427 patients with SVTP of the leg measuring 5 cm or more. Patients were also treated with compression hose. […] For infusion-related SVTP, a randomized controlled trial of 120 patients found both oral and topical diclofenac effective in reducing symptoms (NNT=3), although oral diclofenac had significantly more gastrointestinal side effects (number needed to harm=3 for dyspepsia). […] Two double-blind trials of topical heparin showed it to be superior to placebo in reducing symptoms and speeding healing. […] A randomized trial of infusion-related SVTP (n=100) found that 2% nitroglycerin gel eliminated pain in 50 hours vs 72 hours with topical heparin (P<.05). [...] For SVTP of the leg that does not include the proximal saphenous vein, Up To Date recommends compression and oral NSAIDs, noting that NSAIDs are inexpensive, help with symptom control, and appear comparable to low-molecular-weight heparin in limiting complications.

• #19 Treatment of Superficial Vein Thrombosis: Recent Advances, Unmet Needs and Future Directions

  https://www.mdpi.com/2227-9032/12/15/1517

  This review focuses on the anticoagulant treatment for SVT, emphasizing key unmet needs with current options, and discussing the potential of ongoing studies to address current knowledge gaps. […] Current clinical guidelines suggest anticoagulant treatment with fondaparinux for 45 days for most patients with SVT of the lower extremities. Potential alternatives are represented by rivaroxaban 10 mg once daily or intermediate-dose LMWH. However, whether the same agents and regimens can be effectively and safely adopted regardless of SVT extension or underlying risk factors remains unclear. […] Anticoagulation with fondaparinux for 45 days is generally recommended as first line treatment for most patients with SVT of the lower extremities, while intermediate-dose LMWH or rivaroxaban 10 mg once daily are suggested as reasonable alternatives. However, several uncertainties and knowledge gaps remain, including the optimal dose of LMWH, the efficacy and safety of systemic or topical anti-inflammatory agents either alone or in combination with anticoagulants, and the ideal duration of anticoagulation in high-risk patients.

• #20 Treatment – GPnotebook

  https://gpnotebook.com/pages/cardiovascular-medicine/superficial-vein-thrombosis/treatment

  if thrombus extends to the sapheno-femoral or sapheno-popliteal junctions prophylactic use of low molecular weight heparin may be indicated. Surgical intervention is a controversial option if anticoagulation is contraindicated or not tolerated, but it may compound the risk of venous thromboembolism. […] Prophylactic anticoagulation is recommended for all patients with a superficial thrombus 5 cm in length within the great saphenous (GSV), small saphenous (SSV), or anterior accessory great saphenous (AASV) veins and 3 cm from the sapheno-femoral or sapheno-popliteal junctions (5). […] Guidelines recommend 45 days of anticoagulation, with prophylactic doses of fondaparinux as the preferred option (5).

• #21 Superficial Thrombophlebitis Medication: Nonsteroidal Anti-inflammatory Drugs, Anticoagulants, Hematologic, Antibiotics

  https://emedicine.medscape.com/article/463256-medication

  Antibiotics are usually not necessary in superficial thrombophlebitis unless the process is suppurative. In persistent cases or even as early definitive therapy, excision of the inflammatory process is effective. The wounds usually heal well with primary closure; the inflammatory process, except in suppurative phlebitis, is usually nonbacterial and localized and is removed completely. […] Heparin is essential for patients with superficial thrombophlebitis that is progressive and for those with particular risk factors for progression or recurrence. Heparin should always be used when thrombophlebitis involves the great saphenous vein. Heparin is the mainstay of treatment when deep system involvement is suggested, but anticoagulation alone does not guarantee a successful outcome. The disease may progress despite full and effective heparin anticoagulation.

• #22 Superficial Thrombophlebitis (SVT) – RefHelp

  https://apps.nhslothian.scot/refhelp/guidelines/haematology/superficialthrombophlebitis/

  If more than 5cm in length may be better treated with low molecular weight heparin for 6 weeks; In NHS Lothian it is advised to prescribe a treatment dose of dalteparin (200 units/Kg subcutaneously daily) for 6 weeks duration. […] Patients should be examined for foot pulses and, if present, patients may be offered Class 1 compression stockings, which may help symptoms. Patients without detectable foot pulses do not need compression. ABPI measurement is not required. […] Patients with two or more episodes of thrombophlebitis of the proximal long or short saphenous veins should be referred to the Vascular Service electively.

• #23 Superficial Thrombophlebitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30109

  This Cochrane review also evaluated topical and surgical treatments. Still, it noted that the data regarding these treatments and their effects on venous thromboembolic disease is too limited, so further studies are recommended at this time. Rivaroxaban 10 mg daily for 45 days was found to be non-inferior to fondaparinux in preventing venous thromboembolic complications, with a comparable safety profile in the SURPRISE trial. […] Additionally, further study is recommended on the use of nonsteroidal anti-inflammatory agents and low molecular weight heparins. […] For Trousseau syndrome, the main priority is to eliminate the underlying malignancy. However, as this is commonly a challenge, heparin is the recommended treatment, given that multiple pathways contribute to developing the thrombus. […] Mondor disease, discussed separately, is usually self-limited and benign and resolve in 4 to 8 weeks. However, if it is due to vasculitis, malignancy, or a hypercoagulable state, treatment is aimed at the underlying cause.

• #24 Superficial Thrombophlebitis Medication: Nonsteroidal Anti-inflammatory Drugs, Anticoagulants, Hematologic, Antibiotics

  https://emedicine.medscape.com/article/463256-medication

  When unfractionated heparin is used, an aPTT of at least 1.5 times the control value is necessary for a therapeutic effect. To achieve this, unfractionated heparin must be given intravenously in adequate doses. Low-dose, subcutaneous unfractionated heparin should not be used, as it is not an effective therapy for thrombophlebitis and does not provide effective prophylaxis against progression of the disease. […] Warfarin should not be used in the acute treatment of superficial phlebitis, because the early risk of increased thrombogenesis outweighs any convenience of oral therapy. […] These agents are not routinely useful in nonseptic superficial phlebitis. Antibiotics are indicated whenever infection is suspected to play a role and whenever phlebitis of the great saphenous vein above the knee threatens to approach the saphenofemoral junction. The choice of antibiotics should be guided by blood culture results whenever possible, but empiric therapy should at a minimum provide coverage for group A streptococci and for Staphylococcus aureus.

• #25

  https://www.scielo.br/j/jvb/a/jCwCvPMd8bQFgywdVFQK7Fh/

  Successive pronouncements of the American College of Chest Physicians (ACCP) illustrate this: CHEST 2004 (7th edition): If ST is triggered by intravenous infusion, systemic or topical anti-inflammatories are recommended. If ST is spontaneous, the recommendation is unfractionated or low molecular weight heparin for a minimum of 4 weeks. CHEST 2008 (8th edition): Suggests combining anti-inflammatories with anticoagulant treatment. Emphasizes the recommendation that when the ST thrombotic process is distant from the connection with the deep vein system, topical or systemic anti-inflammatory treatment should be prescribed. CHEST 2012 (9th edition): Anti-inflammatories are relegated to the second option, and the recommendation is that treatment should be with fondaparinux or low molecular weight heparin in prophylactic doses, if the thrombotic process is 5 cm long.

• #26 Management of superficial vein thrombosis of the lower limbs: update and current recommendations – Servier – PhlebolymphologyServier – Phlebolymphology

  https://www.phlebolymphology.org/management-of-superficial-vein-thrombosis-of-the-lower-limbs-update-and-current-recommendations/

  The recommendations and guidelines have assigned these treatments with a low grade, and questions remain about SVT management. […] Treatment of SVT has always been a controversial topic. Great variations in the treatment are reported, especially regarding anticoagulant therapy. […] The use of anticoagulant therapy in patients presenting with an SVT was first reported in 1962 by Zollinger et al, after observing the occurrence of a PE, which was fatal in 34 (10.1%) of a series of 335 patients with an SVT. […] Until recently, although numerous anticoagulant strategies had been tested, including unfractionated heparin or low molecular-weight heparin, at prophylactic or therapeutic doses for various durations, none had clearly demonstrated any clinical benefit. […] The randomized, double-blind CALISTO study compared fondaparinux 2.5 mg daily for 45 days with placebo in 3002 patients with an isolated symptomatic lower limb SVT that was at least 5 cm in length.

• #27 Treatment for superficial thrombophlebitis of the leg – Di Nisio, M – 2018 | Cochrane Library

  https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004982.pub6/abstract

  Prophylactic dose fondaparinux given for 45 days appears to be a valid therapeutic option for ST of the legs for most people. […] The evidence on topical treatment or surgery is too limited and does not inform clinical practice about the effects of these treatments in terms of VTE. […] Further research is needed to assess the role of rivaroxaban and other direct oral factorX or thrombin inhibitors, LMWH, and NSAIDs; the optimal doses and duration of treatment in people at various risk of recurrence; and whether a combination therapy may be more effective than single treatment. […] Adequately designed and conducted studies are required to clarify the role of topical and surgical treatments. […] Overall, topical treatments improved local symptoms compared with placebo, but no data were provided on the effects on VTE and ST extension. […] Surgical treatment combined with elastic stockings was associated with a lower VTE rate and ST progression compared with elastic stockings alone.

• #28 Management of superficial vein thrombosis of the lower limbs: update and current recommendations – Servier – PhlebolymphologyServier – Phlebolymphology

  https://www.phlebolymphology.org/management-of-superficial-vein-thrombosis-of-the-lower-limbs-update-and-current-recommendations/

  The primary efficacy outcome occurred in 0.9% of patients in the fondaparinux group and 5.9% in the placebo group (P<0.001). [...] In practice, most experts recommend treating patients with SVT extended at the SFJ or SPJ with anticoagulant therapy at therapeutic doses for 3 months. [...] SVT should no longer be considered a benign disease. Recent epidemiological studies, which have included a large number of patients, have shown the potential severity of SVTs and have clearly defined their place within the VTE diseases. [...] The recommendations were updated after the CALISTO study validated the anticoagulant therapy protocol based on fondaparinux 2.5 mg daily for 45 days.

• #29 Treatment for thrombophlebitis:

  https://www.medicalnewstoday.com/articles/treatment-for-thrombophlebitis

  Treatment for thrombophlebitis depends on the severity and location of the condition. Options for thrombophlebitis that affect the deep veins may include surgery and medications that help prevent or dissolve blood clots. […] Most occurrences of thrombophlebitis affecting veins close to the skin surface resolve without intervention. However, the usual treatment for this involves home care measures, such as elevating the leg, wearing elastic stockings, and applying warm compresses. In more severe cases, people may require medications that help prevent blood clots. […] Treatment for thrombophlebitis depends on the severity and whether the condition occurs in the surface veins or deep veins. […] Treatment of superficial thrombophlebitis usually involves home care measures, such as elevating the leg, applying warm compresses, wearing compression or elastic stockings, and taking medications to reduce pain or inflammation. Doctors prescribe antibiotics only if an infection is present.

• #30 Superficial Thrombophlebitis: Symptoms and Treatment | CVR

  https://www.centerforvein.com/blog/superficial-thrombophlebitis-symptoms-treatment

  Most cases of superficial thrombophlebitis can be effectively managed with conservative treatments aimed at reducing symptoms and preventing complications: […] Wearing compression stockings helps improve blood flow in the legs and can reduce swelling and discomfort. […] The Mayo Clinic recommends elevating the affected limb to alleviate pain and swelling and using medications such as ibuprofen to reduce pain and inflammation further. […] According to ScienceDirect, applying warm, moist compresses (e.g., a washcloth soaked in warm water) to the affected area can help reduce pain and inflammation by dilating blood vessels and increasing oxygenation. […] Staying hydrated and maintaining moderate activity levels can improve circulation and prevent further clotting. […] In cases where conservative measures are insufficient, or if complications arise, more aggressive treatments may be necessary:

• #31 Thrombophlebitis (Superficial and Migratory): Symptoms, Causes, Treatment

  https://www.webmd.com/dvt/understanding-thrombophlebitis-basics

  Most cases of thrombophlebitis in the shallow veins begin to go away by themselves in a week or two. But on rare occasions, these blocked veins can lead to infection. They can even cause tissue damage from the loss of healthy circulation. […] If you need treatment, your doctor probably will give you something to ease swelling and pain. They may recommend that you keep your leg raised or take over-the-counter aspirin or ibuprofen. They also might suggest you apply heat to the affected leg or arm for 15 to 30 minutes, two to three times daily. […] Antibiotics. You might get them if poor circulation leads to an infection. […] Blood thinners. These medications are usually reserved for thrombosis with a high risk of embolization to the lungs or brain. Deep vein thrombosis requires anticoagulation for this reason. You can give yourself enoxaparin (Lovenox) at home through shots under your skin. They help keep the clot from getting bigger. You also may have to take an oral drug such as warfarin (Coumadin) for several months or longer to keep clots from coming back. Your doctor will give you regular blood tests to make sure the meds are working. Other blood thinners include direct thrombin inhibitors and factor Xa inhibitors. They include apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Savaysa), and rivaroxaban (Xarelto).

• #32 Superficial Thrombophlebitis Treatment & Management: Approach Considerations, Compression Stockings, Pharmacologic Therapy

  https://emedicine.medscape.com/article/463256-treatment

  Anticoagulants are usually not indicated in superficial thrombophlebitis unless the process extends into the deep venous system or persistent inflammation is present in an affected area. […] In the case of thrombosis of a hemorrhoid, evacuation of the thrombus, though very painful, usually provides rapid relief. Magnesium sulfate compresses may also be used to alleviate swelling and pain, though surgery is sometimes necessary to remove the clot from the hemorrhoid. […] Long heavy-gauge elastic stockings or multiple elastic (Ace) bandages are indicated when the patient becomes ambulatory. […] Gradient compression stockings are an often-overlooked adjunctive therapy that is both benign and effective. These highly elastic stockings provide a gradient of compression that is highest at the toes (at least 30-40 mm Hg) and gradually decreases to the level of the thigh. This amount of compression reduces capacitive venous volume by approximately 70% and increases the measured velocity of blood flow in the deep veins by a factor of 5 or more. Gradient compression hose also have been shown to increase local and regional intrinsic fibrinolytic activity.

• #33 Thrombophlebitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thrombophlebitis/diagnosis-treatment/drc-20354613

  Your doctor might also recommend these treatments for both types of thrombophlebitis: Blood-thinning medications. If you have deep vein thrombosis, injection of a blood-thinning (anticoagulant) medication, such as low molecular weight heparin, fondaparinux (Arixtra) or apixaban (Eliquis), can help prevent clots from growing bigger. After the first treatment, you’ll likely be told to take warfarin (Jantoven) or rivaroxaban (Xarelto) for several months to keep preventing clot growth. Blood thinners can cause excessive bleeding. Always follow your doctor’s instructions carefully. […] Compression stockings. Prescription-strength compression stockings help prevent swelling and reduce the chances of complications of DVT. […] A surgeon can remove varicose veins that cause pain or recurrent thrombophlebitis. The procedure involves removing a long vein through small incisions. Removing the vein won’t affect blood flow in your leg because veins deeper in the leg take care of the increased volumes of blood.

• #34 Superficial Thrombophlebitis

  https://emed.ie/Dermatology/Thrombophlebitis.php

  Arterial disease may develop in people with venous disease. Please check ankle brachial pressure index (ABPI) before prescribing Ted stockings. […] ABPI 0.5 – Compression treatment contraindicated […] ABPI 0.5 – 0.8: Ted stockings generally avoided […] ABPI 0.8: Teds safe […] Thrombophlebitis occurs in a previously normal superficial vein and there is no obvious predisposing cause […] Consider a thrombophilia screen. Please check with haematology team as this is rarely indicated in ED (presence of an acute clot interferes with results) […] Migratory or recurrent thrombophlebitis is an indication for a more detailed search for a malignant lesion, or Behcet’s syndrome or Buerger’s disease (again, please check with haematology) […] Admit CDU if systemically unwell […] Suppurative thrombophlebitis […] DVT […] Chest pain or dyspnoea (? PE).

• #35 Superficial Thrombophlebitis: Causes, Symptoms, and Treatment

  https://patient.info/heart-health/varicose-veins-leaflet/superficial-thrombophlebitis

  Superficial thrombophlebitis is inflammation of a vein just under the skin, usually in the leg. Treatments can ease pain or discomfort. […] One or more of the following treatments may be advised, depending on your symptoms and the severity of the condition: Keep active. Try to keep up your normal activities. This should be possible unless the pain is severe. […] Apply a warm compress (a hot cloth) over the vein. This may ease the pain. […] Painkilling tablets. Anti-inflammatory painkillers such as ibuprofen may ease the pain (but are not advised if you are pregnant). Paracetamol is an alternative. […] Anti-inflammatory creams or gels. An example is ibuprofen gel. These are an alternative if superficial thrombophlebitis is mild and only affects a small area of vein. […] Hirudoid cream (heparinoid) may improve your symptoms, although there is some evidence that heparin gel may be more effective.

• #36 Management of superficial venous thrombophlebitis associated with peripheral venous catheters: A review. | Published in Global Journal of Surgery and Case Reports

  https://www.gjscr.com/article/118529-management-of-superficial-venous-thrombophlebitis-associated-with-peripheral-venous-catheters-a-review

  Topical heparinoid or diclofenac gels appear to significantly reduce the intensity of clinical signs and symptoms and achieve higher complete resolution. […] According to the 2008 guidelines of the American College of Chest Physicians these patients can be treated with an oral anti-inflammatory drug, topical diclofenac gel, or heparin gel until resolution of symptoms or for up to two weeks. […] A venous duplex ultrasound is recommended in patients with spontaneous SVT because concomitant deep venous thrombosis (DVT) occurs in 6-36% of patients. […] If symptoms persist after 48 hrs of conservative management, patient develops fever, erythema extends beyond the cannulated vein, or purulence develops at the cannulation site, blood cultures to evaluate for bacteremia, antibiotic therapy, and early surgical consultation are very important as these are signs of suppurative SVT.

• #37 Treatment for superficial thrombophlebitis of the leg | Cochrane

  https://www.cochrane.org/CD004982/PVD_treatment-superficial-thrombophlebitis-leg

  Superficial thrombophlebitis (ST) is a relatively common inflammatory process associated with a blood clot (thrombus) that affects the superficial veins (veins that are close to the surface of the body). […] Treatment aims to relieve the local symptoms and to prevent the extension of the clot into a deep vein, ST recurrence, or the development of more serious events caused by VTE. […] One large study, accounting for half of the participants included in the review, showed that treatment with fondaparinux for 45 days was associated with a significant reduction in symptomatic VTE, ST extension, and recurrence of ST compared to placebo. […] Both low molecular weight heparin and NSAIDs reduced the occurrence of extension or recurrence of ST with no effect on symptomatic VTE or major bleeding.

• #38 Treatment for superficial thrombophlebitis of the leg – itjem

  https://www.itjem.org/2018/07/16/treatment-for-superficial-thrombophlebitis-of-the-leg/

  Superficial thrombophlebitis (ST) is a common condition, with a prevalence of about 0,64% per year. In the last decades, many different therapeutic strategies have been proposed but only recently data from large trials are available for decision making. Main focuses of the treatment should be the prevention of evolution to deep vein thrombosis (DVT) and pulmonary embolism (PE) and the reduction of pain, that is frequently associated. The review we will summarize evaluates the efficacy and safety of the topical, medical and surgical treatments for ST tested in randomized clinical trials. […] Objective: to assess the efficacy and safety of topical, medical, and surgical treatments for ST of the leg in improving local symptoms and decreasing thromboembolic complications. […] Both the American College of Chest Physicians and British Committee for Standards in Haematology (BCSH) documents suggest anti-coagulation for ST of the legs longer than 5 cm with fondaparinux o prophylactic dose LMWH. In this systematic review, fondaparinux (2,5 mg daily for 45 days) appeared to be efficacious in reducing the incidence of MTVE during the follow up (RR 0,15 [95% C.I. 0,04 0,5]), the extension and the recurrence of SVT based on data from the CALISTO trial; quality of evidence was downgraded to moderate because of low number of events.

• #39 Superficial Thrombophlebitis Treatment & Management: Approach Considerations, Compression Stockings, Pharmacologic Therapy

  https://emedicine.medscape.com/article/463256-treatment

  Fondaparinux is an anticoagulant derived from the binding region of heparin and antithrombin. It is an inhibitor of factor Xa, and its main uses are the same as those of heparin more specifically, prevention and treatment of venous thrombosis and pulmonary embolism (PE). Fondaparinux is not shown to interact with platelets and platelet factor 4 and thus theoretically should not cause heparin-induced thrombocytopenia (HIT). […] The 2007 Cochrane review cited above suggested that anticoagulation with LMWH is better in reducing local signs and symptoms, along with reducing propagation to deep venous thrombosis (DVT). […] The efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) is similar to that of LMWH in reducing the risk of extension of superficial thrombophlebitis into the deep venous system along with decreasing recurrence.

• #40 Management of superficial vein thrombosis of the lower limbs: update and current recommendations – Servier – PhlebolymphologyServier – Phlebolymphology

  https://www.phlebolymphology.org/management-of-superficial-vein-thrombosis-of-the-lower-limbs-update-and-current-recommendations/

  Management of superficial vein thrombosis of the lower limbs: update and current recommendations […] Until recently, numerous anticoagulant strategies have been tested, with no clearly demonstrated clinical benefit. However, the recent CALISTO study (Comparison of Arixtra in lower LImb Superficial vein ThrombOsis with placebo) validated an anticoagulant therapy protocol based on fondaparinux, 2.5 mg daily for 45 days, resulting in updated recommendations for the management of SVT. […] For patients with symptomatic SVT at least 5 cm in length, it is recommended to prescribe a prophylactic dose of fondaparinux or low-molecular-weight heparin for 45 days over no anticoagulation (Grade 2B), and when the cost of treatment with fondaparinux is acceptable, it is recommended to use fondaparinux 2.5 mg daily vs low-molecular-weight heparin (Grade 2C).

• #41 Superficial Venous Thrombosis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/peripheral-venous-disorders/superficial-venous-thrombosis

  Treatment of superficial venous thrombosis traditionally involves warm compresses and NSAIDs. […] In patients with extensive superficial venous thrombosis, anticoagulation (eg, with low molecular weight heparin, fondaparinux) is often beneficial. […] 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).

• #42 Treating thrombophlebitis

  https://www.topdoctors.co.uk/medical-articles/treating-thrombophlebitis

  Once the acute episode of thrombophlebitis has settled, it is then necessary to try and correct the underlying cause to prevent the same thing happening again in the future. […] Generally, if deep vein thrombosis is in the pelvic veins or in the major deep veins in the leg above the knee, anticoagulation is the norm. […] By preventing clots from spreading, the body is able to get rid of the original clot. […] If deep vein thrombosis is below the knee, many doctors won’t use anticoagulation solely. […] Migratory thrombophlebitis doesn’t actually occur. […] Therefore, thrombophlebitis appears in one vessel followed by thrombophlebitis in another vessel, often in another limb. […] As such, immediate symptomatic relief can be given in the form of painkillers and anti-inflammatories and intravenous heparin or other anticoagulation can be started.

• #43 Treatment for superficial thrombophlebitis of the leg | Cochrane

  https://www.cochrane.org/CD004982/PVD_treatment-superficial-thrombophlebitis-leg

  In conclusion, fondaparinux appears to be an adequate treatment for most people with ST. […] Prophylactic dose fondaparinux given for 45 days appears to be a valid therapeutic option for ST of the legs for most people. […] Further research is needed to assess the role of rivaroxaban and other direct oral factor-X or thrombin inhibitors, LMWH, and NSAIDs; the optimal doses and duration of treatment in people at various risk of recurrence; and whether a combination therapy may be more effective than single treatment. […] Overall, topical treatments improved local symptoms compared with placebo, but no data were provided on the effects on VTE and ST extension. Surgical treatment combined with elastic stockings was associated with a lower VTE rate and ST progression compared with elastic stockings alone.

• #44 Thrombophlebitis: Causes, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/23311-thrombophlebitis

  In cases where thrombophlebitis happens because of IV or catheter lines, removing that line is usually the first step. Other treatments usually involve the following. […] Several different types of medications can help with the symptoms of thrombophlebitis and resolve the involved clot. These include: […] Because thrombophlebitis can be very painful, controlling that pain is usually one of the top priorities. This often involves milder drugs, like acetaminophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen. If the pain is more severe, providers may prescribe stronger medications. […] By definition, thrombophlebitis involves at least one blood clot. However, where there’s one, there’s a risk for more to form. To prevent more clots from forming, especially clots that might cause a life-threatening condition like a pulmonary embolism, healthcare providers will often give you blood thinners.

• #45 What is the best therapy for superficial thrombophlebitis? | MDedge Family Medicine

  https://www.mdedge9-ma1.mdedge.com/familymedicine/article/60248/pain/what-best-therapy-superficial-thrombophlebitis

  For proximal saphenous vein thrombosis, anticoagulation is more effective than venous ligation (with or without stripping) in preventing deep venous thrombosis (DVT) and pulmonary embolus (PE) (strength of recommendation [SOR]: C, qualitative systematic review of primarily case series). […] For patients with superficial venous thrombophlebitis (SVTP) distal to the saphenous vein of the thigh, tenoxicam (a nonsteroidal anti-inflammatory agent [NSAID]) and low-molecular-weight heparin are similarly effective for reducing extension and subsequent DVT when administered along with compression therapy (SOR: B, 1 randomized controlled trial). Oral or topical NSAIDs, topical heparin, and topical nitroglycerin all alleviate symptoms and speed resolution of SVTP caused by infusion catheters (SOR: B, smaller, occasionally conflicting randomized trials).

• #46 Treatment – GPnotebook

  https://gpnotebook.com/pages/cardiovascular-medicine/superficial-vein-thrombosis/treatment

  The treatment of superficial thrombophlebitis can be controversial: […] Treatment options include: (1) gentle support by means of a bandage or stocking and elevation of the affected leg […] anti-inflammatory drugs such as ibuprofen 400mg t.d.s […] topical measures include treatment with preparations such Hirudoid […] use of low molecular weight heparin. […] In patients with a high risk of thrombus progression into the deep venous system and embolisation, anticoagulation is recommended to prevent thrombus extension, thromboembolic complications, and recurrence. (1) […] Therapeutic strategies must include symptomatic relief, limitation of thrombosis extension, and, very importantly, reduction of the risk of pulmonary embolism (2): […] in cases of limited (below knee) superficial thrombophlebitis without evidence of deep vein thrombosis, compression and non-steroidal anti-inflammatory drugs alone will suffice by providing symptomatic relief

• #47 Superficial thrombophlebitis – Wikipedia

  https://en.wikipedia.org/wiki/Superficial_thrombophlebitis

  Treatment with compression stockings should be offered to patients with lower extremity superficial phlebitis, if not contraindicated (e.g., peripheral artery disease). Patients may find them helpful for reducing swelling and pain once the acute inflammation subsides. […] Nonsteroidal anti-inflammatory drugs (NSAID) are effective in relieving the pain associated with venous inflammation and were found in a randomized trial to significantly decrease extension and/or recurrence of superficial vein thrombosis. […] Anticoagulation is recommended for patients with lower extremity superficial thrombophlebitis at increased risk for thromboembolism (affected venous segment of 5 cm, in proximity to deep venous system, positive medical risk factors). […] Treatment with fondaparinux reduces the risk of subsequent venous thromboembolism.

• #48 Thrombophlebitis: Causes, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/23311-thrombophlebitis

  Commonly known as clot-busting drugs, these medications actively break down existing clots. These may be given through an IV or delivered directly to the clot using catheters placed in your blood vessels. […] In cases where thrombophlebitis involves an infection, antibiotic medications are essential. Antibiotics can prevent an infection from spreading throughout your body and causing sepsis. […] In rarer cases, surgery is the best option to help treat severe thrombophlebitis (especially in your legs). Surgery can involve one or more of the following procedures: […] Your healthcare provider may instruct you to wear compression items or clothing. These items, such as socks, stockings or wrappings/bandages, put consistent (but light) pressure on certain parts of your body. That pressure can help prevent new clots from forming and ease the pain and swelling from any previous clot(s).

• #49 Treatment for thrombophlebitis:

  https://www.medicalnewstoday.com/articles/treatment-for-thrombophlebitis

  Sometimes, treating people with deep vein thrombosis or more serious cases of superficial thrombophlebitis may involve anticoagulants. These are blood-thinning drugs that can help dissolve existing clots and help prevent further clots from forming. […] Thrombolytics are another treatment option for deep vein thrombosis or more serious cases of superficial thrombophlebitis. These are clot-dissolving medications that doctors only prescribe if a person has an extremely high risk of developing a pulmonary embolism. […] If anticoagulants do not work or a person cannot take them, a vena cava filter can serve as a surgical option. This is a small device that captures most clots in the bloodstream. […] Treatment of thrombophlebitis in a persons superficial veins may involve home care measures, such as applying warm compresses, elevating the leg, and taking ibuprofen (Motrin). In some cases, anticoagulants and surgery are necessary. […] For deep vein thrombosis, treatment may entail anticoagulants, thrombolytics, and surgery.

• #50 Phlebitis (Thrombophlebitis) Symptoms, Types, Causes, Treatment

  https://www.medicinenet.com/phlebitis_and_thrombophlebitis/article.htm

  Superficial thrombophlebitis (blood clots) is evaluated by an ultrasound to exclude deep venous thrombophlebitis, especially those involving the saphenous vein. If deep venous thrombophlebitis is suspected or diagnosed, or if its risk of developing is considerable, then anti-coagulation (thinning of the blood) may be necessary. This is typically done by injection of low molecular weight heparin (enoxaparin [Lovenox]), or by injection of fondaparinux (Arixtra). It can be done by treatment with therapeutic dosages of unfractionated heparin (usually in the form of an intravenous drip), followed by oral anti-coagulation with warfarin (Coumadin) for about 3 to 6 months. Newer anticoagulants may replace Coumadin in certain circumstances. […] Patients with extensive deep vein thrombosis (DVT) may be appropriately treated with catheter-directed thrombolysis in selected cases, but will still require maintenance anticoagulation for 3 to 6 months.

• #51 Superficial Thrombophlebitis Treatment & Management: Approach Considerations, Compression Stockings, Pharmacologic Therapy

  https://emedicine.medscape.com/article/463256-treatment

  Antibiotics are not routinely indicated for treatment of superficial thrombophlebitis, in that the erythema and tenderness are local inflammatory reactions, not allergic reactions. […] If thrombophlebitis is associated with a cannula or a catheter, the device should be immediately removed and cultured. If the patient is in a septic state, appropriate antibiotics should be given. […] Follow-up should be performed 2-3 days after treatment for superficial thrombophlebitis, either with an office visit or by telephone, to be sure that the patient is progressing in a satisfactory manner.

• #52 Management of superficial vein thrombosis and thrombophlebitis: status and expert opinion document – PubMed

  https://pubmed.ncbi.nlm.nih.gov/17478877/

  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 neoplastic diseases and hematological disorders, anticoagulants may be necessary. […] 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.

• #53 Management of superficial venous thrombophlebitis associated with peripheral venous catheters: A review. | Published in Global Journal of Surgery and Case Reports

  https://www.gjscr.com/article/118529-management-of-superficial-venous-thrombophlebitis-associated-with-peripheral-venous-catheters-a-review

  In these patients, prompt surgical incision and drainage, excision of the involved vein, and the ligation of the surrounding veins should be performed. […] Continued antibiotic therapy is important because 60% of patients with septic thrombophlebitis have concurrent bacteremia, with Staphylococcus Aureus being the most common pathogen. […] Prevention remains the cornerstone of minimizing the occurrence of SVT.

• #54 Superficial thrombophlebitis – Wikipedia

  https://en.wikipedia.org/wiki/Superficial_thrombophlebitis

  Surgery is reserved for patients with extension of the clot to within 1 cm of the saphenofemoral junction, in patients deemed unreliable for anticoagulation, upon failure of anticoagulation, and in patients with intense pain. Surgical therapy with ligation of the saphenofemoral junction or stripping of thrombosed superficial veins appears to be associated with higher rates of venous thromboembolism compared with treatment with anticoagulants.

• #55 Superficial thrombophlebitis Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/superficial-thrombophlebitis.html

  Treatment is very effective for most simple cases of thrombophlebitis. For leg vein thrombophlebitis, treatment includes bed rest, elevating the legs and applying warm compresses. In some cases, wrapping the legs with an elastic bandage and taking nonsteroidal anti-inflammatory drugs (NSAIDs) also can help. In patients with varicose veins who have had several episodes of thrombophlebitis, the affected veins can be surgically „stripped,” a procedure in which the vein is tied off, cut and removed through a small incision. […] If the vein becomes infected, you will be treated with antibiotics. Mild cases can be treated with oral medications, but more severe cases usually require antibiotics given intravenously (into a vein) or by injection. […] In patients with superficial thrombophlebitis that is not improving with standard therapy, anticoagulant (anti-clotting) medication sometimes is used to prevent blood clots from extending into the deeper leg veins. Blood clots in the deep leg veins, a condition called deep vein thrombosis, can lead to blood clots, called emboli, that float in the bloodstream. These blood clots can travel to the lungs, which can be life threatening.

• #56 Treating thrombophlebitis

  https://www.topdoctors.co.uk/medical-articles/treating-thrombophlebitis

  Thrombophlebitis is a condition whereby veins, normally in the lower half of the body become inflamed due to the presence of a blood clot or clots. […] Generally, treatment for thrombophlebitis involves anti-inflammatory medication and painkillers, support garments if needed, and if the condition is in leg veins, checking that the thrombus/clot does not extend close to deep veins. […] Long term treatment is to remove the cause of thrombophlebitis. In the legs, this is usually varicose veins, which can be treated successfully with endovenous surgery. […] The immediate treatment for superficial thrombophlebitis is symptom relief. […] Nonsteroidal anti-inflammatories are useful to both relieve pain and to help settle inflammation. […] If there is any chance that thrombophlebitis might be near the saphenofemoral junction or saphenopopliteal junction (groin area), the patient should be urgently referred for a venous duplex ultrasound scan.

• #57 Superficial Thrombophlebitis: Ligation vs. Anticoagulation | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0515/p2150.html

  Lower extremity superficial thrombophlebitis is usually treated conservatively with compression support, nonsteroidal anti-inflammatory drugs (NSAIDs), and lower extremity elevation. […] Although anticoagulation is the most effective approach to reduce pulmonary embolism in patients with AK-STP and deep venous involvement, the optimal approach to AK-STP without extension is unclear. […] Operative interventions, including ligation of the saphenofemoral venous junction, and ligation and stripping of the phlebitis vein, are effective in reducing the incidence of pulmonary embolism. […] Another intervention is the use of anticoagulants as the only treatment. […] Surgical treatment of AK-STP appears to significantly reduce pain as well as superficial thrombus extension more rapidly than conventional medical therapy.

• #58 Superficial Thrombophlebitis: Ligation vs. Anticoagulation | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0515/p2150.html

  Medical treatment with anticoagulant therapy more effectively prevents pulmonary embolism, minimizes morbidity, and preserves the greater saphenous vein for future use in bypass procedures. […] The authors conclude that, based on the current literature, a conclusion cannot be drawn as to the superiority of surgical versus anticoagulant therapy for AK-STP without deep venous extension. […] The utility of low-molecular-weight heparin versus intravenous unfractionated heparin remains unclear. So does the appropriate duration of medical anticoagulation therapy; six weeks of anticoagulation appears appropriate followed by additional anticoagulation if concomitant deep venous thrombosis or extension into the deep venous system is noted on follow-up duplex ultrasound scanning.

• #59 Superficial thrombophlebitis

  https://dermnetnz.org/topics/superficial-thrombophlebitis

  Antibiotics should be taken if an infection is present. […] Puncture and evacuation this procedure gives rapid relief and resolution of a palpable clot that causes extreme pain. It involves puncture incision with a needle and evacuation of the clot after local anaesthesia. […] Surgical excision and ligation patients with septic thrombophlebitis require urgent venous excision to stop the spread of bacterial infection. This is done with a direct cut over the vein and removal of the infected segment and any surrounding infected or necrotic tissue. This procedure may also benefit patients with recurrent superficial thrombophlebitis that do not respond to any other treatments.

• #60 Thrombophlebitis (Superficial and Migratory): Symptoms, Causes, Treatment

  https://www.webmd.com/dvt/understanding-thrombophlebitis-basics

  Compression stockings. After the clot has resolved and you are on blood thinners, you may be advised to wear a compression stocking on the leg that was affected. This reduces the risk of post-thrombotic or post-phlebitic syndrome. The stockings decrease swelling of the leg, which lowers pressure in the veins and reduces the risk of varicose veins. […] Filter. This has much more limited use. An inferior vena cava IVC filter is used on people who can not safely take anticoagulation and are at risk for DVTs, which can lead to pulmonary embolism. The vena cava is the main vein in your abdomen. The IVC filter prevents clots in your legs from breaking loose and traveling to your lungs. You’ll need surgery for this treatment. They are ideally removed within three months after placement. […] Varicose vein stripping. This can help with veins that cause pain or recurring thrombophlebitis. The doctor makes small cuts to remove a long vein. It doesn’t affect circulation. Veins deeper down can handle more blood.

• #61 Superficial Thrombophlebitis: Symptoms and Treatment | CVR

  https://www.centerforvein.com/blog/superficial-thrombophlebitis-symptoms-treatment

  Although typically reserved for deep vein thrombosis, anticoagulants might be used to prevent blood clotting in extensive cases of superficial thrombophlebitis. […] Radiofrequency ablation or laser ablation uses heat to close off problem veins, allowing blood to flow through healthy nearby veins and reducing the risk of thrombophlebitis. […] A solution is injected into the affected vein, causing it to collapse and eventually be absorbed by the body. […] The vein is removed during this relatively minor office-based procedure. Called ambulatory phlebectomy or micro-phlebectomy, patients can drive themselves home after the procedure and resume normal activities within days with few restrictions.

• #62 Should I See a Vein Specialist for Superficial Thrombophlebitis? : Center for Varicose Veins: Board Certified Vascular and Interventional Radiologists

  https://www.centerforvaricoseveins.com/blog/should-i-see-a-vein-specialist-for-superficial-thrombophlebitis

  If you are at high risk for developing a complication, your vein specialist might recommend newer nonsurgical procedures. Endovenous thermal ablation is one such procedure. Your doctor will make a tiny hole in your calf and place a catheter into the saphenous vein. Laser or radiofrequency energy will then run through the catheter, closing the vein. Closing off this vein will result in the superficial varicose veins diminishing in size. […] Sclerotherapy may also play a role in treating superficial thrombophlebitis. Instead of treating the saphenous vein, your vein specialist will inject a solution directly into the adjacent enlarged varicose veins. The veins will shrink and eventually turn into scar tissue. […] If you think you have superficial thrombophlebitis, Dr. Vinay Madan and the Center for Varicose Veins can help. Dr. Madan offers endovenous laser ablation, radiofrequency ablation, sclerotherapy, and other treatments. With his help, you can recover quickly and safely. Contact the Center for Varicose Veins to schedule an evaluation today.

• #63 Superficial Thrombophlebitis: Symptoms, Risks & Causes

  https://www.usaveinclinics.com/vein-disease/superficial-thrombophlebitis/

  Modern vein treatments can be another option for superficial thrombophlebitis. These minimally invasive procedures use lasers, heat, and chemical injections to help resolve conditions that affect damaged veins. […] The right treatment for you can depend on the severity and location of the affected veins. USA Vein Clinics offers a range of non-surgical vein treatments, and our doctors can help determine your best treatment plan. […] Treatments offered by USA Vein Clinics include: Endovenous Laser Vein Treatment (EVLT), ClariVein, Varithena, Ultrasound-Guided Sclerotherapy (USGS), VenaSeal, Radiofrequency Ablation (RFA), Visual Sclerotherapy.

• #64 Superficial vein thrombosis and phlebitis of the lower extremity veins – UpToDate

  https://www.uptodate.com/contents/superficial-vein-thrombosis-and-phlebitis-of-the-lower-extremity-veins

  Phlebitis and thrombosis of the lower extremity superficial veins is generally a benign, self-limited disorder; however, when the axial veins are involved (eg, great saphenous vein, accessory saphenous vein, small saphenous vein), thrombus propagation into the deep vein system (ie, deep vein thrombosis [DVT]) and even pulmonary embolism can occur. Treatment is aimed at relieving local symptoms and preventing thromboembolic complications. […] Treatment of phlebitis: Pain management, Compression therapy. […] Treatment of SVT: Low risk for VTE: no anticoagulation, Intermediate risk for VTE: prophylactic anticoagulation, Elevated risk for VTE: therapeutic anticoagulation. […] Treatment of specific veins: Great saphenous vein, Small saphenous vein, Perforating veins, Tributary veins.

• #65 Superficial thrombophlebitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/superficial-thrombophlebitis?lang=us

  Superficial thrombophlebitis is generally considered a self-limiting condition. However, concurrent deep venous thrombosis can be seen in 25% of cases. There is risk of superimposed infection. […] Management depends on risk-stratification of the disease which is generally determined on the basis of underlying etiology, length of thrombosis and distance from the deep venous system: […] low risk (symptomatic management with topical or oral non-steroidal anti-inflammatory medications) […] intermediate risk (typically prophylactic-dose anticoagulation e.g. 40mg enoxaparin subcutaneously or 10mg rivaroxaban orally once-daily) […] high risk (treatment-dose anticoagulation as per DVT/PE) […] Suggested treatment lengths include 45 days of intermediate-risk and 3 months for high-risk SVTs.

• #66 Treatment – GPnotebook

  https://gpnotebook.com/pages/cardiovascular-medicine/superficial-vein-thrombosis/treatment

  if thrombus extends to the sapheno-femoral or sapheno-popliteal junctions prophylactic use of low molecular weight heparin may be indicated. Surgical intervention is a controversial option if anticoagulation is contraindicated or not tolerated, but it may compound the risk of venous thromboembolism. […] Prophylactic anticoagulation is recommended for all patients with a superficial thrombus 5 cm in length within the great saphenous (GSV), small saphenous (SSV), or anterior accessory great saphenous (AASV) veins and 3 cm from the sapheno-femoral or sapheno-popliteal junctions (5). […] Guidelines recommend 45 days of anticoagulation, with prophylactic doses of fondaparinux as the preferred option (5).

• #67 Management of superficial venous thrombophlebitis associated with peripheral venous catheters: A review. | Published in Global Journal of Surgery and Case Reports

  https://www.gjscr.com/article/118529-management-of-superficial-venous-thrombophlebitis-associated-with-peripheral-venous-catheters-a-review

  Superficial thrombophlebitis associated with peripheral venous catheters remains the most frequent complication of peripheral venous infusion and leads to serious medical complications that impact negatively both patients and healthcare institutions. […] Our review shares evidence-based information on the pathophysiology, risk factors, clinical presentation, treatment, and prevention of infusion-related superficial thrombophlebitis. […] Although no consensus exists on the SVT management, prompt removal of the catheter is generally performed when patients develop pain and erythema or swelling at the catheter site. This usually leads to a quick resolution of symptoms. […] If discomfort persist after catheter removal, conservative therapy is initiated and includes elevation of the affected site, cold compressions, analgesics, and non-steroidal anti-inflammatory medications, as well as medications to help maintain patency of the vein.

• #68 Superficial Thrombophlebitis – Venous Diseases – Vascular Diseases, Peripheral – Cardiovascular Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.2.30.

  Superficial thrombophlebitis refers to inflammation of the veins located above the fascial layer that is usually accompanied by thrombosis of varying severity. […] Treatment: 1. Catheter-related superficial thrombophlebitis: In patients with a short peripheral catheter, stop using the catheter and remove it. In cases of mild to moderate pain, use nonsteroidal anti-inflammatory drugs (NSAIDs) (oral or topical; agents: see Table 2 in Osteoarthritis) or heparin (topical gel) until the resolution of symptoms, but no longer than for 2 weeks. […] 2. Purulent superficial thrombophlebitis: Remove the source of infection (eg, a catheter) and use antimicrobial treatment, which should optimally be targeted; if ineffective, consider drainage or resection of the affected segment of the vein. […] 3. Superficial thrombophlebitis affecting a segment of a vein of a lower extremity 5 cm: Subcutaneous fondaparinux 2.5 mg/d, low-molecular-weight heparin at a prophylactic dose, or oral rivaroxaban 10 mg/d (see Table 3 in Primary Prevention of Venous Thromboembolism) for 4 weeks. In selected patients with severe, extensive superficial thrombophlebitis, typically involving the entire length of the greater saphenous vein, consider a therapeutic-dose anticoagulation as done for the treatment of DVT (eg, a vitamin K antagonist [acenocoumarol or warfarin] at a dose adjusted to maintain the international normalized ratio [INR] in the range of 2.0-3.0, in combination with heparin for 5 days, and continued as monotherapy for 4 weeks). […] Once acute inflammation and edema have subsided, consider using appropriate compression stockings.

• #69 Phlebitis: Facts & Fallacies

  https://veinhealthcarecenter.com/vein-health-news-articles-detail.php?Phlebitis-Facts-Fallacies-6

  Phlebitis describes a condition in which a vein in the superficial vein system becomes inflamed and swollen. (It is also referred to as superficial phlebitis.) Spontaneous phlebitis happens when there is a sudden onset of vein inflammation. […] Three out of 10 patients may develop spontaneous phlebitis after endovenous laser ablation (EVLA) therapy, but according to phlebologist (vein specialist) Cindy Asbjornsen, D.O., ABPh, it is very preventable. […] „We rarely see phlebitis post procedure at our vein care practice, especially if patients follow the post-procedure guidelines closely,” said Dr. Asbjornsen. […] Post-operative requirements include wearing prescribed graduated compression stockings and walking at least 30 minutes a day. If a patient does experience pain or swelling, he or she should apply heat to the area, elevate the legs, and take a non-steroidal anti-inflammatory drug, such as ibuprofen or naproxen.

• #70 Superficial Thrombophlebitis | Doctor

  https://patient.info/doctor/superficial-thrombophlebitis-pro

  Management of superficial thrombophlebitis […] General measures include elastic support of the limb to reduce swelling and ease discomfort. Severe thrombophlebitis does not usually require bed rest unless there is severe pain on movement. The affected extremity should be elevated if possible and large, warm compresses may be applied, although the evidence base for their effectiveness is limited and care must be taken to avoid burning the patient. Exercise reduces pain and the possibility of DVT. Only in cases in which pain is very severe is bed rest necessary. DVT prophylaxis should be established in patients with reduced mobility. Keeping the leg elevated when sitting may improve venous blood flow and reduce swelling. […] Pharmacological treatment includes topical anti-inflammatory creams applied locally to the superficial vein thrombosis/superficial thrombophlebitis area to control mild symptoms. Otherwise, an oral non-steroidal anti-inflammatory drug (NSAID) and/or paracetamol will be required for pain relief. Topical heparin has been shown to have some limited benefit in treating superficial venous thrombosis but studies have been poor. Low molecular weight heparin (LMWH) and fondaparinux have been shown to reduce the risk of superficial vein thrombosis extension and recurrence. Prophylactic fondaparinux given for 45 days appears to be an effective option for superficial thrombophlebitis for most people. A Cochrane review in 2018 suggests that 45 days of subcutaneous fondaparinux should be offered to all patients with superficial thrombophlebitis extending more than 5cm in length, proximal to the knee, particularly within 10cm of the saphenofemoral junction, with severe symptoms, greater saphenous vein involvement, previous VTE or previous superficial thrombophlebitis, active malignancy, or recent surgery. […] Antibiotics are only required if there is evidence of infection. […] Surgical intervention may be necessary if there are recurrences of the thrombophlebitis associated with extensive varicose veins, which should be excised.

• #71 Superficial Thrombophlebitis: Causes, Symptoms, and Treatment

  https://patient.info/heart-health/varicose-veins-leaflet/superficial-thrombophlebitis

  Fondaparinux (also called Arixtra) is an injected medicine which inhibits one of the body’s clotting factors. When given for six weeks it reduces the risk of DVT and of extension and recurrence of thrombophlebitis. […] Raising the affected leg. When you rest (when watching TV, or reading a book, etc), if you raise an affected leg so that your foot is higher than your hip, it helps to reduce swelling and discomfort. […] Compression (support) stockings. These may be advised by your doctor if a vein in your leg is affected. They may ease discomfort and reduce swelling whilst the inflammation settles.

• #72 Phlebitis: Facts & Fallacies

  https://veinhealthcarecenter.com/vein-health-news-articles-detail.php?Phlebitis-Facts-Fallacies-6

  It’s important to note that it is possible for a blood clot in the superficial vein system to grow into the deep vein system. […] Dr. Asbjornsen advises that „all the things that prevent DVT” also keep phlebitis at bay, including evaluation by a board certified phlebologist if venous disease symptoms are present in the legs: spider veins, varicose veins, heaviness, achiness, and/or discoloration or changes of the skin. […] Some doctors recommend an anti-inflammatory diet, such as the DASH diet (dietary approaches to stop hypertension).

• #73 Superficial Thrombophlebitis: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.superficial-thrombophlebitis-care-instructions.uf8404

  Superficial thrombophlebitis is inflammation in a vein where a blood clot has formed close to the surface of the skin. Blood clots in veins close to the skin’s surface usually are not serious and often can be treated at home. […] Follow-up care is a key part of your treatment and safety. […] Take your medicines exactly as prescribed. […] Ask your doctor about compression stockings. These may help prevent blood clots from forming in your legs. […] Call your doctor now or seek immediate medical care if: You have signs of a blood clot, such as: Pain in your calf, back of the knee, thigh, or groin. Redness and swelling in your leg or groin. […] Watch closely for changes in your health, and be sure to contact your doctor if: You do not get better as expected.

• #74 Superficial Thrombophlebitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30109

  Despite the number of studies performed, there is still debate on the appropriate treatment for superficial thrombophlebitis. Multiple strategies have been proposed to control symptoms and decrease the extension of thrombosis and risk for PE in low-risk superficial thrombophlebitis. […] In these cases, the consensus is that nonsteroidal anti-inflammatory agents, heat, and anticoagulants are all reasonable. Those who are at higher risk include patients with an SVT in the lower extremity that is at least 5 cm in length; SVT proximal to the knee, especially within 10 cm of the saphenofemoral junction; the presence of severe symptoms; greater saphenous vein involvement; previous SVT/venous thromboembolic disease; active malignancy; or recent surgery. Based on the Cochrane review published in 2018, these patients should receive fondaparinux 2.5 mg/day subcutaneously for 45 days.

• #75 Ultrasound proven superficial thrombophlebitis | CUH

  https://www.cuh.nhs.uk/patient-information/ultrasound-proven-superficial-thrombophlebitis/

  Most bouts of superficial thrombophlebitis last for three to four weeks. If they are associated with varicose veins, they are likely to recur. No treatment may be needed if the symptoms are mild. One or more of the following treatments may be advised, depending on your symptoms and the severity of the condition: […] Anti-inflammatory tablets may reduce the risk of superficial thrombophlebitis enlarging or extending within a vein and/or it coming back. […] Depending on the extent of your superficial thrombophlebitis you may be referred for medical assessment and a course of daily anticoagulant injections or tablets prescribed. The aim of treatment is to improve symptoms, reduce the risk of thrombus extension and risk of deep vein thrombosis.

Zobacz więcej