How I treat superficial venous thrombosis

Thrombosis of superficial veins has long been regarded as a benign disorder. If patients with a clinical diagnosis of superficial venous thrombosis (SVT) are thoroughly evaluated, the degree and extent of thrombosis in patients with SVT are characteristically underestimated (similar to 75% of the time) and such patients have coexistence (similar to 25% of the time) of, and/or rapid progression (similar to 10% of the time) to, systemic venous thromboembolism (VTE). Pulmonary embolism (PE; similar to 25% of the time) and death (similar to 1% of the time) occur. Contributory risk factors for SVT are the same for VTE. Treatment of patients' SVT with parenteral anticoagulants appears to be both efficacious and certainly safe. I regard most patients with a clinical diagnosis of SVT the same as those with VTEs. Systemic anticoagulant therapy of patients with a clinical diagnosis of SVT obviates extensive imaging and laboratory workup and may be cost effective while encompassing treatment of any unknown concomitant thromboses with only low risk for hemorrhage. This decision is especially clear in those patients with known hypercoagulability. Patients without clinical risk factors are at lower risk to develop VTE complications and might be those who can be simply observed. (Blood. 2011;117(1):39-44)