This condition is a primary clinical manifestation of thrombophlebitis of the superficial veins and often occurs in varicose veins. It is commonly associated with prolonged or repeated intravenous infusions. Due to varying degrees of inflammatory changes in the venous wall, intraluminal thrombi frequently adhere to the vessel wall, making embolization less likely.
In a small number of cases, superficial venous thrombosis can extend and lead to deep venous thrombosis. Migratory superficial venous thrombosis is often a sign of malignancy but can also occur in thromboangiitis obliterans (Buerger's disease).
The diagnosis is relatively straightforward, with symptoms including pain and redness along the course of the vein, as well as localized linear or nodular areas of tenderness.
Treatment primarily involves supportive measures:
- Addressing the underlying cause, such as discontinuing the infusion of irritant solutions or eliminating local venous catheter-related infections.
- Resting, elevating the affected limb, and applying warm compresses.
- Given the tendency for recurrence, graduated compression stockings are recommended.
- Pain relief can be achieved through oral administration of diclofenac sodium or other nonsteroidal anti-inflammatory drugs (NSAIDs), as well as the topical application of diclofenac sodium gel or heparin ointment until symptoms resolve or for at least two weeks.
- For cases where the superficial venous thrombus is located within 3 cm of the junction with a deep vein or if the thrombus length exceeds 5 cm, anticoagulation therapy with fondaparinux or low-molecular-weight heparin for 45 days is advised. If the thrombus is less than 3 cm from the deep vein junction or high-risk factors are present (e.g., malignancy or thrombophilia), anticoagulation therapy for three months is recommended.