Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- previous superficial vein thrombosis (SVT), deep vein thrombosis, or pulmonary embolism
- redness/erythema of overlying skin
- hot/warm overlying skin
- painful/tender over affected vein
- swelling/edema of surrounding area
- cord-like mass palpable
- development of symptoms over hours to days
- signs/symptoms of concomitant DVT or PE
Outros fatores diagnósticos
- varicose veins
- history of thrombophilic disorders
- autoimmune diseases (e.g., Behcet and Buerger disease)
- recent vein instrumentation (e.g., sclerotherapy)
- recent vein catheterization and intravenous drug administration
- low-grade fever
- pigmentation changes
Fatores de risco
- varicose veins
- thrombophilic disorders
- autoimmune diseases (e.g., Behcet and Buerger disease)
- prior history of superficial vein thrombosis (SVT)
- female sex
- sclerotherapy
- intravenous catheterization
- malignancy
- pregnancy
- use of oral contraceptives (OCPs) and hormonal replacement therapy
- older age
- history of prior venous thromboembolism (VTE), including deep vein thrombosis and PE
- obesity
- prolonged immobilization (e.g., long-haul air travel)
- blood type
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- Doppler ultrasonography
Investigações a serem consideradas
- biopsy
- pulmonary CT angiography
- ventilation perfusion (VQ) scan
- conventional pulmonary angiography
- assessment for malignancy
- thrombophilia screening
Algoritmo de tratamento
extension into the femoral vein or popliteal vein, thrombus ≤3 from the saphenofemoral or saphenopopliteal junction, or concomitant DVT or PE
nonpregnant: SVT ≥5 cm in length within axial superficial vein and >3 cm from the saphenofemoral or saphenopopliteal junction
nonpregnant: SVT <5 cm in length within axial superficial vein or thrombus within tributary varicose veins only
pregnant: SVT (any size) within axial or tributary vein
incompetent saphenous vein with associated varicose veins or recurrent SVT
Colaboradores
Autores
Sherry Scovell, MD, FACS
Vascular and Endovascular Surgeon
Massachusetts General Hospital
Assistant Professor of Surgery, Part Time
Harvard Medical School
Boston
MA
Declarações
SS is an author for UpToDate, which is compensated. SS declares that she has no conflicts of interest with medical or pharmaceutical companies.
Agradecimentos
Dr Sherry Scovell would like to gratefully acknowledge Professor Vicky Tagalakis, a previous contributor to this topic.
Declarações
VT has received reimbursement for advisory board work for Servier and Pzifer. Both of these companies are makers of anticoagulants. VT has received an investigator-initiated grant from Sanofi, manufacturer of Enoxaparin.
Revisores
Francois Becker, MD, PhD
Consultant
Division of Angiology and Hemostasis
University Hospital of Geneva
Geneva
Switzerland
Declarações
FB declares that he has no competing interests.
Michael Bromberg, MD, PhD
Professor of Medicine
Section of Hematology
Director of Hematologic Malignancies
Temple University School of Medicine
Philadelphia
PA
Declarações
MB declares that he has no competing interests.
Louis Aledort, MD
The Mary Weinfeld Professor of Clinical Research in Hemophilia
Mount Sinai School of Medicine
New York
NY
Declarações
LA declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Stevens SM, Woller SC, Kreuziger LB, et al. Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 2021 Dec;160(6):e545-608.Texto completo Resumo
Kakkos SK, Gohel M, Baekgaard N, et al. Editor's Choice - European Society for Vascular Surgery (ESVS) 2021 clinical practice guidelines on the management of venous thrombosis. Eur J Vasc Endovasc Surg. 2021 Jan;61(1):9-82.Texto completo Resumo
Thrombosis Canada. Superficial thrombophlebitis, superficial vein thrombosis. Aug 2023 [internet publication].Texto completo
Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev. 2018 Feb 25;(2):CD004982.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Deep vein thrombosis
- Cellulitis
- Lymphedema
Mais Diagnósticos diferenciaisDiretrizes
- Superficial thrombophlebitis, superficial vein thrombosis
- Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report
Mais DiretrizesFolhetos informativos para os pacientes
Deep vein thrombosis
Varicose veins
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