Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- 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
Otros factores de diagnóstico
- 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
Factores de riesgo
- 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
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- Doppler ultrasonography
Pruebas diagnósticas que deben considerarse
- biopsy
- pulmonary CT angiography
- ventilation perfusion (VQ) scan
- conventional pulmonary angiography
- assessment for malignancy
- thrombophilia screening
Algoritmo de tratamiento
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
Divulgaciones
SS is an author for UpToDate, which is compensated. SS declares that she has no conflicts of interest with medical or pharmaceutical companies.
Agradecimientos
Dr Sherry Scovell would like to gratefully acknowledge Professor Vicky Tagalakis, a previous contributor to this topic.
Divulgaciones
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 por pares
Francois Becker, MD, PhD
Consultant
Division of Angiology and Hemostasis
University Hospital of Geneva
Geneva
Switzerland
Divulgaciones
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
Divulgaciones
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
Divulgaciones
LA declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
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 Resumen
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 Resumen
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 Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

Diferenciales
- Deep vein thrombosis
- Cellulitis
- Lymphedema
Más DiferencialesGuías de práctica clínica
- Superficial thrombophlebitis, superficial vein thrombosis
- Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report
Más Guías de práctica clínicaFolletos para el paciente
Deep vein thrombosis
Varicose veins
Más Folletos para el pacienteInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
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