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Trombose venosa superficial

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  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 2 Feb 2026
Last updated: 08 Mar 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • trombose venosa superficial (TVS) prévia, trombose venosa profunda ou embolia pulmonar
  • vermelhidão/eritema da pele sobrejacente
  • pele sobrejacente quente/morna
  • dor/sensibilidade na veia afetada
  • inchaço/edema da área circundante
  • massa semelhante a um cordão palpável
  • desenvolvimento de sintomas ao longo de horas a dias
  • sinais/sintomas de TVP ou EP concomitantes
Full details

Other diagnostic factors

  • veias varicosas
  • história de doenças trombofílicas
  • doenças autoimunes (por exemplo, doença de Behçet e Buerger)
  • intervenção recente na veia (por exemplo, escleroterapia)
  • punção recente da veia e administração de medicamento intravenoso
  • febre baixa
  • alterações na pigmentação
Full details

Risk factors

  • veias varicosas
  • doenças trombofílicas
  • doenças autoimunes (por exemplo, doença de Behçet e Buerger)
  • história prévia de trombose venosa superficial (TVS)
  • sexo feminino
  • escleroterapia
  • cateterismo intravenoso
  • neoplasia maligna
  • gestação
  • uso de contraceptivos orais (PCO) e terapia de reposição hormonal
  • idade avançada
  • história de tromboembolismo venoso prévio, incluindo trombose venosa profunda e EP
  • obesidade
  • imobilização prolongada (por exemplo, viagem aérea longa)
  • tipagem sanguínea
Full details

Diagnostic tests

1st tests to order

  • ultrassonografia com Doppler
Full details

Tests to consider

  • biópsia
  • angiotomografia pulmonar
  • exame de ventilação-perfusão (V/Q)
  • angiografia pulmonar convencional
  • avaliação de malignidade
  • rastreamento para trombofilia
Full details

Treatment algorithm

INITIAL

extensão para a veia femoral ou veia poplítea, trombo ≤3 da junção safeno-femoral e safeno-poplítea ou TVP ou EP concomitantes

ACUTE

não gestante: TVS ≥5 cm de comprimento na veia superficial axial e >3 cm da junção safeno-femoral ou safeno-poplítea

não gestante: TVS <5 cm de comprimento na veia superficial axial ou trombo apenas nas veias varicosas tributárias

gestante: TVS (qualquer tamanho) na veia axial ou tributária

ONGOING

veia safena incompetente com veias varicosas associadas ou TVS recorrente

Contributors

Authors

Sherry Scovell, MD, FACS

Vascular and Endovascular Surgeon

Massachusetts General Hospital

Assistant Professor of Surgery, Part Time

Harvard Medical School

Boston

MA

Disclosures

SS is an author for UpToDate, which is compensated. SS declares that she has no conflicts of interest with medical or pharmaceutical companies.

Acknowledgements

Dr Sherry Scovell would like to gratefully acknowledge Professor Vicky Tagalakis, a previous contributor to this topic.

Disclosures

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.

Peer reviewers

Francois Becker, MD, PhD

Consultant

Division of Angiology and Hemostasis

University Hospital of Geneva

Geneva

Switzerland

Disclosures

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

Disclosures

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

Disclosures

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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.Full text  Abstract

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.Full text  Abstract

Thrombosis Canada. Superficial thrombophlebitis, superficial vein thrombosis. Aug 2023 [internet publication].Full text

Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev. 2018 Feb 25;(2):CD004982.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Trombose venosa superficial images

  • Differentials

    • Trombose venosa profunda
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    • Linfedema
    More Differentials

  • Guidelines

    • European Society for Vascular Surgery (ESVS) 2023 clinical practice guidelines on antithrombotic therapy for vascular diseases
    • Superficial thrombophlebitis, superficial vein thrombosis
    More Guidelines

  • Patient information

    Trombose venosa profunda

    Veias varicosas: o que são?

    More Patient information
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