Royal Cornwall Hospital

Truro

Cornwall TR1 3LJ

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© 2023 by Acute GP Service, CPFT. 

Superficial thrombophlebitis guidelines

 

Superficial vein thrombosis or thrombophlebitis (STP) in the lower limb is a relatively common, painful, and in many cases self-limiting condition. Around 10-21% of patients with STP will already have DVT at presentation and a further 3-4% will progress to it if untreated. Patients with at least 5 cm of thrombus in a superficial vein are more likely to have underlying DVT if the STP is in the proximal long saphenous vein (within 10 cm of the saphenofemoral junction). STP within a varicose vein is less likely to be associated with underlying DVT.

 

  • Patients with clinical signs of superficial thrombophlebitis affecting the proximal long saphenous vein should have an ultrasound scan to exclude concurrent DVT.

  • Patients with confirmed SVT within 3cm of the sapheno-femoral junction should be considered for therapeutic anticoagulation

  • Patients with superficial thrombophlebitis, without DVT, should have anti-embolism stockings and, if extending above the knee, be considered for treatment with prophylactic doses of LMWH for up to 30 days or fondaparinux for 45 days.

  • If LMWH is contraindicated, or where the STP is confined to the calf, 8-12 days of oral NSAIDs should be offered. 

 

Taken from the BCSH guidelines, page 7