Superficial venous thrombosis in the upper extremity most commonly results from IV infusions or catheterization. Varicose veins Varicose Veins Varicose veins are dilated superficial veins in the lower extremities. Usually, no cause is obvious. Varicose veins are typically asymptomatic but may cause a sense of fullness, pressure, and... read more seem to be the main risk factor for superficial venous thrombosis in the lower extremity, especially among women. Superficial venous thrombi rarely cause serious complications and rarely become emboli.
Typically, patients present with pain, tenderness, or an indurated cord along a palpable superficial vein. The overlying skin is usually warm and erythematous.
Migratory superficial venous thrombosis, which develops, resolves, and recurs in normal veins of the arms, legs, and torso at various times, is a possible harbinger of pancreatic cancer Pancreatic Cancer Pancreatic cancer, primarily ductal adenocarcinoma, accounts for an estimated 64,050 cases and 50,550 deaths in the United States annually ( 1). Symptoms include weight loss, abdominal pain... read more and other adenocarcinomas (Trousseau syndrome).
Diagnosis is based on history and physical examination. Patients with superficial venous thrombosis above the knee have an increased risk of deep venous thrombosis Deep Venous Thrombosis (DVT) Deep venous thrombosis (DVT) is clotting of blood in a deep vein of an extremity (usually calf or thigh) or the pelvis. DVT is the primary cause of pulmonary embolism. DVT results from conditions... read more (DVT) and should probably have ultrasonography (1 General reference Superficial venous thrombosis is a blood clot in a superficial vein of the upper or lower extremities or, less commonly, in one or more veins of the chest or breast (Mondor disease). Superficial... read more ).
General reference
1. Galanaud JP, Sevestre MA, Pernod G, et al. Long-term risk of venous thromboembolism recurrence after isolated superficial vein thrombosis. J Thromb Haemost 2017;15(6):1123-1131. doi:10.1111/jth.13679
Treatment of Superficial Venous Thrombosis
Warm compresses and nonsteroidal anti-inflammatory drugs (NSAIDs)
Sometimes anticoagulation
Treatment of superficial venous thrombosis traditionally involves warm compresses and NSAIDs.
In patients with extensive superficial venous thrombosis, anticoagulation Anticoagulants Deep venous thrombosis (DVT) is clotting of blood in a deep vein of an extremity (usually calf or thigh) or the pelvis. DVT is the primary cause of pulmonary embolism. DVT results from conditions... read more (eg, with low molecular weight heparin, fondaparinux) is often beneficial (1 Treatment reference Superficial venous thrombosis is a blood clot in a superficial vein of the upper or lower extremities or, less commonly, in one or more veins of the chest or breast (Mondor disease). Superficial... read more ). The optimal regimen and duration are unknown, but most experts recommend treating for about 1 month using either a low molecular weight heparin (eg, enoxaparin 40 mg subcutaneously once a day) or fondaparinux (2.5 mg subcutaneously once a day).
Treatment reference
1. Decousus H, Prandoni P, Mismetti P, et al. Fondaparinux for the treatment of superficial-vein thrombosis in the legs. N Engl J Med 2010;363(13):1222-1232. doi:10.1056/NEJMoa0912072