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 venous thrombosis in the upper extremity most commonly results from IV infusions or catheterization. Varicose veins, pregnancy, malignancy, obesity, and immobilization are other risk factors for superficial venous thrombosis in the lower extremity (1). Untreated superficial venous thrombi can progress to deep vein thromboses and pulmonary emboli (2), particularly those in close proximity to the saphenofemoral junction (1).
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 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 (DVT) and should probably have ultrasound (3).
General references
1. Piazza G, Krishnathasan D, Hamade N, et al. Superficial Vein Thrombosis: A Review. JAMA. Published online September 15, 2025. doi:10.1001/jama.2025.15222
2. Gloviczki P, Lawrence PF, Wasan SM, et al. The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II: Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine. J Vasc Surg Venous Lymphat Disord. 2024;12(1):101670. doi:10.1016/j.jvsv.2023.08.011
3. 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, compression stockings, limb elevation, and NSAIDs (1).
In patients with lower extremity superficial venous thrombosis ≤ 3 cm from the saphenofemoral junction, treatment with anticoagulation as for a deep vein thrombosis for 6 weeks or longer is recommended (2). For patients lower extremity superficial venous thrombosis that is > 3 cm from the saphenofemoral junction but ≥ 5 cm in length, treatment with fondaparinux (or, alternatively, rivaroxaban or a low molecular weight ). For patients lower extremity superficial venous thrombosis that is > 3 cm from the saphenofemoral junction but ≥ 5 cm in length, treatment with fondaparinux (or, alternatively, rivaroxaban or a low molecular weightheparinsuch as enoxaparin) for 45 days is recommended.such as enoxaparin) for 45 days is recommended.
Upper extremity superficial venous thromboses are treated similarly, following removal of any associated intravenous catheter (1).
Treatment references
1. Piazza G, Krishnathasan D, Hamade N, et al. Superficial Vein Thrombosis: A Review. JAMA. Published online September 15, 2025. doi:10.1001/jama.2025.15222
2. Gloviczki P, Lawrence PF, Wasan SM, et al. The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II: Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine. J Vasc Surg Venous Lymphat Disord. 2024;12(1):101670. doi:10.1016/j.jvsv.2023.08.011
