Clinical significance of superficial vein thrombosis.

OBJECTIVE: To evaluate the clinical implications of superficial thrombophlebitis (STP) including its demographic characteristics, distribution, risk factors, relationship with deep vein thrombosis (DVT), pulmonary embolism (PE), diagnosis and management.

METHODS: Data were collected from relevant papers using a MEDLINE search and an extensive bibliography review. Studies were considered only when they contained pertinent material to STP. Thirty-seven papers were analysed.

RESULTS: The diversity of patients and methods used in the different studies made the comparison among them difficult. STP is a common condition with an underestimated prevalence. There are many risk factors associated with STP but the strongest relation was seen with hypercoagulable states. Malignancy may be another important factor but the strength of this association remains unknown. Coexistence with DVT was found in 6-53%. PE occurred in 0-33.3%. Propagation to DVT ranged from 2.6 to 15%. Treatment has not been standardised and may include elastic compression, anti-inflammatory drugs, anticoagulation and surgery.

CONCLUSION: The limited number of prospective randomised studies on STP does not allow strong recommendations to be given. Although STP most often is perceived as benign, it can coexist with or progress to DVT, and even give rise to PE. It is also associated with hypercoagulability and malignancy.