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Superficial Venous Thrombosis

(Superficial Thrombophlebitis)

By

James D. Douketis

, MD, McMaster University

Reviewed/Revised Dec 2023
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Superficial venous thrombosis is inflammation and clotting in a superficial vein, usually in the arms or legs.

  • The skin over the vein becomes red, swollen, and painful.

  • Doctors examine the area, but tests are not usually needed.

  • People may need to take analgesics to relieve pain until the disorder resolves.

Superficial venous thrombosis most often affects the superficial veins Overview of the Venous System Veins return blood to the heart from all the organs of the body. Arteries carry blood with oxygen and nutrients away from the heart to the rest of the body. The large veins parallel the large... read more (veins located just under the skin) in the legs but may also affect superficial veins in the groin or in the arms. Superficial venous thrombosis in the arms usually results from having an IV. Superficial venous thrombosis in the legs usually results from varicose veins Varicose Veins Varicose veins are abnormally enlarged superficial veins in the legs. Varicose veins may cause your legs to ache, itch, and feel tired. Doctors can detect varicose veins by examining the skin... read more Varicose Veins . However, most people with varicose veins do not develop blood clots (thrombosis).

Blood Vessels
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Even a slight injury can cause a varicose vein to become inflamed (phlebitis). Unlike deep vein thrombosis Deep Vein Thrombosis (DVT) Deep vein thrombosis is the formation of blood clots (thrombi) in the deep veins, usually in the legs. Blood clots may form in veins if the vein is injured, a disorder causes the blood to clot... read more Deep Vein Thrombosis (DVT) , which causes very little inflammation, superficial venous thrombosis involves a sudden (acute) inflammatory reaction that causes the blood cot (thrombus) to adhere firmly to the vein wall and lessens the likelihood that it will break loose. Unlike deep veins, superficial veins have no surrounding muscles to squeeze and dislodge a blood clot. For these reasons, superficial venous thrombosis rarely causes a blood clot to break loose (embolism).

Migratory phlebitis or migratory thrombophlebitis is superficial venous thrombosis that repeatedly occurs in normal veins. It may indicate a serious underlying disorder, such as cancer of an internal organ. When migratory phlebitis and cancer of an internal organ occur together, the disorder is called Trousseau syndrome.

Symptoms of Superficial Venous Thrombosis

Pain and swelling develop rapidly in the area of inflammation. The skin over the vein appears red on light skin and may appear purplish or may be difficult to identify on dark skin. The area feels warm and is very tender. Because blood in the vein is clotted, the vein feels like a hard cord under the skin, not soft like a normal or varicose vein. The vein may feel hard along its entire length.

Diagnosis of Superficial Venous Thrombosis

  • Doctor's evaluation

Doctors recognize superficial venous thrombosis by its appearance. Tests are not usually needed. However, if people have superficial venous thrombosis above the knee that developed suddenly and not in an area of varicose veins, doctors often do ultrasonography to see if there is a blood clot in the deep veins Deep Vein Thrombosis (DVT) Deep vein thrombosis is the formation of blood clots (thrombi) in the deep veins, usually in the legs. Blood clots may form in veins if the vein is injured, a disorder causes the blood to clot... read more Deep Vein Thrombosis (DVT) .

Treatment of Superficial Venous Thrombosis

  • Warm compresses and analgesics for pain relief

  • Sometimes an anticoagulant medication

Although the inflammation generally subsides in a matter of days, several weeks may pass before the lumps and tenderness subside completely. Sometimes people who have very extensive superficial venous thrombosis are also given heparin or a different anticoagulant Anticoagulant medications Deep vein thrombosis is the formation of blood clots (thrombi) in the deep veins, usually in the legs. Blood clots may form in veins if the vein is injured, a disorder causes the blood to clot... read more Anticoagulant medications to help limit the blood's clotting.

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