Definition

Superficial thrombophlebitis (STP) is a condition in which a blood clot forms in one of the superficial veins of the body causing inflammation and tenderness of the vein.  This typically affects the veins in the legs, but can occasionally occur in other areas.  Unlike deep vein thrombosis, the risk of a blood clot in the superficial veins breaking free and traveling to the lungs is low.   STP is generally a short lived condition with low rates of complication.

Symptoms

Warmth, redness, and tenderness over the affected vein are typical symptoms of STP.  When a vein close to the surface of the skin is affected, it may also feel firm and cordlike due to the clotted blood in the vein.

Causes

Pooling of the blood in the veins, abnormalities of the blood clotting process, and injury to the veins from trauma or infection can all contribute to the development of STP.   Pooling of blood in the leg veins may occur whenever leg activity is restricted.  Examples of this include prolonged airplane or car trips, after a surgery, or following any type of hospitalization.  Abnormalities of the blood clotting process may occur following surgery or injury, or may occur due to illness such as heart disease or cancer.  In some cases blood clotting abnormalities which contribute to the development of STP may run in families and is hereditary.  This is called thrombophilia.

Diagnosis

A visual examination and thorough history are used to diagnose an STP.  A venous ultrasound is also completed to assess for any blood clots in the deep veins.

Risk Factors for STP

• Varicose Veins
• Prolonged sitting
• Inherited blood-clotting disorder (Thrombophilia-Factor V Leiden,etc)
• Prolonged bed rest
• Injury or surgery
• Cancer
• Heart Failure
• Smoking
• Obesity
• History of prior Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE)
• Family history of DVT or PE
• Birth control pills or hormone replacement therapy

Treatment

Reducing the pain and inflammation as well as limiting complications of STP are the primary short term goals of treatment.  Medical grade prescription strength compression stockings, leg elevation, and over-the-counter medications such as ibuprofen are used to reduce inflammation and discomfort associated with STP.   Long term management of STP is directed towards preventing a recurrence of the condition through identification and treatment of refluxing veins that may have contributed to development of the STP.

There are some circumstances of STP in which anticoagulant medication may be recommended.

Situations in which anticoagulant medications may be recommended are:

• A very large segment of superficial vein is affected with STP
• There is evidence that the STP is getting worse
• STP encroaching on the deep vein system
• Underlying clotting disorders