Thrombosed superficial veins are veins close to the surface of the skin with blood clots inside them. They can occur in the arms or legs and rarely in the veins of the chest or breast (Mondor's disease). When inflamed, the condition is called superficial thrombophlebitis. According to the Merck Manual, because of their superficial nature, they rarely cause complications. Treatment is generally aimed at reducing pain and the chances of the thrombus (blood clot) becoming inflamed and penetrating into deeper veins, where there is an increased risk of the clot migrating to another site in the body. This is called an embolism and can be dangerous.
Thrombosed superficial veins are more common in women than men. Risk factors include varicose veins, pregnancy, obesity, intravenous drug abuse, smoking, damage to the blood vessel walls and prolonged use of a catheter or cannula because of hospital treatment.
Traditionally, warm compresses are used along with elastic stockings to support the affected limb. If you have severe thrombosed superficial veins, your doctor may advise bed rest while keeping the affected limb elevated, according to Merck and Patient UK.
Drug treatments include the use of NSAIDs (non-steroidal anti-inflammatory drugs) to reduce inflammation and pain.
Blood Thinners and Anticoagulants
According to the Merck Manual, patients with extensive phlebitis (inflammation of the thrombosed vein) may benefit from the use of the blood thinner heparin.
If the thrombosis manages to penetrate the deeper veins, according to Patient UK, anticoagulants (drugs that prevent the blood clots) may be required. If the thrombosis occurs or migrates to the saphenous veins, the largest veins in the legs, anticoagulants are highly recommended, as, according to eMedicine, there can be more than a 40 per cent chance of deep vein thrombosis, which can lead to life-threatening complications such as pulmonary embolism (when the blood clot migrates to the lungs).
Antibiotics and Anticoagulants
If a cannula or catheter causes a thrombosed vein, then it should be removed immediately and tested for microbes. If you are found to have an infection in the blood (sepsis) as a result, antibiotic therapy would be required as soon as possible. If the thrombus produces pus, then it may be infected and is said to be a suppurative thrombophlebitis. In this case, your doctor may, according to eMedicine, completely remove all veins involved as soon as possible and give you intravenous antibiotics. Your wound may be left open and packed with dressings for closure using skin grafting later on. If the suppurative thrombophlebitis also involves veins deeper in your tissues, aggressive anticoagulant and antibiotic therapy would be advised immediately.
If the thrombosis occurs above the knee or is persistent or spreads, there is again an increased risk of deep vein thrombosis, and your doctor may advise a thrombectomy (removal of the thrombus during surgery), most likely using a local anesthetic, according to Merck and Patient UK. Your doctor may also advise a thrombectomy in the event the thrombus migrates to the saphenous vein to minimise the deep vein thrombosis risk and if you cannot use anticoagulants.