Management of Superficial Vein Thrombosis
RECOMMENDATIONS FOR MANAGEMENT OF SUPERFICIAL VEIN THROMBOSIS
Patient presents with signs/symptoms of superficial vein thrombosis Obtain duplex ultrasound to confirm diagnosis
Duplex positive for DVT
Duplex Negative for DVT and positive for SVT
Treat according to Guidelines for Treatment of VTE
Yes to any
Review risk of VTE vs risk/benefit of prophylactic anticoagulation
Through shared decision making , patient prefers
VTE Prophylaxis
Through shared decision making , patient prefers repeat duplex strategy
1. Repeat duplex scan at 7-10 days and treat according to Guidelines for Treatment of VTE if DVT or significant extension of SVT is detected
2. Consider oral non-steroid anti-inflammatory agent for symptom relief
3. Consider referral to Vascular Surgery if varicose
Evaluate for VTE Risk factors
History of VTE Known Thrombophilia
Male
Pregnancy
Chronic venous insufficiency
Recent surgery, trauma or injury
Recent hospital admission
Active malignancy+/- active cancer treatment
Ongoing use of oral contraceptives or hormone replacement therapy
Absence of varicose veins
No to all
Superficial thrombus is > 5cm and/or within 3-5 cm from spheno-femoral junction
No
Yes
Treat with VTE Prophylaxis Fondaparinux 2.5mg SQ daily (unless contraindicated) x 45 days
(preferred unless contraindicated by CrCl < 50 ml/min) Enoxaparin 40mg SQ daily x 45 days Alternative Oral Agents (not studied for this indication)
Apixaban 2.5mg po bid x 45 days Rivaroxaban 10mg daily x 45 days
UW Medicine VTE Treatment Taskforce April 2015
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