Superficial thrombophlebitis, unjustly underestimated disease - has the time come to change our view?
Abstract
Superficial thrombophlebites represent a very heterogeneous group of diseases which is caused by the difference between two basic forms of ST - varicophlebitis and thrombophlebitis of a "healthy" vein, as well as by other factors - the ratio of thrombotic and inflammatory process, the location and extent of thrombosis in superficial venous system, the distance from deep venous system, the stage of venous insufficiency and the general thrombotic risk of a patient. ST shares many common features with deep vein thrombosis (clinical risk factors, thrombophilic disorders), both diseases often coincide or follow one another.
Some authors suggest considering ST as a part of venous thromboembolism in a broader sense. There are ensuing unresolved questions regarding ST management.
So far, no evidence-based treatment has been clearly defined. Anticoagulation is recommended in more serious cases but no consensus about dosing and duration has been reached.
The CALISTO trial confirmed a benefit of fondaparinux in prophylactic dose in the therapy of isolated ST and the results have been reflected in recent guidelines of expert groups. Further studies to improve our knowledge of ST and to earn more evidence about its management are definitely needed.