The consequences of superficial thrombophlebitis (STBP) of the lower extremities are not as well recognized as those of deep venous thrombosis (DVT). Similarly, there is some uncertainty among clinicians about best management. Choosing treatment wisely is important because untreated STBP can extend to DVT; indeed, even treated STBP can progress or recur in as many as 10% of patients.
Although other consequences are important (extension of STBP, recurrence), the most concerning sequel of STBP is DVT. Although trials of fondaparinux found a significant reduction in risk for DVT when administered for 45 days (an 85% risk reduction), data from studies with low-molecular-weight heparin (LMWH) and nonsteroidal anti-inflammatory drugs (NSAIDs) did not confirm venous thromboembolism risk reduction.
LMWH and NSAIDs provided lower rates of STBP recurrence than placebo, but based on equivocal results for VTE reduction, fondaparinux should be the preferred treatment.