Bedside ultrasound detected long saphenous vein thrombosis requiring ligation
© Springer-Verlag 2011
Received: 11 November 2010
Accepted: 26 January 2011
Published: 19 February 2011
Although superficial thrombophlebitis is generally regarded as a benign condition without risk of pulmonary embolization, this is not always the case. If the long saphenous vein is affected and thrombus approaches the sapheno-femoral junction or indeed extends into the deep system, then the risk of PE is significantly increased. The rate of progression of the thrombotic process from the long saphenous vein into the deep venous system has been reported as 8.6%, of which 10% embolise to the lungs . It is important therefore for Emergency Physicians to assess the proximal extent of the thrombus when managing such patients; this can easily be done at the bedside using portable ultrasound. There remains some debate in the medical literature, however, on the optimal treatment for saphenofemoral junction thrombus, with some preferring operative management , and others advocating anti-coagulation . If the thrombus has not entered the femoral vein then the condition may be treated with a high tie of the long saphenous thus preventing embolization and sparing the patient the need for prolonged anticoagulation.
Conflict of interest
None to declare.
- Verlato F, Zucchetta P, Prandoni P et al (1999) An unexpectedly high rate of pulmonary embolism in patients with superficial thrombophlebitis of the thigh. J Vasc Surg 30:1113–1115PubMedView ArticleGoogle Scholar
- Lohr J, McDevitt D, Lutter K et al (1992) Operative management of greater saphenous thrombophlebitis involving the saphenofemoral junction. Am J Surg 164:269–275PubMedView ArticleGoogle Scholar
- Marchiori A, Verlato F, Sabbioni P et al (2002) High versus low dose of unfractionated heparin for the treatment of superficial thrombophlebitis of the leg. A prospective, controlled, randomized study. Hamatologica 87:523–527Google Scholar