Perth's Leading Specialist in the Treatment of Varicose Veins
Dr Luke Matar | MBBS, FRANZCR, FACP
What is Superficial Venous Thrombosis?
Superficial venous thrombosis, often shortened to SVT, is a blood clot in a superficial vein. These veins sit closer to the surface of the skin than the deep veins of the leg.
SVT is sometimes called superficial thrombophlebitis because the affected vein is usually inflamed as well as thrombosed. It can occur in normal veins, but it is more common in people with varicose veins.
SVT is a clotting (thrombotic) condition — not a skin infection — so antibiotics are not usually part of treatment.
Typical symptoms include:
- redness along the line of a vein
- warmth, swelling and tenderness of the overlying skin
- pain that worsens with touch or pressure
- a firm, cord-like thickening — often felt as a palpable “rope” along the affected vein
- darkening or hardening of the skin in the area
Because the inflammation extends into the surrounding skin and soft tissue, SVT is commonly mistaken for cellulitis — as in this patient with SVT of the great saphenous vein.
If you notice these symptoms, see your doctor to arrange an ultrasound scan of the area. Fever or chills are not usual with SVT and may indicate infection or another condition — if these develop, seek urgent medical care.
Why assessment is important
SVT is diagnosed via clinical examination of the affected area as well as a detailed Doppler ultrasound scan of the veins.
Although SVT is usually less serious than a deep vein thrombosis, it should not always be dismissed as a minor condition because a co-existing deep vein thrombosis (DVT) may be present in up to 25% of cases. (Decousus et al., Ann Intern Med 2010;152:218–224 — POST study) In view of this, ultrasound is essential to confirm the clot and determine its significance. We assess its location, length and how close it lies to the deep veins.
How is superficial venous thrombosis treated?
Treatment depends on the location and extent of the SVT, the severity of symptoms, and whether there are risk factors for extension into the deep veins, the patient’s individual risk factors and coexisting medical conditions.
Treatment may include:
- walking and remaining mobile
- compression stockings or bandaging, where appropriate
- anti-inflammatory medication, if suitable
- pain relief
- elevation for comfort
- repeat ultrasound in selected cases
-
anticoagulant medication in higher-risk cases
- measures to relieve symptoms, such as anti-inflammatory medication, compression stockings and staying mobile
- a course of anticoagulant (blood-thinning) medication, usually for around six weeks, where the clot is longer or lies close to the deep veins, to prevent it extending into the deep system — the choice and duration are individualised
- monitoring with a repeat ultrasound for small clots well away from the deep veins
Where SVT has occurred within varicose veins, treating the underlying venous reflux once the acute episode settles can reduce the risk of recurrence.
SVT and varicose veins
SVT often occurs in association with varicose veins. In this situation, the immediate episode of inflammation and clotting may settle, but the underlying varicose veins can remain.
If varicose veins are contributing to recurrent SVT, further assessment may be recommended after the acute inflammation has improved. Treatment of the underlying refluxing veins may reduce the chance of further episodes, but the appropriate timing and method depends on the individual case.
Assessment and treatment at The Vein Clinic
At The Vein Clinic, duplex ultrasound scans are performed on-site by our experienced sonographer, in our purpose-built vein treatment rooms in Perth. Dr Matar — a specialist radiologist and phlebologist — provides a thorough assessment and a personalised treatment plan tailored to your ultrasound findings, aimed at relieving your symptoms and reducing the risk of recurrence.
Can Superficial Venous Thrombosis Be Prevented?
When SVT occurs in varicose veins or refluxing saphenous veins, treatment of the underlying condition is the most effective way of preventing recurrence in those veins.
SVT cannot always be prevented, but general measures that may reduce venous stasis include:
- regular walking
- avoiding long periods of immobility
- moving the ankles and calves during long travel
- maintaining hydration during flights or prolonged sitting
- using compression stockings if recommended
- assessing and managing varicose veins where clinically appropriate
People with previous SVT, previous DVT, significant varicose veins, pregnancy, hormone therapy, recent surgery, cancer, thrombophilia, or long-haul travel plans should seek individual medical advice.
In most cases, SVT settles with appropriate management. The acute discomfort usually eases over one to two weeks, although the firm cord and any skin discolouration can take several months to resolve fully.
The main complication to be aware of is extension of the clot into the deep veins (DVT) — which is precisely why ultrasound assessment and appropriate treatment matter. SVT can also recur, particularly if you have underlying varicose veins or venous reflux.
Our Approach to Treatment
Stage 1
Treatment of large malfunctioning veins (trunk)
Endovenous Laser Treatment (EVLA) to great, small, and/or anterior accessory saphenous veins. 60 minutes
Stage 2
Treatment of large varicose veins (branches)
Phlebectomy removal of larger bulging varicose veins 90-120 minutescombined with
Ultrasound-Guided Foam Sclerotherapy (UGFS) on smaller veins. 30 minutes
Stage 2
Treatment of small varicose veins (branches) if required
Extra sessions of UGFS to close smaller veins if identified as required at post-treatment follow-up scan 30 minutes
You may not require this stage.
Stage 3
Optional treatment surface veins (leaves)
Usually done by Microsclerotherapy 30 minutes
Most patients require multiple treatment sessions to remove spider veins.
Stage 4
Follow up and maintenance to ensure best results
Other Minimally Invasive
Superficial Venous Thrombosis Treatments
Meet Your Vein Specialist
Dr Luke Matar MBBS, FRANZCR, FACP
Dr Luke Matar is the only Australian doctor to have been personally trained by the inventor of laser perforator vein ablation, the world-renowned UK-based EVLA expert Professor Mark Whiteley. This advantage positions him as the clear choice for your laser treatment for varicose veins. Having suffered the discomfort experienced from venous insufficiency personally, Dr Matar is uniquely sympathetic to his patients. This has influenced his commitment to providing world-class non-surgical varicose vein treatments. For Dr Matar, it’s all about great results from minimal pain using leading technologies that minimise recovery time and post-treatment discomfort.
Meet Dr Luke MatarExperiencing Other Symptoms?
Frequently Asked Questions
Why do I have varicose veins?
Most varicose vein issues are hereditary. If you have one parent with varicose veins your risk of having them is around 65%. If both parents are affected the risk rises to approximately 90%. Another main risk factor for women is pregnancy, with the risk increasing with each additional pregnancy. Standing occupations such as hairdressers, nurses, and chefs also have a high risk of varicose veins as gravity puts pressure on the veins and weakens them.
How do I prevent varicose veins?
Once varicose veins are present, they will not resolve of their own accord. Measures to reduce the rate of progression include maintaining a normal healthy weight and going for regular walks of 20-30 minutes per day. Reducing the length of time spent on the feet in a stationary position may help and alternating between standing and sitting positions during the day will also reduce the pressure on the veins.
What will happen if I don’t treat these veins?
Generally, without treatment, varicose veins will get progressively worse over time. Symptoms may occur such as heaviness, ache, pain, and tiredness in the legs towards the end of the day. Further progression may result in leg swelling, itch, skin discolouration, and eventual skin ulceration. Blood clots related to superficial venous thrombosis may also occur in severe cases and can lead to the more serious condition of Deep Vein Thrombosis.
What treatment options exist?
Outdated, old-fashioned options such as surgical stripping are rapidly becoming obsolete due to poor long-term success, with recurrence rates of up to 50%. Modern treatment options include endovenous laser ablation, sclerotherapy injections, and ultrasound-guided ambulatory phlebectomy. In many cases a combination of different treatments will give the best long-term results.
Will the veins come back after treatment?
Many people are concerned that the treatment will be of limited value because the veins will just come back. This was certainly the case in the days of surgical stripping with a 50% recurrence rate at 5 years; however, using the latest minimally invasive techniques, we can reduce the risk of recurrent varicose veins to the baseline risk of approximately 3% per year.
What is the downtime following treatment?
This depends on the type of procedure performed and the severity of the veins being treated. Modern treatment with laser can involve no time off work and approximately two weeks off heavy gym work and four weeks off international travel.
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