Venous duplex scanning in the diagnosis and treatment of progressive superficial thrombophlebitis

Venous duplex scanning, employing both B-Mode imaging and Doppler waveform analysis, is a valuable noninvasive technique for the evaluation of venous disorders of the lower extremities. During the past three years, 442 venous duplex scans were performed in our laboratory, evaluating both the deep and superficial venous systems. Sixty-four scans revealed deep venous thrombosis; twenty studies revealed superficial thrombophlebitis. A subgroup of six studies revealed progressive thrombophlebitis approaching or involving the deep venous system. Three of these six studies documented progression of superficial thrombophlebitis extending into the deep venous system, producing limited deep venous thrombosis. All six patients were treated with venous excision and local venous thrombectomy. None of the patients developed deep venous thrombosis on follow-up venous duplex scans. We conclude that venous duplex scanning is a valuable noninvasive method in the detection of progressive superficial thrombophlebitis. Therefore, prompt therapy may prevent the development of deep venous thrombosis and its sequelae. Additionally, venous duplex scanning provides a method for noninvasive follow-up of the results of therapy.