Version May 2024
| Anatomic classification or compartment | Consequence of thrombosis and associated pathologies |
| BRAIN | |
| Dural veins: Superior sagittal sinus; inferior sagittal sinus; straight sinus; basilar sinus; intercavernous sinus; transverse sinuses (right, left); sigmoid sinuses (right, left); occipital sinuses (right, left); cavernous sinuses (right, left); petrosal sinuses (right, left; superior, inferior); sphenoparietal sinuses (right, left); great cerebral vein (of Galen) | Cerebral sinus thrombosis is a serious condition that can affect the veins on the surface of the brain or deep within the cerebral cortex. Isolated thrombosis of the different sinuses and veins produces diverse clinical pictures. First-line treatment generally consists of antithrombotic therapy. |
| Other veins of the brain: Ophthalmic veins (right, left); cerebral veins (superficial, deep) | – |
| HEAD/NECK | |
| Superficial neck veins | – |
| Anterior jugular veins (right, left) | – |
| External jugular veins (right, left) | – |
| Deep neck | – |
| Internal jugular veins (right, left) | Thrombosis is typically related to instrumentation. Lemierre's syndrome is a rare complication of acute tonsillitis that can be associated with internal jugular vein thrombosis. |
| Scalp veins | – |
| Facial veins (right, left) | Thrombosis can occur as a consequence of sinusitis or extension of vein thrombosis related to oropharyngeal infection. |
| Frontal veins (right, left) | – |
| Temporal veins (right, left) | – |
| UPPER EXTREMITY | |
| Deep compartment veins | Thrombosis of the deep veins of the upper extremities is usually treated with anticoagulation to reduce the potential for pulmonary embolism. |
| Axillary veins (right, left) | Thrombosis is often related to compression (eg, thoracic outlet syndrome, crutch use). |
| Brachial veins (right, left) | – |
| Ulnar veins (right, left) | – |
| Radial veins (right, left) | – |
| Interosseous veins | – |
| Superficial compartment veins | Thrombosis of the superficial veins of the upper extremities is typically related to instrumentation, often phlebotomy, or peripherally inserted lines. Thrombosis of upper arm veins in the absence of instrumentation is unusual and can happen as a part of migratory phlebitis pattern signaling malignancy (ie, Trousseau's syndrome) or Buerger's disease (thromboangiitis obliterans). |
| Basilic veins (right, left) | – |
| Cephalic veins (right, left) | – |
| Median antecubital veins (right, left) | – |
| Accessory cephalic veins (right, left) | – |
| Median veins of the forearm (right, left) | – |
| CHEST | |
| Central veins | Thrombosis of the central veins is usually treated with anticoagulation in the absence of contraindications. |
| Brachiocephalic vein | – |
| Subclavian veins (right, left) | – |
| Superior vena cava | Thrombosis is often due to compression from a nearby mass/tumor but may be from extension of thrombus from other central veins. |
| Inferior vena cava | Thrombosis is often related to prior inferior vena cava filter placement. May also be related to tumor compression or extension of thrombus from the renal vein(s) in patients with renal cell carcinoma. |
| Azygous and hemiazygos veins | – |
| Chest wall veins | Dilation of the veins of the chest wall may be a sign of chronic central venous obstruction. Thrombosis of chest wall veins is unusual and can happen as a part of migratory phlebitis pattern signaling malignancy (ie, Trousseau's syndrome). It may also occur with cirrhosis due to portal hypertension. |
| Lateral thoracic veins (right, left) | Mondor's disease (superficial phlebitis of the chest wall). |
| Internal thoracic veins (right, left) | – |
| Intercostal veins (right, left) | – |
| Musculophrenic veins (right, left) | – |
| ABDOMEN | |
| Abdominal wall veins | Dilation of the veins of the abdominal wall may be a sign of chronic iliocaval venous obstruction. Thrombosis of abdominal wall veins is unusual and can happen as a part of migratory phlebitis pattern signaling malignancy (ie, Trousseau's syndrome) and Mondor's disease. |
| Superficial epigastric veins (right, left) | – |
| Inferior epigastric veins (right, left) | – |
| Subcostal veins (right, left) | – |
| Hepatoportal system | – |
| Hepatic veins | Hepatic venous outflow tract obstruction is Budd-Chiari syndrome. |
| Portal vein | Thrombosis may lead to portal hypertension, variceal hemorrhage (gastroesophageal varices), intestinal ischemia, and portal cholangiopathy. |
| Splenic vein | Thrombosis may lead to isolated gastric varices. |
| Pancreaticoduodenal veins (anterior, posterior, superior, inferior) | – |
| Gastric veins (right, left) | – |
| Superior mesenteric vein | Thrombosis causes abdominal pain due to venous congestion, which may lead to full-thickness bowel infarction. In the absence of severe bowel ischemia, anticoagulation is the mainstay of therapy. |
| Inferior mesenteric vein | – |
| Colic veins (right, middle, left) | – |
| Retroperitoneal veins | – |
| Renal veins (right, left) | Renal vein thrombosis can cause nephrotic syndrome, renal infarction, and acute kidney injury. Renal carcinoma can be intraluminal and often mimics renal vein thrombosis. Compression of the left renal vein between the superior mesenteric artery and aorta (ie, Nutcracker syndrome) can lead to left renal vein thrombosis. |
| Adrenal veins (right, left) | – |
| PELVIS | |
| Retroperitoneal veins | – |
| Iliac veins (common, internal, external; right, left) | Iliac vein thrombosis can be related to extension of lower extremity vein thrombosis or as a consequence of iliac vein stenosis and subsequent thrombosis (May-Thurner syndrome). Thrombus associated with large, proximal veins is more likely to embolize. |
| Internal pudendal veins | – |
| Pelvic organ veins | When septic thrombophlebitis of the veins associated with the female pelvic organs occurs, it is usually in association with pregnancy and delivery. |
| Gonadal veins (ovarian, testicular; right, left) | Dilation of veins can lead to pelvic congestion syndrome and can cause aspermia in men. May be related to Nutcracker syndrome of left renal vein. |
| Uterine veins | – |
| Vaginal veins | Dilation of veins can cause dyspareunia. Vaginal varicosities do not typically thrombose, but it can happen. |
| Vesicular veins (superior, inferior; right, left) | – |
| Rectal veins (superior, middle, inferior; right, left) | – |
| Gluteal veins (superior, inferior; right, left) | – |
| Internal hemorrhoidal plexus | Thrombosis of the veins of the internal hemorrhoidal plexus can cause constipation and are not painful. |
| Groin/perineum veins | Dilation of the veins of the lower abdominal wall may be a sign of chronic iliofemoral venous obstruction. |
| Superficial circumflex iliac veins (right, left) | – |
| Superficial epigastric veins (right, left) | – |
| Deep circumflex iliac veins (right, left) | – |
| External pudendal veins (right, left) | – |
| External hemorrhoidal plexus | Thrombosis of the veins of the external hemorrhoidal plexus are extremely painful. |
| LOWER EXTREMITY | |
| Deep compartment veins | Thrombosis of the deep veins of the lower extremities is usually treated with anticoagulation to reduce the potential for pulmonary embolism. Thrombus associated with large, proximal veins is more likely to embolize. The femoral vein may be duplicated. |
| Common femoral veins (right, left) | – |
| Deep femoral veins (right, left) | – |
| Femoral veins (right, left) | Vein may be duplicated. |
| Popliteal veins (right, left) | Vein may be duplicated. |
| Gastrocnemius veins (right, left) | – |
| Soleal sinuses | – |
| Tibial veins (anterior, posterior; right, left) | Typically paired veins. |
| Fibular (peroneal) veins (right, left) | Typically paired veins. |
| Superficial compartment veins | Phlebitis and thrombosis of the superficial veins of the lower extremities are usually treated conservatively; however, if thrombus is identified in a location that is near a confluence with the deep venous system, antithrombotic therapy is advocated. |
| Great saphenous veins (right, left) | – |
| Small saphenous veins (right, left) | – |
| Anterior accessory saphenous veins (right, left) | – |
| Intersaphenous veins (formerly vein of Giacomini) | – |
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