Superficial thrombophlebitis Information | Mount Sinai

Thrombophlebitis – superficial

Thrombophlebitis is a swollen or inflamed vein due to a blood clot. Superficial refers to veins just below the skin’s surface.

Superficial thrombophlebitis is an inflammation of a vein just below the surface of the skin, which results from a blood clot. This condition may occur after recently using an IV line, or after trauma to the vein. Some symptoms can include pain and tenderness along the vein and hardening and feeling cord-like. Superficial thrombophlebitis is usually a benign and short-term condition. Symptoms generally subside in 1 to 2 weeks, but hardness of the vein may remain for much longer.

Shown here is erythema following the vascular pattern on a lower extremity. The superficial veins have become inflamed and dilated, causing the discoloration.

Causes

This condition may occur after injury to the vein. It may also occur after having medicines given into your veins. If you have a high risk for blood clots, you may develop them for no apparent reason.

Risks for thrombophlebitis include:

• Cancer or liver disease
• Deep vein thrombosis
• Disorders that involve increased blood clotting (may be inherited)
• Infection
• Pregnancy
• Sitting or staying still for a prolonged period
• Use of birth control pills
• Swollen, twisted, and enlarged veins (varicose veins)

Symptoms

Symptoms may include any of the following:

• Skin redness, inflammation, tenderness, or pain along a vein just below the skin
• Warmth of the area
• Limb pain
• Hardening of the vein

Exams and Tests

Your health care provider will diagnose this condition based mainly on the appearance of the affected area. Frequent checks of the pulse, blood pressure, temperature, skin condition, and blood flow may be needed.

Ultrasound of the blood vessels helps confirm the condition.

If there are signs of an infection, skin or blood cultures may be done.

Treatment

To reduce discomfort and swelling, your provider may recommend that you:

• Wear support stockings, if your leg is affected.
• Keep the affected leg or arm raised above heart level.
• Apply a warm compress to the area.

If you have a catheter or IV line, it will likely be removed if it is the cause of the thrombophlebitis.

Medicines called NSAIDs, such as ibuprofen, may be prescribed to reduce pain and swelling.

If clots in the deeper veins are also present, your provider may prescribe medicines to thin your blood. These medicines are called anticoagulants. Antibiotics are prescribed if you have an infection.

Surgical removal (phlebectomy), stripping, or sclerotherapy of the affected vein may be needed. These treat large varicose veins or to prevent thrombophlebitis in high-risk people.

Outlook (Prognosis)

This is usually a short-term condition that does not cause complications. Symptoms often go away in 1 to 2 weeks. Hardness of the vein may remain for much longer.

Possible Complications

Complications are rare. Possible problems may include the following:

• Infections (cellulitis)
• Deep vein thrombosis

When to Contact a Medical Professional

Contact your provider for an appointment if you develop symptoms of this condition.

Also contact your provider if you already have the condition and your symptoms worsen or do not get better with treatment.

Prevention

In the hospital, swollen or inflamed veins can be prevented by:

• The nurse regularly changing the location of your IV line and removing it if swelling, redness, or pain develop
• Walking and staying active as soon as possible after surgery or during a long-term illness

When possible, avoid keeping your legs and arms still for long periods. Move your legs often or take a stroll during long plane trips or car trips. Try to avoid sitting or lying down for long periods without getting up and moving about.

Cardella JA, Amankwah KS. Venous thromboembolism: prevention, diagnosis, and treatment. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:1072-1082.

Wasan S. Superficial thrombophlebitis and its management. In: Sidawy AN, Perler BA, eds. Rutherford’s Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 150.

Last reviewed on: 5/10/2022

Reviewed by: Deepak Sudheendra, MD, MHCI, RPVI, FSIR, Founder and CEO, 360 Vascular Institute, with an expertise in Vascular Interventional Radiology & Surgical Critical Care, Columbus, OH. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Superficial Thrombophlebitis | Michigan Medicine

Superficial thrombophlebitis is a form of venous disease (disease of the veins) that occurs when a blood clot forms that partially or totally blocks blood flow in a vein in the superficial venous system. When this occurs in the deep venous system, it is called deep vein thrombosis or DVT,  which is  more serious because of the risk of a piece of clot breaking loose and traveling to the lungs (called pulmonary embolus, or PE). This can impair breathing and can even cause death.

Symptoms of Superficial Venous Thrombophlebitis and Deep Venous Thrombophlebitis

Signs and symptoms of superficial venous thrombophlebitis are:

• A hard cord-like feeling along a vein
• Soreness over this area, redness and warmth over the vein
• Swelling in the area
• Limb pain

People with deep venous thrombophlebitis (DVT) may have:

• No signs or symptoms
• Sudden swelling of the limb
• Pain or aching of the limb
• Fever
• Skin discoloration in severe cases

Learn more about Deep Vein Thrombosis (DVT).

Risk Factors for Superficial Thrombophlebitis

Superficial thrombophlebitis may occur after injury to the vein or the recent use of an intravenous (IV) line or catheter. Some people with a high risk for this condition may develop it in lieu of any of these risk factors:

• Chemical irritation of the area
• Disorders that involve increased blood clotting
• Infection
• Pregnancy
• Sitting or staying still for a prolonged period
• Use of birth control pills or hormone replacement therapy
• Varicose veins
• Malignancy
• Chronic venous insufficiency

Diagnosis of superficial thrombophlebitis may be made based on appearance of the affected area. Other tests can be used to confirm the diagnosis, including:

• Ultrasound
• Venography
• Blood culture, if there is a sign of infection

Treatments for Superficial Thrombophlebitis

Superficial thrombophlebitis is treated with elevation of the leg, anti-inflammatory medicines such as Motrin, mild pain relievers if needed and warm, moist soaks to the area either continuously or every 4-6 hours as needed. Elastic bandages or compression stockings are also used from the base of the toes to below the knee or higher. A short course of  low-molecular weight heparin (LMWH), Lovenox or Fondaparinux may also be prescribed. Antibiotics are used if there is sign of infection. Additionally, certain patients may benefit from surgical correction of superficial venous insufficiency.

The Venous Health Program at the University of Michigan Cardiovascular Center

The Venous Health Program at the University of Michigan Frankel Cardiovascular Center is an all-inclusive resource for the treatment of venous disease. This program brings together established and experienced vascular surgeons, vascular medicine specialists, interventional radiologists and nurse practitioners to provide seamless multidisciplinary care.

Patient Resources

• Deep Vein Thrombosis Information Guide

Make an Appointment

Visit our Make an Appointment page for more information.

15 risk factors for thrombosis

Risk factors are factors that do not directly cause thrombosis, but may increase its likelihood.

There are many risk factors for venous thrombosis, the most significant of which are:

Age over 40 years

¹

Age is a significant factor in assessing the risk of thrombosis. The older the person, the higher his risk of occurrence and development of thrombosis.

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Obesity

¹

If a person’s body mass index (BMI) is over 30 (i.e. the person is obese), they are at risk of thrombosis. Obese people have a significantly higher risk than people with a normal build.

Body mass index is calculated using the formula:

where:

• m is body weight in kilograms
• h – height in meters /

Top

Hospitalization for surgery or acute or exacerbation of a chronic disease

¹ .

During hospitalization (stay in a hospital), the patient is usually in a lying position for a long time, moving little. This is not very good for his health and increases the risk of thrombosis. If the patient has undergone surgery, has an acute illness (or an exacerbation of a chronic illness), or has a catheter in their vein, the risk of thrombosis also increases. Therefore, most patients undergo thrombosis prophylaxis during their stay in the hospital.

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Trauma and fractures of the lower extremities

¹

Trauma and fractures contribute to increased thrombosis. If the injury is on the lower limb, then the person cannot move normally, his mobility is limited. And this dramatically increases the likelihood of a venous thrombus. If you have an injury or fracture of the lower limb, you should consult with your doctor about the possible prevention of venous thrombosis.

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Pregnancy and postpartum period

¹

During pregnancy, the risk of thrombosis increases significantly. There are also additional risk factors for expectant mothers, which are detailed in the article for pregnant women. While carrying a fetus, it is very important to take care of your health, so you should consult with your doctor about the prevention of thrombosis.

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Bed rest (more than 3 days)

²

Prolonged bed rest (for example, after surgery or severe injury), as well as hospital stay, increases the risk of thrombosis. If there is a risk, it is necessary to carry out extended prophylaxis after discharge from the hospital, if this prophylaxis was prescribed by a doctor.

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Long trips

¹

During long-distance air travel, as well as travel by train, car and other modes of transport, a person is in a sitting position for a long time, his movements are limited. This leads to a decrease in blood flow velocity, which significantly increases the risk of thrombosis. In the cabin of the aircraft, atmospheric pressure is lowered, the air is dry. All this favors the formation of blood clots, that is, blood clots.

Top

Oral contraceptive use and hormone therapy

¹

Women who take oral contraceptives containing estrogens, as well as hormonal agents, are advised to carefully monitor their health and consult a specialist about the possible risk of thrombosis.

Top

Varicose veins of the lower extremities

¹

Deep vein thrombosis can be a complication of varicose veins, as a result of which a blood clot forms in the lumen of the veins of the lower extremities, which is the cause of blockage of blood vessels.

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Cancer

¹

Cancer is one of the leading causes of death worldwide, especially in developed countries. In cancer patients, blood clotting increases, this is due to the development of the tumor itself and, as a result, violations of the hemostasis system. Chemotherapy also increases the risk of thrombosis. Thrombosis is the second most common cause of death among cancer patients. Therefore, patients with malignant tumors should consult with their doctor about the need for prophylaxis.

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Chronic heart failure

³

Heart failure alters the blood coagulation system, resulting in swelling of the extremities, which, in turn, makes it difficult for blood to flow through the veins. In such patients, edema may be the only symptom of thrombosis, which often goes unnoticed.

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Severe lung disease

¹

In chronic lung diseases (complications of chronic bronchitis, acute respiratory failure, severe course of bronchial asthma), disturbances in the hemostasis system develop, in which the blood’s ability to clot increases and the activity of blood clots decreases.

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Ischemic stroke

⁴

If a person has had a stroke, especially accompanied by impaired motor activity, for example, in the form of paresis and paralysis, then the risk of developing venous thrombosis is high.

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Acute and chronic infections, sepsis

¹

In the event of severe infectious diseases (as a rule, such patients are in the intensive care unit in a hospital), especially with sepsis, the risk of developing venous thrombosis is very high.

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History of venous thrombosis

¹ (i.e. the person has previously had thrombosis) or close relatives in the direct line of kinship (father, mother, sister, brother, grandparents).

The development of deep vein thrombosis in relatively young people in the absence of obvious prerequisites may be the result of genetically determined disorders of hemostasis.

Top

The combination of several risk factors leads to a significant increase in the risk of thrombosis.

Sources:

1. Cushman M. Semin Hematol. 2007 Apr; 44(2): 62–69.
2. Hikmat AR. Ann Thorac Med. 2010 Oct-Dec; 5(4): 195–200.
3. Dean SM, Abraham W. Congest Heart Fail. 2010 Jul-Aug;16(4):164-9.
4. Rinde LB et al. J Am Heart Assoc. 2016;5(11).

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What provokes thrombosis

• Main
• Blog
• What provokes thrombosis

Content:

• What provokes thrombosis

• How alcohol provokes thrombosis

• Vaccination provokes thrombosis: truth or myth?

• Which foods provoke thrombosis

• Prevention, diagnosis and treatment

In case of damage to blood vessels, the mechanism of stopping blood loss is activated, due to which clots form in the blood. This is a normal process, essential for life support. But in some cases, blood clots appear even if the vessel is not physically damaged. Thrombosis can be very dangerous, threatening not only health, but also life. Broken blood clots (emboli) can clog a part of the vessel, causing the death of large parts of the organ: the heart, lung, intestines, etc.

What causes thrombosis

The main causes of thrombosis are increased blood clotting, changes in the nature and direction of blood flow, as well as damage to arteries and veins. All these violations are observed for various reasons: there can be many triggers, and in each case it is necessary not only to get rid of blood clots, but also to look for the underlying disease.

Factors provoking thrombosis:

• Smoking, alcohol abuse.
• Serious disorders of the respiratory system, eg asthma.
• Age over 45 years.
• Overweight.
• Genetic anomalies.
• Autoimmune diseases.
• Taking hormones, including in the form of contraceptives.
• Traumatic injuries, operations, amputation of limbs.
• Blood poisoning.
• Infections affecting the walls of blood vessels.
• Cancers and at the same time some types of treatment of malignant tumors.
• Stagnation due to low mobility. Both the way of life and the nature of work, as well as forced immobility as a result of injuries, illnesses or heavy weight, matter here.
• Stagnation due to diseases of the heart and blood vessels, including varicose veins.
• Frequent and long flights by air.

The risk of thrombosis increases during pregnancy and in the postpartum period, so patients require special monitoring. People who are bedridden or who have undergone surgery are immediately at risk, as the risk of congestion increases.

How alcohol provokes thrombosis

Any alcohol-containing drinks, even aged and high-quality ones, negatively affect the vascular system and all organs. Let’s figure out how ethanol affects a person:

• A frequent drinker’s blood becomes thicker over time, and the risk of blood clots increases.
• Ethanol provokes jumps in blood pressure, which increases the load on the vessels: fragility increases, resistance to injury decreases.
• In a drinking person, fatty deposits are retained in the vessels, plaques increase in size faster than in those who do not drink alcohol.

It is a mistake to believe that strong drinks somehow help blood vessels. Of course, there are long-lived alcoholics, but should we follow their example? Especially if you are already at risk, for example, due to a disease or lifestyle.

Vaccination provokes thrombosis: truth or myth?

Repeated studies have shown that coronavirus provokes thrombosis. People who did not really understand the issue concluded that the vaccine provokes thrombosis. Blood clots do not form in every patient; people with a severe course of the disease are at risk. There are at least two explanations for why blood clots appear:

• During illness, immunoglobulins are produced, and antibodies provoke thrombosis.
• Forced lying position contributes to congestion.

Patients who carry the disease at home are at risk. In the hospital, patients can receive anticoagulants, but the need for therapy should be established individually. It is impossible to drink blood-thinning drugs on their own because of the high risks of provoking bleeding.

However, back to the question of why the vaccine provokes thrombosis. Modern covid vaccines are drugs that were urgently developed to build immunity and reduce the burden on doctors. Like any drug, the vaccine has side effects, but they occur extremely rarely – only 0.0005% of cases. For comparison, complications in the form of blood clots are observed in every fourth patient who had a severe covid. It is incorrect to say that Sputnik provokes thrombosis. In terms of action, our vaccine is not inferior to foreign analogues, and even surpasses in safety, since side effects are observed 2 times less often.

Which foods provoke thrombosis

Patients with hypercoagulability should consult with their doctor regarding the elimination of foods with vitamin K from the diet. The fact is that it affects the clotting system. It can be said that green tea and many green herbs and spices provoke thrombosis.

In addition, patients at risk need to be careful with foods that contribute to the accumulation of bad cholesterol. These are yolks, cattle meat, fatty cheese, butter. Diet advice is also necessary for diabetic patients whose blood vessels are damaged due to metabolic disorders.

Prevention, diagnosis and treatment

The advice to prevent any kind of CVD is the same – it’s a healthy lifestyle. With regard to thrombosis, the following recommendations can be made:

• Monitor the course of the underlying disease, which increases the risk of thrombosis.
• If you are going to have surgery, talk to your doctor about compression during this period. Few patients know that it is necessary to bandage the legs, regardless of which area is being operated on.
• Do not self-administer therapy. Even if hypercoagulation is found in you, the approach should be individualized with an accurate dosage selection. In addition, various drugs are used to dissolve blood clots in veins and arteries.
• Do not forget that varicose veins are not just an aesthetic problem, but a risk factor for thrombosis. A defective vein can be switched off from the bloodstream using various techniques, including low-traumatic ones (i.e., without surgery and incisions).
• Do not take oral contraceptives if your doctor has prescribed pills without testing. Choosing the right OC will help keep you healthy.
• See your doctor during pregnancy and after childbirth.

If you suspect that you have a thrombosis or want to calm down and make sure that there are no blood clots, come to us, to the Chekhov Vascular Center of the Moscow Region, to undergo the necessary examination.