What are the main types of thrombophlebitis. How can you recognize the symptoms of thrombophlebitis. What factors increase the risk of developing thrombophlebitis. How do doctors diagnose and treat thrombophlebitis. What preventive measures can help reduce the risk of thrombophlebitis.

Understanding Thrombophlebitis: When Blood Clots Form in Your Veins

Thrombophlebitis is a condition characterized by the formation of blood clots in veins, accompanied by inflammation. This medical issue primarily affects the legs, but can also occur in the arms or other parts of the body. The term “thrombophlebitis” combines two key components: “thrombo” referring to clots, and “phlebitis” indicating vein inflammation.

The condition can manifest in different forms, each with its own set of characteristics and potential complications. Understanding these variations is crucial for proper diagnosis and treatment.

Types of Thrombophlebitis

• Superficial thrombophlebitis: Affects veins close to the skin surface
• Deep vein thrombosis (DVT): Involves clots in deep veins, potentially leading to serious complications
• Migratory thrombophlebitis: Characterized by recurrent clots in different body parts, often associated with underlying conditions like cancer

Is superficial thrombophlebitis less dangerous than deep vein thrombosis? Generally, yes. While superficial thrombophlebitis can be painful and require treatment, it rarely leads to severe complications. In contrast, DVT poses a higher risk due to the potential for clots to break loose and travel to the lungs, causing a life-threatening pulmonary embolism.

Recognizing the Signs: Key Symptoms of Thrombophlebitis

Identifying thrombophlebitis early is crucial for prompt treatment and prevention of complications. The symptoms can vary depending on the type and severity of the condition, but some common signs include:

• Redness and swelling around the affected area
• Pain or tenderness, especially when pressure is applied
• A hardened, cord-like vein that can be felt under the skin
• Pain when flexing the ankle (in cases affecting the legs)
• Swelling in the foot or ankle

When should you seek immediate medical attention for suspected thrombophlebitis? If you experience severe leg pain, swelling, or any of the following symptoms, it’s crucial to call emergency services:

• One leg appearing warmer, more swollen, or more painful than the other
• Sudden coughing, possibly with blood
• Sharp chest pain or tightness
• Difficulty breathing or rapid breathing
• Severe lightheadedness or rapid heartbeat

These symptoms could indicate a more serious condition, such as a pulmonary embolism, which requires immediate medical intervention.

The Root of the Problem: Causes and Risk Factors for Thrombophlebitis

Thrombophlebitis occurs when blood flow in a vein is impaired, leading to clot formation. Several factors can contribute to this condition:

Common Causes of Thrombophlebitis

• Prolonged immobility (e.g., bed rest after surgery or long-distance travel)
• Varicose veins causing blood pooling
• Injury to blood vessels
• Certain medical conditions affecting blood clotting

Who is at higher risk of developing thrombophlebitis? Several factors can increase an individual’s susceptibility to this condition:

• Age over 60
• Obesity
• Smoking
• Use of hormone-based medications (e.g., birth control pills or hormone replacement therapy)
• Pregnancy or recent childbirth
• Personal or family history of blood clots
• Presence of central venous catheters
• Certain types of cancer
• Hypercoagulable states (conditions that increase blood clotting tendency)

Understanding these risk factors can help individuals and healthcare providers take appropriate preventive measures and ensure early detection of thrombophlebitis.

Diagnosing Thrombophlebitis: Medical Approaches and Tests

Accurate diagnosis of thrombophlebitis is essential for appropriate treatment and management. Healthcare providers employ various methods to confirm the presence of blood clots and assess their extent:

Diagnostic Procedures for Thrombophlebitis

1. Physical examination: The doctor will visually inspect and palpate the affected area, looking for signs of swelling, redness, and tenderness.
2. Medical history review: Understanding the patient’s risk factors and symptoms helps guide the diagnostic process.
3. Imaging tests: These may include:
   • Duplex ultrasound: A non-invasive method using sound waves to visualize blood flow and detect clots
   • CT scan or MRI: These advanced imaging techniques can provide detailed views of blood vessels and surrounding tissues
4. Blood tests: Specific tests may be ordered to assess clotting factors and inflammation markers.

What is the significance of the D-dimer test in diagnosing thrombophlebitis? The D-dimer test is a blood test that detects the presence of a protein produced when blood clots break down. An elevated D-dimer level can indicate the presence of abnormal blood clotting, although it’s not specific to thrombophlebitis and may be elevated in other conditions as well. Therefore, it’s often used in combination with other diagnostic tools to confirm or rule out thrombophlebitis.

Treatment Approaches: Managing Thrombophlebitis Effectively

The treatment of thrombophlebitis aims to relieve symptoms, prevent clot progression, and reduce the risk of complications. The specific approach depends on the type and severity of the condition:

Treatment Options for Superficial Thrombophlebitis

• Warm compresses to reduce inflammation and promote circulation
• Over-the-counter pain relievers (e.g., ibuprofen) to manage pain and inflammation
• Compression stockings to improve blood flow
• Elevation of the affected limb to reduce swelling
• Topical anti-inflammatory medications

Treatment for Deep Vein Thrombosis (DVT)

• Anticoagulant medications (blood thinners) to prevent clot growth and reduce the risk of new clots
• Thrombolytic therapy in severe cases to dissolve existing clots
• Compression stockings to manage swelling and improve circulation
• In some cases, placement of a vena cava filter to prevent clots from reaching the lungs

How long does treatment for thrombophlebitis typically last? The duration of treatment varies depending on the type and severity of thrombophlebitis. For superficial thrombophlebitis, symptoms often improve within 1-2 weeks with conservative measures. In cases of DVT, anticoagulant therapy may be required for several months or even longer, based on individual risk factors and the underlying cause of the condition.

Preventing Thrombophlebitis: Strategies for Reducing Risk

While not all cases of thrombophlebitis can be prevented, several measures can help reduce the risk of developing this condition:

Lifestyle Modifications for Thrombophlebitis Prevention

• Stay active and avoid prolonged periods of immobility
• Maintain a healthy weight through proper diet and exercise
• Quit smoking and limit alcohol consumption
• Stay hydrated, especially during long-distance travel
• Wear loose-fitting clothing that doesn’t restrict blood flow

Medical Interventions for High-Risk Individuals

• Use of compression stockings in situations with increased risk (e.g., long flights, post-surgery)
• Prophylactic anticoagulant therapy for those at very high risk
• Regular movement and exercises during periods of immobility (e.g., flexing ankles during long flights)

Can thrombophlebitis be completely prevented? While it’s not possible to eliminate all risk factors for thrombophlebitis, particularly those related to genetics or certain medical conditions, many cases can be prevented through a combination of lifestyle modifications and appropriate medical interventions. Regular consultations with healthcare providers can help identify individual risk factors and develop personalized prevention strategies.

Living with Thrombophlebitis: Long-Term Management and Considerations

For individuals who have experienced thrombophlebitis, ongoing management and vigilance are crucial to prevent recurrence and complications:

Follow-up Care and Monitoring

• Regular check-ups with healthcare providers to assess healing and adjust treatment plans
• Adherence to prescribed medications, including anticoagulants if necessary
• Monitoring for signs of recurrence or new clot formation
• Management of underlying conditions that may contribute to thrombophlebitis risk

Lifestyle Adaptations for Long-Term Health

• Incorporating regular exercise into daily routines to promote circulation
• Maintaining a healthy diet rich in fruits, vegetables, and whole grains
• Avoiding prolonged periods of sitting or standing
• Using compression stockings as recommended by healthcare providers

What impact does a history of thrombophlebitis have on future health decisions? A previous episode of thrombophlebitis, especially DVT, may influence various aspects of an individual’s healthcare:

• Increased vigilance during high-risk situations (e.g., surgery, pregnancy)
• Consideration of thrombophlebitis risk when making decisions about hormone-based medications
• Potential need for long-term anticoagulant therapy in some cases
• Importance of informing all healthcare providers about the history of thrombophlebitis

By staying informed and proactive about their condition, individuals with a history of thrombophlebitis can effectively manage their health and reduce the risk of future complications.

Advances in Thrombophlebitis Research: New Insights and Future Directions

The field of thrombophlebitis research continues to evolve, with ongoing studies aimed at improving diagnosis, treatment, and prevention strategies:

Emerging Diagnostic Technologies

• Development of more sensitive and specific blood tests for detecting clots
• Advancements in imaging techniques for better visualization of blood vessels and clots
• Exploration of biomarkers for early detection of thrombophlebitis risk

Novel Treatment Approaches

• Investigation of new anticoagulant medications with improved safety profiles
• Research into targeted therapies for specific types of thrombophlebitis
• Exploration of minimally invasive techniques for clot removal

Prevention Strategies

• Development of personalized risk assessment tools
• Studies on the effectiveness of various lifestyle interventions in reducing thrombophlebitis risk
• Research into genetic factors influencing clot formation and potential targeted prevention strategies

How might future advancements change the landscape of thrombophlebitis management? As research progresses, we can anticipate more personalized approaches to thrombophlebitis prevention and treatment. This may include:

• Tailored anticoagulation regimens based on individual genetic profiles
• Advanced wearable devices for continuous monitoring of blood flow and early detection of clot formation
• Development of novel therapies targeting the underlying mechanisms of abnormal blood clotting

These advancements hold the promise of improving outcomes for individuals at risk of or affected by thrombophlebitis, potentially reducing the incidence of complications and enhancing overall quality of life.

Thrombophlebitis (Superficial and Migratory): Symptoms, Causes, Treatment

Thrombophlebitis is when a blood clot forms in one of your veins and slows the blood flow in the vein. It most often affects your legs, but it can also happen in your arms or other veins in your body. Thrombophlebitis can happen right under the skin or deeper in your leg or arm.

“Thrombo” means clot, and “phlebitis” means inflammation in a vein. That’s the swelling and irritation that happen after an injury.

What Are the Types of Thrombophlebitis?

Phlebitis and thrombosis of the lower extremity superficial veins. You might also hear this called superficial phlebitis or superficial thrombophlebitis. It’s a blood clot in the vein just below the surface of your skin. It doesn’t usually get to your lungs, but superficial thrombophlebitis can be painful, and you may need treatment.

Deep vein thrombosis (DVT). It’s a blood clot in a vein deep in your body that can occur with or without phebitis. Most happen in your lower leg or thigh, but they may happen in other parts of your body. A clot like this can get loose and travel through your bloodstream. If it gets to an artery in your lungs and blocks blood flow, it’s called a pulmonary embolism, which can damage your lungs and cause death. This is what makes DVTs are more dangerous than superficial vein thrombosis. DVTs require blood thinners.

Migratory thrombophlebitis. Also called Trousseau’s syndrome or thrombophlebitis migrans, it’s when the clot comes back in a different part of your body. It often goes from one leg to the other. It’s often linked to cancer, especially of the pancreas or lung.

What Are the Symptoms of Thrombophlebitis?

If the blood flow to one of your veins is slowed because of a clot, you might have:

• Red, swollen, and irritated skin around the affected area
• Pain or tenderness that gets worse when you put pressure on the affected area
• A swollen vein that feels like a tough “cord” under your skin
• Pain when flexing your ankle (keep in mind that thrombophlebitis can happen in other parts of the body, but it usually happens in the legs)
• A swollen foot or ankle

If you have any of these symptoms, see your doctor right away.

Call 911 if you have leg pain or swelling or any of the following symptoms:

• One leg seems warmer than the other or is swollen, red, painful, or irritated
• The affected limb becomes pale or cold, or you start feeling chills and fever
• Sudden coughing, which may bring up blood
• Sharp chest pain or chest tightness
• Pain in your shoulder, arm, back, or jaw
• Rapid breathing or shortness of breath
• Pain when you breathe
• Severe lightheadedness
• Fast heartbeat

What Causes It?

First, a blood clot forms. This can be due to several things. Most often, it’s caused by blood not moving the way it should through the leg veins. This can happen because of:

Long-term bed rest, such as after a major illness or surgery.

Sitting for a long time, as you would in a car, on a plane, or in some other place where you can’t stretch your legs.

Varicose veins. They cause your blood vessels to stretch too much. This allows blood to pool in the vessel instead of flowing straight through in one direction. This can lead to blood clots.

Who’s at Risk?

Anyone who has poor circulation in their legs may be more likely to have this condition. This could include women who may get thrombophlebitis during or after pregnancy. People who’ve been kept in the hospital on an IV are at risk, too. Hospital staffers try to lower this risk by changing the spots where IV lines are placed in the body.

Other things that raise your chances of having this condition include:

• Certain cancers
• Use of the hormone estrogen for birth control or hormone replacement
• Being over age 60
• Obesity
• Smoking
• A family or personal history of blood clots
• Catheters placed in central veins of the arm or leg
• Anyone who has a hypercoagulable state
• if you have had trauma
• Are immoboloized
• Have had surgery and are immobolized

How Is It Diagnosed?

The doctor will start by asking about your symptoms and taking a look at veins near the surface of your skin. They’ll do a physical exam. They may also do blood and circulation tests or imaging exams like a CT scan or MRI. They might also do tests like:

Duplex ultrasound. This painless imaging test doesn’t have radiation the way an X-ray does. It uses sound waves to create a picture of your legs. The doctor spreads warm gel on your skin and then rubs a wand over the area where they think the clot is. The wand sends sound waves into your body. The echoes go to a computer, which makes pictures of your blood vessels and sometimes the blood clots.

A radiologist will review the images and send a report to your primary care doctor or to the doctor who requested the ultrasound.

D-dimer test. This is a blood test to look for a protein, called D-dimer, that’s made when a blood clot breaks down. Your doctor will order this test if they think you’ve got a dangerous clot, like a deep vein thrombosis (DVT) or pulmonary embolism (PE).

If your D-dimer level is high, it could mean a clot is breaking down. If your results are negative, it means you probably don’t have a clot. But even if the results are positive, that still doesn’t mean you have a clot. Your doctor will need to order imaging studies to visualize the clot.

MR Venography and CT Venography. If the results of your ultrasound aren’t clear, your doctor will use these imaging studies to confirm the presence of a clot. They will inject a dye into your vein and the image will show up on an X-ray. Possible side effects include pain and an allergic reaction to the dye.

MR angiography (MRA). This test takes a detailed picture of your veins using a large MRI machine. Your doctor will inject a special dye into your veins. It’ll allow them to see your blood vessels. They’ll also be able to see anything that looks unusual, like plaque buildup in your arteries.

CT scan. If your doctor is concerned that a deep vein clot has moved to your lung, they might order this test to get a better image.

How Is Thrombophlebitis Treated?

Most cases of thrombophlebitis that happen in the shallow veins begin to go away by themselves in a week or two. But on rare occasions, these blocked veins can lead to infection. They can even cause tissue damage from the loss of healthy circulation.

If you need treatment, your doctor will probably give you something to relieve swelling and pain. They may recommend that you keep your leg raised or take over-the-counter aspirin or ibuprofen. They might also suggest you apply heat to the affected leg or arm for 15 to 30 minutes, two to three times daily.

Antibiotics. You might get them if poor circulation leads to an infection.

Blood thinners. These medications are usually reserved for thrombosis with a high risk of embolization to the lungs or brain. Deep vein thrombosis requires anticoagulation for this reason. You can give yourself heparin and enoxaparin (Lovenox) at home through shots under your skin. They help keep the clot from getting bigger. You may also have to take an oral drug like warfarin (Coumadin) for several months or longer to keep clots from coming back. Your doctor will give you regular blood tests to make sure the meds are working.

Bllood thinners, like direct thrombin inhibitors and factor Xa inhibitors, are also available. But doctors don’t normally recommend them as the main treatment for thrombophlebitis because they cost more and may cause uncontrollable bleeding. They include apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Savaysa), and rivaroxaban (Xarelto).

Compression stockings. After the clot has resolved and you are on blood thinners, you may be advised to wear a compression stocking on the leg that was affected. This reduces the risk of post-thrombotic or post-phlebitic syndrome.
They decrease swelling of the leg which decreases pressure in the veins and reduces risk of varicose veins..

Filter. This has much more limited use than suggested here. An IVC filter is used on people who can not safely take anticoagulation and are at risk for DVTs which put the person at risk for pulmonary embolism. The vena cava is the main vein in your abdomen. The IVC filter prevents clots in your legs from breaking loose and traveling to your lungs. You’ll need surgery for this treatment. They are ideally removed within  3 months after placement.

Varicose vein stripping. This can help with veins that cause pain or recurring thrombophlebitis. The doctor makes small cuts to remove a long vein. It doesn’t affect circulation. Veins deeper down can handle more blood.

Complications

They’re rare, but you could have:

Pulmonary embolism. If the clot breaks loose, it could move to your lungs and block an artery. This condition can be life-threatening.

Postphlebitic syndrome. It can show up months or years after DVT. It often causes pain, swelling, and a feeling of heaviness in the affected leg or arm. You might hear it called post-thrombotic syndrome, venous stasis syndrome, or chronic venous insufficiency.

Can It Be Prevented?

Sitting on long drives or flights is a major cause of blood clots. To prevent them:

• Walk around. Get up for a stroll every hour.
• Keep moving. Don’t just sit there. Flex your ankles. Or press your feet against the floor or footrest about 10 times an hour.
• Keep it loose. Don’t wear tight clothing.
• Stay hydrated. Drink plenty of fluids, but avoid alcohol.
• Blood thinners. If you have had a clot previously or are at high risk for one, blood thinners may be prescribed prophylactically.

Benefits, Risks, & How They Prevent Blood Clots

Blood thinners are medicines that help blood flow smoothly through your veins and arteries. They also keep blood clots from forming or getting bigger. They’re used to treat some types of heart disease and heart defects, and other conditions that could raise your risk of getting dangerous clots.

They can protect against heart attacks and strokes. But they also come with risks: For example, they’ll cause you to bleed more than usual when you cut yourself.

The lifesaving benefits of these drugs often outweigh the potential dangers. Still, it’s important to learn about both before you start taking them.

Types of Blood Thinners

There are two. The first is called anticoagulants. These keep your blood from clotting, or turning into solid clumps of cells that stick together. Most come in pill form though some such as  heparin, fondaparinux, dalteparin and enoxaparin are given as a shot or as an intravenous infusion. Some of the more widely know anticoagulants include

The second class of blood thinners is called antiplatelets. These target tiny particles in the blood called platelets. They come in pill form, and include:

How They Work

Blood thinners don’t actually make your blood thinner. Nor can they break up clots. But they do keep blood from forming new clots. They can also slow the growth of existing ones.

Some anticoagulants do this by competing with vitamin K from the liver. Your body needs this to make proteins called clotting factors. These help blood cells and platelets (tiny pieces of blood cells) bind together.

Antiplatelets keep platelets from sticking to each other and to the walls of blood vessels. These drugs are weaker than anticoagulants. They’re often prescribed to people at risk for future blood clots, rather than to treat existing ones.

Who Needs Them?

About 2 million to 3 million people take blood thinners every year. You may need them if you’ve already had a heart attack or a stroke, since they can lower your risk of having a second one.

You may also need this type of medicine if you have a heart or blood vessel disease, an irregular heart rhythm, lupus, or deep vein thrombosis. (DVT is a dangerous type of blood clot that often forms in the leg.) You also have a greater risk for blood clots if you’re overweight, recently had surgery, or have an artificial heart valve.

Some people only need these meds for a few months. But if you have ongoing health problems, you may need to take them long term.

If you have atrial fibrillation, blood thinners can help keep you from having a stroke. That’s one of the most common reasons doctors prescribe it.

Risks

Clotting isn’t always a bad thing: When you cut yourself, it’s what seals your wound and keeps you from losing too much blood. Blood thinners prevent clotting. So, even tiny cuts or bruises will bleed a lot more if you take these drugs.

You should be very careful when taking part in activities that could cause any type of injury. Call your doctor right away if you fall or hit your head. Even if you don’t tear your skin, you could bleed internally.

Let your doctor know right away if you notice any signs of unusual bleeding, like:

If you take an anticoagulant like warfarin, you’ll need regular blood tests so your doctor can adjust your levels if needed. Ask them about other steps you should take to stay safe while you’re on this medication. Be careful with activities that can lead to head injuries. Any type of trauma is extremely dangerous if you’re taking a blood thinner.

If you get a dangerous bleeding problem while taking warfarin, doctors can turn to an “antidote” of vitamin K or a combination of prothrombin complex concentrate (PCC) and fresh frozen plasma to stop it. In addition, approval has been given for using a reversal agent like andexanet alfa (Andexxa) to reverse the anti-clotting effects of apixaban (Eliquis) and rivaroxaban (Xarelto) or idarucizumab (Praxbind) to reverse the anti-clotting effects of dabigatran etexilate (Pradaxa). in emergencies.

Other medicines and supplements, including over-the-counter ones, can interfere with these drugs. Tell all of your doctors, including your dentist, that you’re taking a blood thinner. Don’t start any new medicines without their OK.

And remember that your diet is also very important. Some foods — like green, leafy vegetables — contain vitamin K. This can counteract the blood thinners. Talk to your doctor about your diet.

Vericose Vein Basics and Causes

What Are Varicose Veins?

Varicose veins are usually bulging, bluish cords running just beneath the surface of your skin. They almost always affect legs and feet. Visible swollen and twisted veins — sometimes surrounded by patches of flooded capillaries known as spider veins — are considered superficial varicose veins. Although they can be painful and disfiguring, they are usually harmless. When inflamed, they become tender to the touch and can hinder circulation to the point of causing swollen ankles, itchy skin, and aching in the affected limb.

Besides a surface network of veins, your legs have an interior, or deep, venous network. On rare occasions, an interior leg vein becomes varicose. Such deep varicose veins are usually not visible, but they can cause swelling or aching throughout the leg and may be sites where blood clots can form.

Varicose veins are a relatively common condition, and for many people they are a family trait. Women are at least twice as likely as men to develop them. In the U.S. alone, they affect about 23% of adult Americans.

What Causes Varicose Veins?

To help circulate oxygen-rich blood from the lungs to all parts of the body, your arteries have thick layers of muscle or elastic tissue. To push blood back to your heart, your veins rely mainly on surrounding muscles and a network of one-way valves. As blood flows through a vein, the cup-like valves open to allow blood through, then close to prevent backflow.

In varicose veins, the valves do not work properly, allowing blood to pool in the vein and making it difficult for the muscles to push the blood “uphill.” Instead of flowing from one valve to the next, the blood continues to pool in the vein, increasing venous pressure and the likelihood of congestion while causing the vein to bulge and twist. Because superficial veins have less muscle support than deep veins, they are more likely to become varicose.

Any condition that puts excessive pressure on the legs or abdomen can lead to varicose veins. The most common pressure inducers are pregnancy, obesity, and standing for long periods. Chronic constipation and — in rare cases, tumors — also can cause varicose veins. Being sedentary also may contribute to varicosity because muscles that are out of condition offer poor blood-pumping action.

The likelihood of varicosity also increases as veins weaken with age. A previous leg injury may damage the valves in a vein, which can result in a varicosity. Genetics also plays a role, so if other family members have varicose veins, there is a greater chance you will, too. Contrary to popular belief, sitting with crossed legs will not cause varicose veins, although it can aggravate an existing condition.

Can You Prevent Varicose Veins?

Even though your genetics play a part in your risk for varicose veins, there are things you can do to prevent them.

• Exercise regularly. Staying fit is the best way to keep your leg muscles toned, your blood flowing, and your weight under control.
• Maintain a healthy weight. If you are overweight or obese, lose weight. Weight control prevents excess pressure buildup on veins of the legs and feet.
• Avoid tight clothing. Tight clothes can constrict blood flow in the waste, groin, or legs.
• Avoid high heel shoes.  Wearing high heels for prolonged periods of time can hinder circulation. Flat or low-heel shoes are better for circulation, as they improve calf muscle tone.
• Move around. Avoid sitting or standing for prolonged periods of time to encourage blood flow. If your daily routine requires you to be on your feet constantly, consider wearing daily support hose. Stretch and exercise your legs as often as possible to increase circulation and reduce pressure buildup.
• Quit smoking. Studies show that smoking may contribute to the development of varicose veins.
• If you’re pregnant, sleep on your left side rather than your back.   This will minimize pressure from the uterus on the veins in your pelvic area. This position will also improve blood flow to the fetus. If you are prone to developing varicose veins, ask your doctor for a prescription for compression stockings.

Phlebitis (superficial thrombophlebitis) – NHS

Phlebitis means “inflammation of a vein”.

The vein becomes inflamed because there’s blood clotting inside it or the vein walls are damaged.

Superficial thrombophlebitis is the term for an inflamed vein near the surface of the skin (usually a varicose vein) caused by a blood clot.

Symptoms of phlebitis

Symptoms of superficial thrombophlebitis include:

• painful hard lumps underneath the skin
• redness of the skin

This is usually on the lower leg, although it can occasionally affect surface veins in the arms, penis or breast.

Is phlebitis serious?

Superficial thrombophlebitis in a leg is not usually serious.

The blood clot usually clears and the inflammation dies down within a few weeks.

Most people with superficial thrombophlebitis are otherwise well.

There should not be any foul discharge or abscess, and it’s normally just lumps under the skin rather than swelling of the whole calf.

This may be painful, but it should not prevent you walking normally.

At-risk groups

You’re more at risk of superficial thrombophlebitis if you:

• have varicose veins
• smoke
• are very overweight
• take the contraceptive pill or HRT (although these only slightly increase your risk of blood clots)
• are pregnant
• have had a previous blood clot or another problem with the vein
• have recently had injections or a drip put into the vein
• have a condition that causes the blood to clot more easily, such as thrombophilia, inflammation of the smaller arteries (polyarteritis) or a high concentration of red blood cells in your blood (polycythaemia)
• have cancer

Treatments for phlebitis

Phlebitis is inflammation, not infection, so antibiotics are not helpful.

You can follow this advice to help reduce any pain and swelling:

• raise the leg to help reduce swelling
• ask your doctor if compression stockings would be suitable for you to help reduce swelling
• keep active to keep the blood circulating
• press a cold flannel over the vein to ease any pain
• take painkillers or anti-inflammatory medicine like ibuprofen – but if you’ve been prescribed anticoagulant (blood-thinning) medicine, do not take aspirin or ibuprofen unless advised to by your doctor
• rub an anti-inflammatory cream or gel on the area if the affected area is only small

Outlook

When the inflammation settles, you may be left with darkened skin and the lump may take 3 or 4 months to go. But most people make a full recovery.

If the thrombophlebitis was in a varicose vein, it’s likely that the varicose veins will keep coming back, possibly with further episodes of thrombophlebitis. 

This is because there’s a basic problem with the vein and you may need this removed.

Find out more about how varicose veins are treated

Risk of deep vein thrombosis

There’s a small chance of the blood clot travelling along the vein to where it meets a deeper vein and a deep vein thrombosis (DVT) developing.

This is more likely if the surface clot extends into the upper thigh or groin, or behind the knee (in places where superficial veins meet deeper veins).

It’s also more likely to happen if:

• the affected vein is a normal vein rather than a varicose vein
• you have had a DVT before
• you’re immobile

A DVT can cause pain, swelling and a heavy ache in your leg. See a GP immediately if you experience these symptoms.

Find out more about DVTs

Page last reviewed: 01 May 2019
Next review due: 01 May 2022

What is phlebitis, and what’s the best treatment? : Vascular Solutions: Vein Specialists

VEINS CHARLOTTE BLOG

WHAT IS PHLEBITIS?

Phlebitis, or inflammation of a vein, is a condition where a leg vein and surrounding tissues have become irritated, red, warm, and tender. In an area of phlebitis, the skin can feel as if there are knots or lumps underneath the skin surface.

Phlebitis can occur in superficial veins (close to the skin surface) or deep veins (in the central portion of the leg). Phlebitis affecting the superficial veins is less concerning than phlebitis affecting the deep veins.

If phlebitis occurs in a superficial vein (ie. close to the skin) the overlying skin will commonly be warm and sensitive to light touch. A common pathway for developing phlebitis is when a clot develops in a varicose vein, just underneath the skin surface.

Symptoms of phlebitis are caused by inflammation, which represents the body’s response to injury or tissue damage.

Phlebitis can be triggered by excessive stretching of the leg veins. This situation is commonly encountered in people with varicose veins, where the veins have become abnormally engorged and dilated.

Another situation where phlebitis can occur is when a blood clot has developed in a vein. The presence of blood clot triggers an inflammatory response, which causes pain and tenderness.

When phlebitis occurs is in conjunction with superficial blood the medical term for this condition is “superficial venous thrombophlebitis,” commonly simply abbreviated as “thrombophlebitis”

When a blood clot occurs in a deep vein the term deep vein thrombosis (DVT) more accurately describes the condition and is the preferred terminology.

WHAT ARE THE SYMPTOMS OF PHLEBITIS?

When phlebitis affects superficial veins common symptoms include pain, tenderness, reddish skin discoloration, and warmth/heat arising from the skin. The most commonly affected area is the calf, but it’s also common for symptoms to occur just above the ankle or on the thigh.

Symptoms of phlebitis affecting the deep veins include aching pain, throbbing, leg heaviness, and leg swelling. Sometimes deep vein thrombosis can occur without significant pain. In this situation, leg/ankle swelling may be the only sign of a deep vein blood clot.

The severity of symptoms due to phlebitis is variable. Most often symptoms are mild-moderate, but sometimes the pain can be severe. Quite often symptoms start to build up over 24-48 hours. Most people who get phlebitis cannot recall a specific triggering injury or event.

RISK FACTORS

Risk factors for phlebitis include being sedentary for long periods (eg. long plane flight or car ride), obesity, smoking, estrogen-containing medications (including oral contraceptives and hormone replacement therapy), clotting disorders (which may predispose to easy clotting), and externally visible varicose veins. Other risk factors include trauma to a varicose vein (eg. if your leg bumps against the dishwasher), and cancer (which can increase the risk of developing blood clots).

WHAT ELSE COULD IT BE?

Several medical conditions mimic phlebitis. Probably the most common condition that mimics phlebitis is cellulitis, a bacterial infection of the skin. Several other dermatologic and auto-immune conditions can mimic phlebitis.

HOW IS PHLEBITIS DIAGNOSED?

The diagnosis of phlebitis is based on symptoms and examination findings, supplemented by diagnostic imaging. The most common imaging study used to support the diagnosis of phlebitis is venous ultrasound.

TREATMENT OPTIONS

The optimal treatment of phlebitis varies on several factors. If phlebitis is localized to a small section of a superficial vein then warm compresses, oral anti-inflammatory medications (eg. Motrin), topical anti-inflammatory creams (eg. Arnica), and leg elevation may be all that’s required.

If you have a superficial clot (superficial thrombophlebitis) that’s close to a connection with a deep vein, you may require blood thinners.

If a blood clot is identified in a deep vein (deep vein thrombosis – DVT) you’ll likely need to start on a blood-thinner, unless there’s a contraindication.

If you think you might have phlebitis, it’s important to seek medical attention. You’ll probably need a vein ultrasound to diagnose what’s going on.  Other management recommendations will be guided by the assessment of your medical provider.

OTHER CONSIDERATIONS

A high percentage of patients with superficial phlebitis have an associated condition known as venous reflux. This is a condition where the valves in the leg veins have ceased to function effectively. If venous reflux is present procedures can be performed to treat the underlying problem.

Commonly performed vein procedures include such as radiofrequency ablation (ClosureFast procedure), VenaSeal closure system, Varithena microfoam, Clarivein, and endovenous laser therapy (EVLT). These procedures seal closed the bad veins that creating the environment in which superficial phlebitis can occur. Vein procedures are usually performed in a staged fashion after the flare-up of superficial phlebitis has abated.

Vascular Solutions is the leading vein clinic for varicose veins treatment in Charlotte, NC. We use the latest technology and get the best results. Our vein specialists are the best in the Carolinas. If you believe you have phlebitis contact our office now to set up your new patient consultation.

VEINS CHARLOTTE BLOG – SOLUTION SOLVED

Author

Peter Ford MD FACS RPVI
Peter Ford, MD, FACS, RPVI, is a board certified vascular surgeon who works at Vascular Solutions in Charlotte, North Carolina. Dr. Ford specializes in the management of varicose veins and venous disease.

Phlebitis | Aurora Health Care

Pain and swelling in the leg can be concerning, and our experts are here to care for you quickly. From medication and compression socks to minimally invasive surgery, we’ll provide the treatment you need to be well again.

What is phlebitis?

Phlebitis, or thrombophlebitis, is an inflammation that causes a blood clot to form in a vein, usually in your leg. When it affects a vein close to your skin’s surface, it’s called superficial phlebitis. When it affects a deeper vein, it’s called deep vein thrombosis (DVT).

Superficial phlebitis usually develops after you’ve had a mild trauma to one of your veins, such as having an IV line. It typically subsides quickly and doesn’t cause any serious health problems.

In deep vein thrombosis, the blood clot in the deep vein can break loose and travel through your bloodstream to your lungs. This can cause a pulmonary embolism, a dangerous blockage that prevents blood from reaching your lungs.

Phlebitis symptoms 

 If you have either type of phlebitis, the most common signs are:

• Pain, swelling and tenderness of the skin, which, if on your leg, may get worse when you lower your leg
• Red, itchy skin that feels warm to the touch
• Low-grade fever if related to an infection 

Learn more about the signs of deep vein thrombosis (DVT).

Phlebitis diagnosis 

To diagnose phlebitis, we’ll begin with a thorough physical exam and ask about any symptoms you’re having. We may order diagnostic tests for you, too, such as blood tests or an ultrasound.

Find out more about our heart and vascular testing and diagnosis. 

Phlebitis treatment 

If you’re diagnosed with phlebitis, we’ll tailor a treatment plan to you. We may recommend:

• Medication such as antibiotics, anti-inflammatories or blood thinners
• Compression stockings
• Vein ligation and stripping for severe phlebitis, where we surgically tie off and remove the vein through a small incision

Superficial Thrombophlebitis: Background, Pathophysiology, Etiology

Author

Khanjan H Nagarsheth, MD, MBA Assistant Professor of Surgery, Department of Vascular Surgery, University of Maryland Medical System

Khanjan H Nagarsheth, MD, MBA is a member of the following medical societies: Academic Surgical Congress, American College of Surgeons, American Venous Forum, Association of Trauma and Military Surgery, Eastern Association for the Surgery of Trauma, Eastern Vascular Society, Knoxville Academy of Medicine, Society for Clinical Vascular Surgery, Society for Vascular Surgery, Society of American Gastrointestinal and Endoscopic Surgeons, Society of Critical Care Medicine, Southeastern Surgical Congress, Tennessee Medical Association, Vascular Society of New Jersey

Disclosure: Nothing to disclose.

Coauthor(s)

Adam J Rosh, MD Assistant Professor, Program Director, Emergency Medicine Residency, Department of Emergency Medicine, Detroit Receiving Hospital, Wayne State University School of Medicine

Adam J Rosh, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Vincent Lopez Rowe, MD Professor of Surgery, Program Director, Integrated Vascular Surgery Residency and Fellowship, Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Keck School of Medicine of the University of Southern California

Vincent Lopez Rowe, MD is a member of the following medical societies: American College of Surgeons, American Surgical Association, Pacific Coast Surgical Association, Society for Clinical Vascular Surgery, Society for Vascular Surgery, Western Vascular Society

Disclosure: Nothing to disclose.

Acknowledgements

David FM Brown, MD Associate Professor, Division of Emergency Medicine, Harvard Medical School; Vice Chair, Department of Emergency Medicine, Massachusetts General Hospital

David FM Brown, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Ryan Doss, MD Resident Physician, Department of Emergency Medicine, Detroit Medical Center, Wayne State University School of Medicine

Ryan Doss, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Emergency Medicine Residents Association, Michigan College of Emergency Physicians, and Michigan State Medical Society

webmd.com”>Disclosure: Nothing to disclose.

Craig F Feied, MD, FACEP, FAAEM, FACPh, Professor of Emergency Medicine, Georgetown University School of Medicine; General Manager, Microsoft Enterprise Health Solutions Group

Craig F Feied, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Phlebology, American College of Physicians, American Medical Association, American Medical Informatics Association, American Venous Forum, Medical Society of the District of Columbia, Society for Academic Emergency Medicine, and Undersea and Hyperbaric Medical Society

Disclosure: Nothing to disclose.

Jonathan A Handler, MD, HSG Chief Deployment Architect, Microsoft Corporation, Adjunct Associate Professor, Department of Emergency Medicine, Northwestern University, Feinberg School of Medine

webmd.com”>Jonathan A Handler, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Jeffrey Lawrence Kaufman, MD Associate Professor, Department of Surgery, Division of Vascular Surgery, Tufts University School of Medicine

Jeffrey Lawrence Kaufman, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Society for Artificial Internal Organs, Association for Academic Surgery, Association for Surgical Education, Massachusetts Medical Society, Phi Beta Kappa, and Society for Vascular Surgery

Disclosure: Nothing to disclose.

webmd.com”>Samuel M Keim, MD Associate Professor, Department of Emergency Medicine, University of Arizona College of Medicine

Samuel M Keim, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Public Health Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Robert G Klever Jr, MD Resident Physician, Department of Emergency Medicine, Detroit Receiving Hospital, Wayne State University School of Medicine

Robert G Klever Jr, MD is a member of the following medical societies: American College of Emergency Physicians, Emergency Medicine Residents Association, and Society for Academic Emergency Medicine

webmd.com”>Disclosure: Nothing to disclose.

Eddy S Lang, MDCM, CCFP(EM), CSPQ Associate Professor, Senior Researcher, Division of Emergency Medicine, Department of Family Medicine, University of Calgary Faculty of Medicine; Assistant Professor, Department of Family Medicine, McGill University Faculty of Medicine, Canada

Eddy S Lang, MDCM, CCFP(EM), CSPQ is a member of the following medical societies: American College of Emergency Physicians, Canadian Association of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose

William A Marston, MD, Associate Professor, Department of Surgery, Division of Vascular Surgery, University of North Carolina School of Medicine

William A. Marston, MD is a member of the following medical societies: American College of Surgeons, American Venous Forum, North Carolina Medical Society, Peripheral Vascular Surgery Society, and Southern Association for Vascular Surgery

webmd.com”>Disclosure: Nothing to disclose.

Nelson S Menezes, MD, FRCS(Edin), FACS Assistant Professor of Surgery, Weill Cornell Medical College; Chief of Vascular Surgery, Department of Surgery, Brooklyn Hospital Center

Nelson S Menezes, MD, FRCS(Edin), FACS is a member of the following medical societies: American College of Surgeons, International Society of Endovascular Specialists, Medical Society of the State of New York, and Society for Vascular Surgery

Disclosure: Nothing to disclose.

Travis J Phifer, MD Chief, Division of Vascular Surgery, Professor, Department of Surgery and Radiology, Louisiana State University Health Sciences Center in Shreveport

Travis J Phifer, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Surgeons, American Medical Association, Association for Academic Surgery, Society for Academic Emergency Medicine, Society for Vascular Surgery, and Society of Critical Care Medicine

webmd.com”>Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

90,000 phlebitis treatment in Kaliningrad – Nadezhda medical center

Phlebitis treatment

Phlebitis is a disease in which there is inflammation of the veins in the legs. This inflammation is chronic and affects the venous wall. The reasons for the development of this disease can be varied, but the most common cause of phlebitis is a complication of varicose veins of the legs. Despite the rather harmless explanation of the term, phlebitis is terrible in its consequences: it leads to the onset of blood clots and can cause thrombophlebitis.Modern methods of ultrasound examination, duplex scanning allow to identify phlebitis in time. Phlebitis, which is treated conservatively, requires prompt preventive action as soon as it is detected.

Inflammation of the veins

As mentioned above, the main cause of phlebitis is the consequences of varicose veins on the legs. But it is also not uncommon for phlebitis to provoke a complicated abscess. An infected wound and an infectious disease can also trigger the development of this unpleasant disease.The viral pathogen is often a fairly commonplace infection – streptococcus. In addition, the likelihood of developing inflammation after a chemical burn in the vein zone is not excluded.

It is also worth remembering that phlebitis is sometimes induced artificially in order to treat diseased veins. If there is neglected varicose veins, there is a practice of introducing a substance that causes aseptic phlebitis. This type of phlebitis provokes gluing of damaged vein walls.

Phlebitis of vein

Phlebitis is characterized by a comparative variety of symptoms. So, acute superficial phlebitis can be seen in a vein, which sharply becomes painful and obviously irritated. The skin that covers the affected vein acquires a red, painful tint and becomes denser. Also not excluded:

• hyperemia;
• formation of red streaks along the inflamed veins;

90,017 temperature rise;

• general physical weakness.

Chronic phlebitis has similar symptoms, but they appear extremely irregularly, only during an exacerbation.Acute phlebitis of deep veins can manifest itself through pain, swelling in the area of ​​inflammation, and also hyperemia. In this type of disease, you will not be able to observe redness, but you will face the opposite option: the skin over the affected vein becomes milky white. It is the type of deep vein phlebitis that is fraught with the development of blood clots and the transition to acute thrombophlebitis.

The main type of treatment is conservative therapy. In some cases, phlebitis of superficial veins can be overcome on an outpatient basis. Phlebitis of other localizations often means hospitalization.

90,000 causes, symptoms and treatment in the article of the vascular surgeon I. N. Illarionov

Date of publication December 10, 2019 Updated April 26, 2021

Definition of the disease. Causes of the disease

Phlebitis is an inflammation of the venous vessel wall, often occurring against the background of varicose veins and accompanied by the formation of thrombosis. This condition is called “superficial vein thrombophlebitis” or “varicothrombophlebitis”.Phlebitis is also a common complication of peripheral intravenous therapy, which is carried out through a venous cannula (catheter) – taking venous blood and intravenous infusion ^[1] .

Various studies have identified many risk factors for the development of phlebitis. They can be divided into several groups: causes of phlebitis related to patients, cannula, prescribed therapy, and other factors ^{[1] [2]} .

The most common risk factors associated with a patient are age, gender, and comorbid conditions.The incidence of phlebitis increases with age: most studies have shown that overt signs of phlebitis were present in about 50% of patients over 60 years old ^[3] . It was also found that phlebitis most often occurs among women, but there is still no satisfactory explanation for this statistic ^{[4] [5]} . In addition, conditions that impair circulation (peripheral vascular disease, smoking), sensitivities (peripheral neuropathy) and diabetes mellitus ^[3] increase the risk of phlebitis.

The reasons related to the intravenous cannula include the physicochemical properties of the material and its size ^[6] . Most often, the development of phlebitis is influenced by cannulas made from Teflon derivatives, for example, fluoroethylenepropylene copolymer.

Other risk factors for the development of phlebitis are associated with the tolerance of the injected solutions. It depends on the pH of the drug, its osmolarity (concentration of kinetically active particles) and the rate of injection into the vein. The likelihood of phlebitis is significantly increased if the pH and osmolarity of solutions differ from those of the patient’s blood ^[7] .Also, the risk of developing phlebitis increases the use of antibacterial drugs, mainly from the group of beta-lactams, due to their high activity ^[8] .

If you find similar symptoms, consult your doctor. Do not self-medicate – it is dangerous for your health!

Symptoms of phlebitis

At the site of the lesion, you can feel a painful, compacted, tense section of the inflamed vein. The pain is of a different nature and occurs along the course of the vein immediately with the development of phlebitis.The skin in the area of ​​inflammation becomes hyperemic (reddened), the temperature of the affected area rises.

In rare cases, with the development of phlebitis of the upper limb, numbness occurs. Swelling of the hand is usually not observed. Sometimes this process is accompanied by a general deterioration in well-being, the development of weakness, malaise.

With phlebitis of the dorsal vein of the penis, redness, induration, swelling and sharp pain along the course of the vein are also observed. The penis becomes bluish in color.

With phlebitis of the veins of the brain, a constant headache occurs, blood pressure rises, neurological symptoms appear – visual impairment.

Inflammation of the portal vein is characterized by severe purulent intoxication. The patient’s condition worsens, weakness, vomiting, headache, cutting pains in the right hypochondrium, jaundice, fever are possible. There is a danger of death.

Pathogenesis of phlebitis

The outer cell layer of the vein is called adventitia .It is an elastic membrane that contains a large number of collagen fibers that form the skeleton of the vein, and a number of muscle fibers located along its bed. In the middle – muscle – vein sheath has the largest number of smooth muscle fibers. They are located spirally around the lumen of the vessel and enclosed in a network of coiled collagen fibers. With a strong stretching of the vein, collagen fibers are straightened, and its lumen increases. The inner cell layer is called intima .It consists of endothelial cells as well as smooth muscle and collagen fibers.

The inflammatory process in phlebitis can begin both in the outer and inner layers of the vein. The mechanism of development of pathology can be associated with one of the reasons:

• external trauma;
• internal direct endothelial trauma;
• inflammation of the vein wall;
• primary blood clotting disorder.

External trauma can result from direct external impact due to blunt trauma or external dressings ^[8] .The vein is compressed, the width of its lumen is disturbed. As a result, blood flow slows down, which leads to the development of thrombosis and phlebothrombosis, and local long-term exposure provokes the appearance of local phlebitis. A decrease in the speed of blood flow and venous stasis is also observed with visible varicose veins and local external damage – trophic ulcers.

Inner wall damage includes direct disruption of adventitia cells. It activates the same inflammatory response as external trauma, with similar consequences.The injury is often associated with routine intravenous procedures, including phlebotomy (dissection of a vein) and intravenous fluids through a catheter (action of solutions, injury to veins from needles).

The timing of the placement of the catheter in the vein is related to the rate at which inflammation appears. The longer he is there, the higher the risk and rate of development of phlebitis, as well as the likelihood of a bacterial infection, during which purulent superficial venous thrombosis may occur.

In addition, the infusion of hypertonic solutions can directly damage the endothelium.This is usually the case for diazepam and pentobarbital. They can cause chemical inflammation that disrupts the normal functioning of the vein and leads to blood clots around the catheter tip, secondary infection and sepsis. Also, infusion of fluids in the area with slower venous return is more likely to lead to thrombosis of superficial veins.

Classification and stages of development of phlebitis

Depending on the cause, phlebitis is divided into large groups:

1. Phlebitis, which has arisen against the background of varicose veins.
2. Phlebitis not associated with varicose veins – most likely caused by genetic disorders of blood coagulation:
3. Post-injection phlebitis – develops as a result of chemical irritation of the vein by the injected solution or mechanical trauma. Most often it is accompanied by the appearance of pain along the vein and at the site of the catheter, as well as the presence of redness.
4. Allergic phlebitis – develops due to a vein’s reaction to an allergen (drug, catheter material).The symptoms are similar to post-injection phlebitis.

According to the location of the inflamed vein , the following types of phlebitis are distinguished:

• Phlebitis of the penis is associated with varicose veins or an infectious disease (for example, gonorrhea). Causes redness and swelling of the skin, the formation of a volumetric painful induration on the dorsum of the penis .
• Portal vein phlebitis (or pylephlebitis) is associated with a complicated course of inflammatory processes in the abdominal cavity (cirrhosis of the liver, pancreatitis, Budd-Chiari syndrome, etc.). Differs in signs of purulent intoxication. Can lead to death.
• Cerebral phlebitis – develops in the veins of the brain against the background of infection or purulent inflammation (abscess or phlegmon). It manifests itself as a constant headache, increased blood pressure, visual impairment.
• Phlebitis of the veins of the upper extremities – in the area of ​​the lesion on the arm, pain appears, redness of the skin, a cord-like thickening of the vein is observed.
• Phlebitis in the basin of the small saphenous vein – accompanied by muscle tension, pain and redness of the skin, fever and the appearance of stripes along the inflamed vein .
• Phlebitis in the basin of the great saphenous vein is similar in manifestations to phlebitis of the lesser saphenous vein.
• Migratory phlebitis – develops in the veins of the legs, is characterized by a long recurrent course, more common in young men. It can also affect the walls of the arteries. When migratory thrombophlebitis is associated with cancer, it can occur years before diagnosis. It is manifested by the appearance of redness, induration, and tightness along the vein in various parts of the body.

Phlebitis can also be classified by pathophysiology :

• Primary phlebitis is a direct inflammation in the veins.
• Secondary phlebitis is a systemic inflammatory process. This group includes septic thrombophlebitis – an inflammation of a vein that occurs in conditions of infection.

According to the site of localization of inflammation in the vein , three forms of the disease are distinguished:

• endophlebitis – inflammation of the inner lining of the vein;
• periphlebitis – inflammation of the outer membrane of the vein;
• Panphlebitis – inflammation of all vein membranes ^[13] .

Complications of phlebitis

The main complication of phlebitis is venous thrombosis – the formation of a blood clot in the lumen of a vein.The incidence of this disease at the age of 40 and earlier is about one case in 10,000 people per year; after 45 years, the incidence increases and by the age of 80 it reaches 5-6 cases per 1000 people per year ^[22] . The reasons for the increased risk of thrombosis with age are not entirely clear, but may be associated with the presence of diseases of the cardiovascular system, liver and other organs that increase coagulation (blood clotting).

The incidence of venous thrombosis is slightly higher in men than in women.About two-thirds of the episodes manifest as deep vein thrombosis. The main outcomes of venous thrombosis are reoccurrence of blood clots, post-thrombotic syndrome, severe bleeding due to thinning drugs, and death.

Thrombosis leads to a deterioration in the quality of life, especially with the development of post-thrombotic syndrome, which is accompanied by chronic edema of the limb, discoloration of the lower leg skin, trophic disorders ^{[18] [19]} . Death occurs within one month after an episode in about 6% of patients with deep vein thrombosis and in 10% of patients with embolism – blood clots entering the vital organs ^[20] .In 30% of cases, a person dies from thromboembolism before the diagnosis is made ^[21] . Mortality rates are lower among patients with venous thrombosis that occurs without an obvious cause and are highest among those who develop thrombosis in the setting of existing oncology.

Phlebitis can also contribute to the development of infectious complications such as abscess and phlegmon. Both conditions can be fatal.

In the center of the superficial abscess , the skin becomes thinner, sometimes appears white or yellow due to “ripe” pus inside, ready to spontaneously break through.With 90,037 deep abscesses , local pain, fever, weight loss, fatigue are typical.

Phlegmon is a painful swelling with diffuse redness of the skin. It develops rapidly, accompanied by a high temperature (40 ° C and more), disruption of the affected part of the body. When it spreads to the surrounding tissues, phlegmon can provoke the development of purulent arthritis, tendovaginitis and other purulent diseases.

Phlebitis diagnostics

Local phlebitis can be found directly in the area of ​​an indwelling venous catheter or when questioning the patient when it turns out that this area was injured or the drug ^[4] was injected into it.

Patients with suspected superficial venous thrombosis and phlebitis should have duplex ultrasound scan . If you suspect phlebitis of the penis, you need to undergo an ultrasound of vessels of the penis and scrotum.

Also, all patients need to assess the likelihood of developing pulmonary embolism and deep vein thrombosis. For this, the Wells scales and the Geneva classification are used. They take into account age, previous illness and surgery.With a high score, it is required to perform a computed tomography of the lungs to exclude pulmonary embolism.

Patients with catheter-associated peripheral venous thrombosis of the upper extremities, or minor phlebitis caused by direct trauma, may not require duplex ultrasound scanning due to the presence of subcutaneous inflammation and the possibility of making a diagnosis clinically, i.e. for signs of the disease. The extent of superficial thrombosis with assessment of deep vein thrombosis should be documented.

Some patients require laboratory tests to detect hypercoagulability – changes in blood clotting – or to confirm cancer, especially when superficial venous thrombosis is not associated with a catheter or varicose veins. Hypercoagulation is detected using a coagulogram , sometimes a hemostasiogram. If deviations from the norm in the direction of increase or decrease are detected, , consultation with a hematologist is required to jointly determine the tactics of further diagnostics.This score is influenced by signs of the disease, risk factors, and family history of the disease. In some cases, it may include simple screening for hereditary thrombophilia or more extensive cancer or vasculitis screening (as recommended by a rheumatologist) ^{[15] [22]} .

Treatment of phlebitis

Most patients with phlebitis are treated symptomatically with anti-inflammatory drugs and compression. It is aimed at reducing pain and inflammation, preventing complications and relapses.Treatment depends on the site of inflammation, the presence of concomitant acute deep vein thrombosis and varicose veins.

Duplex ultrasound scanning of the limb is important at an early stage of treatment, especially for phlebitis associated with local varicose veins, an intravenous catheter or other device. If the study confirms the presence of varicose veins and reflux (reverse blood flow), then these patients can initially be treated without surgery ^[12] .With the progression of the disease into the deep venous system, a decision is made on surgical treatment or anticoagulant therapy.

For the treatment of patients with spontaneous thrombosis of superficial veins, prophylactic or intermediate doses of low molecular weight heparin or intermediate doses of unfractionated heparin are used. They must be applied for at least four weeks.

Surgical removal of the vein is performed for recurrent cases of superficial venous thrombosis ^[22] .The vein must be removed if phlebitis occurs at least a second time.

After treatment, patients are advised to use compression hosiery. The period of wearing is determined by the attending physician

Forecast. Prevention

With a timely visit to a vascular surgeon, the prognosis of phlebitis is relatively favorable, especially with phlebitis of the upper extremities – it passes almost without a trace. Hirudotherapy (treatment with leeches) can lead to a sharp progression of the disease due to trauma to the vascular wall.

If the inflammation has spread to the deep vein system, treatment takes longer. Subsequently, post-thrombotic disease develops. In 5-10% of cases, it leads to disability, a decrease in the quality of life and the preservation of permanent limb edema.

The main way to prevent is to observe physical activity, especially when traveling. Sitting on a long flight or car trip can lead to swelling of the ankles, calves and increase the risk of thrombophlebitis.To prevent thickening of the blood in these cases, it is worth taking a walk down the aisle once an hour. For a long drive, you need to stop every hour and drive for 10-15 minutes. It is worth performing venous gymnastics: bending the ankles or raising and lowering the shins on the socks at least 10 times an hour.

You should try to wear loose clothing that does not tighten your shins, drink plenty of fluids to avoid dehydration. When taking hormonal contraceptives, you should undergo a triplex ultrasound scan once a year and be observed by a gynecologist ^{[11] [20]} .

If there are one or more risk factors, it is necessary to discuss a prevention strategy with your doctor before long flights, travel or planned surgery, after which you will have to stay in bed.

Venous inflammation

What is venous inflammation?

When a vein is inflamed (phlebitis), the vein wall becomes inflamed.Veins in the leg area (thighs, legs, feet, ankles) are usually affected. If acute inflammation develops in a previously healthy vein, it is commonly referred to as thrombophlebitis. Varicophlebitis (inflammation of the veins with varicose veins) is more common. Inflammation of the veins should be treated by a doctor. The treatment lasts from several days to several weeks. If left untreated, inflammation of the veins can lead to thrombosis.

Causes of phlebitis

Slowing blood flow is the most common cause of phlebitis, especially with a weakened venous wall prone to varicose veins.Phlebitis can also develop if a vein is squeezed for a long time by tight clothing or, for example, is squeezed by the edge of a chair. Another common cause is venous catheters, which are placed in a vein for several days to administer infusions or medications. Phlebitis can also be caused by mechanical damage to the venous wall or the penetration of bacteria after surgery and with prolonged bed rest.

Another common cause of venous inflammation is damage to the vessel wall.Such damage can be caused by:

• Infusion, for example, during or after surgery,
• blood sampling,
• venous access (catheter) or
• insect bite

Ingestion of bacteria can cause inflammation of infectious phlebitis. Blood composition also plays an important role in the development of phlebitis. Blood clotting can increase due to diseases or a lack of fluid in the body. This can lead to the development of blood clots.

Recognition of phlebitis: symptoms and signs

Vein inflammation is usually local and very painful.Typical symptoms include:

• Pain
• Swelling
• Hyperemia
• Feeling of pressure
• Feeling of heat
• Clotting of veins.

Prevention of phlebitis

You can independently prevent the development of phlebitis and other venous diseases, minimizing the risk factors described below. Tips:

• Basic Treatment: Use medical compression hosiery daily if you have a predisposition to varicose veins.
• Exercise: Avoid prolonged standing and sitting, and do vein support exercises to activate the muscle-venous pump.
• Sports: Sports such as swimming, hiking and brisk walking support your veins.
• Drink plenty of water: Lack of fluid thickens the blood and increases the risk of blood clots.
• See a doctor: Varicose veins need to be treated.
• Risk Factor: Take care of your health: quit smoking, because smoking changes the walls of blood vessels.

Treatment of phlebitis

Treatment of venous inflammation depends on its type and severity. The doctor first checks to see if the deep veins are affected.

Many patients with thrombophlebitis find that cooling the inflamed area relieves pain. There are different treatments depending on the location and size of the blood clot. Treatment with anticoagulants to dissolve the thrombus is possible.The clot can also be surgically removed. In some cases, symptomatic treatment is sufficient.

Main treatment: Use of medical compression hosiery for phlebitis

The main treatment involves the use of properly selected medical compression hosiery. It is especially effective when combined with exercise: compression hosiery stockings and activation of the muscle-venous pump ensure that the diameter of the veins is reduced. This means that blood moves faster towards the heart and does not accumulate in the vessels of the legs.Symptoms such as pain, swelling and pressure are significantly reduced, resulting in an improved quality of life.

What happens if phlebitis is left untreated?

Easily diagnosed superficial phlebitis is well treated and often regresses within a few days without any complications. If phlebitis is not treated, then it can progress and cause long-term pain syndrome lasting up to several weeks. The situation becomes especially dangerous if the vein affected by phlebioma is connected to the deep venous system.If, in this case, treatment is not timely started, deep vein thrombosis may develop with a high risk of pulmonary embolism.

Which doctor treats phlebitis?

If you develop phlebitis, you should immediately see a doctor (phlebologist, vascular surgeon, dermatologist).

Compression hosiery medi

Thanks to the breathable and elastic material, the compression hosiery provides high wearing comfort.Modern medical compression hosiery is visually indistinguishable from model hosiery, but provides high medical efficiency in use.

Here you can find more information about the medi compression hosiery.

Human body

How do veins work?

Veins

90,000 Phlebitis, thrombophlebitis (inflammation of the veins) – symptoms and treatment in adults.MC “Health” in Moscow, Southern Administrative District (Warsaw and Annino), Central Administrative District (Krasnopresnenskaya and Rizhskaya).

Phlebitis (thrombophlebitis) is an inflammation of the veins characterized by swelling, edema, and redness of the skin over the vein. It can be caused by allergies, infections, and postpartum changes.

Why can phlebitis occur?

Phlebitis is an inflammation of the walls of blood vessels as a result of exposure to irritants or microflora.

This pathology is very common in the modern world, both among women and men, and is quite dangerous: without treatment, phlebitis easily progresses to thrombophlebitis. With the further course of the disease, the risk of developing formidable complications, such as sepsis and embolism, is very high.

The reasons for the occurrence can be :

• Various injuries
• Excess weight
• Pregnancy
• Constant patient overvoltage
• Certain insect bites
• Prolonged immobility due to various factors

The signs and symptoms of phlebitis often depend on the location.Acute attacks are often accompanied by the most typical signs of inflammation, visible to a specialist upon examination – redness, swelling, fever – both local and general.

Chronic phlebitis often has a latent course, especially if it runs in deep veins, to the extent that patients take pain for fatigue or fatigue.

How to recognize phlebitis?

If you begin to suffer from severe pain in your legs, your body temperature has increased, lymph nodes have enlarged, and when you feel the limb, you can reveal a swollen, hardened vein that painfully reacts to touch, or when lowering your leg, the pain increases significantly, then do not delay a minute.No self-medication, only the help of a qualified specialist! Immediately contact one of the clinics of the “Health” network.

Our doctors will conduct a duplex scan or ultrasound scan of the veins of the area of ​​concern, make an accurate diagnosis and prescribe all the necessary treatment.

>
90,000 Phlebitis and thrombophlebitis of superficial vessels

Bitsadze V.O., Bredikhin R.A., Bulatov V.L., Golovina V.I., Jenina O.V., Zolotukhin I.A., Ilyukhin E.A., Kalinin R.E., Katorkin S.E., Kirienko A.I., Krylov A.Yu., Lobastov K.V., Makatsaria A.D., Mzhavanadze N.D., Porembskaya O. Ya., Pryadko S.I., Seliverstov E.I., Son’kin I.N., Soroka V.V., Stoyko Yu.M., Suchkov I.N.A., Schastlivtsev I.V., Cherkashin M.A. Phlebitis and thrombophlebitis of superficial vessels.
Phlebology.
2021; 15 (3): 211-244.
Bitsadze VO, Bredikhin RA, Bulatov VL, Golovina VI, Dzhenina OV, Zolotukhin IA, Ilyukhin EA, Kalinin RE, Katorkin SE, Kirienko AI, Krylov AYu, Lobastov KV, Makatsaria AD, Mzhavanadze ND, Porembskaya O EI, Sonkin IN, Soroka VV, Stoyko YuM, Seliverstov DV, Schastlivtsev IV, Cherkashin MA. Superficial phlebitis and thrombophlebitis. Flebologiya. 2021; 15 (3): 211-244.

https: // doi.org / 10.17116 / flebo202115031211

90,000 Phlebitis – signs, causes, symptoms, treatment and prevention

Diagnostics

To make a correct diagnosis, as well as to detect blood clots or embolisms, a diagnostic measure such as Doppler ultrasound (ultrasound duplex scanning) is commonly used.

Qualified full-time consultation with a phlebologist often allows you to accurately determine phlebitis.

Treatment

Uncomplicated phlebitis can be successfully treated with conservative therapy. Prescribed tablets that have a complex therapeutic effect on the arteriovenous system: micronized fractions of diosmin, cardio aspirin, acetylsalicylic acid. Against the background of their intake, the rheological properties of blood (viscosity, fluidity) improve, the tendency to thrombosis decreases, and the tone of the venous wall increases.

Topically used venotonic creams and gels containing heparin, diosmin, troxerutin, escin.They effectively eliminate inflammation, swelling and pain, improve venous outflow and microcirculation.

Physiotherapeutic methods give good results: laser therapy, phonophoresis and electrophoresis with drugs. Many patients are helped by hirudotherapy: applying medicinal leeches to sore spots.

Thrombophlebitis in most cases is treated promptly. Thrombectomy is performed: surgical removal of a formed blood clot in order to restore normal blood flow.In difficult situations, when thrombus formation has occurred in a varicose vessel, it is also removed. This radical decision is made by the surgeon to avoid further thrombosis.

There are modern medications in the form of solutions for injection, which directly contribute to the resorption of formed blood clots and actively prevent the emergence of new ones. These include sulodexide, a substance derived from the lining of the porcine intestine.

Prevention

It is necessary to give your legs good rest.With pronounced edema and heaviness in the limbs, unloading positions are useful. These include placing your feet high above your heart and getting on all fours.

Persons with cardiovascular pathology are recommended to undergo angioprotective courses twice a year. In order to timely detect varicose veins in the early stages, you should make an appointment with a phlebologist in the presence of any alarming manifestations with suspicion of this diagnosis.

Literature and sources

Related Videos:

90,000 Medicines for the treatment of Phlebitis and thrombophlebitis

Actavis [Actavis]

Berlin-Chemie / A.Menarini [Berlin-Chemi / A. Menarini]

Bosnalijek [Bosnalijek]

Dompe [Dompe]

Hemofarm [Hemofarm]

Istituto De Angeli [Institut de Angeli]

Laboratoires Chemineau

Lannacher Heilmittel [Lannacher Heilmittel]

Madaus [Madaus]

Medena [Medena]

Pfizer [Pfizer]

Sopharma [Sopharma]

Stada Arzneimittel AG [Stada Arzneimittel]

Zentiva / Zentiva

Akrikhin

Balkanfarma

Belmedpreparaty

Biocom

Borisov plant of medical preparations

Velpharm OOO

Vertex

VetProm AD

Grotex OOO

Health – pharmaceutical company

Green Dubrava

Lecco

Lizafarma S.p.A.

Minskintercaps

Moscow endocrine plant

Samson-Med

Tatkhimpharmaceuticals

Tula pharmaceutical factory

Usolye-Sibirskiy

FarmVilar

Pharmstandard-Leksredstva

.