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Thrombophlebitis refers to the development of blood clots within one or more veins, often found in the legs. Superficial thrombophlebitis affects veins near the skin’s surface, while Deep Vein Thrombosis (DVT) occurs in deeper veins within the muscles, posing significant health risks. Treatment typically involves blood-thinning medications to manage both types of thrombophlebitis effectively.
Blood clot in leg vein
A blood clot in a leg vein can result in pain, warmth, and tenderness in the affected region. Thrombophlebitis can be triggered by factors such as trauma, surgery, or extended periods of inactivity.
DVT elevates the risk of severe health complications and is typically managed with blood-thinning medications. Similarly, superficial thrombophlebitis may also be addressed with blood-thinning medications in some cases.
Symptoms
Symptoms of superficial thrombophlebitis encompass warmth, tenderness, and pain. Additionally, redness and swelling may occur, along with the presence of a tender, red, firm cord just beneath the skin’s surface. Symptoms of deep vein thrombosis involve swelling, tenderness, and pain in the leg.
For superficial DVT, symptoms are:
- Tenderness, warmth, and soreness in the affected region
- Swelling and redness
Signs and symptoms of DVT encompass:
- Pain
- Swelling
When a superficial vein near the skin’s surface is involved, you may observe a tender, red, firm cord just beneath the skin’s surface. Conversely, if a deep vein in the leg is affected, the leg can swell, become tender, and experience pain.
Seek immediate medical attention from your doctor if you notice a red, swollen, or tender vein, particularly if you have any risk factors for thrombophlebitis.
Call your emergency contact number or your local emergency number if:
- You also experience chest pain, shortness of breath, blood in your cough, and other symptoms that could point to a blood clot in your lungs (pulmonary embolism).
- The vein swelling and pain are quite severe.
If at all feasible, have someone drive you to the emergency room or doctor. You may find it difficult to drive, so having someone with you to assist you recall the information you are given is beneficial.
Causes
Thrombophlebitis arises from blood clot formation, triggered by factors like vein injury, inherited clotting disorders, or extended periods of immobility such as hospitalization or post-injury recovery. Various factors contribute to the onset of thrombophlebitis, including:
- Vein damage
- Hereditary blood-clotting problem
- Extended periods of immobility, as following an injury or hospital stay
Risk factors
Increased risk of thrombophlebitis can occur with prolonged periods of inactivity or the placement of a catheter into a central vein for medical purposes. Conditions like varicose veins or having a pacemaker can also elevate risk. Women who are pregnant, have recently given birth, or use certain medications like birth control pills or hormone replacement therapy may face heightened risk. Other contributing factors include a family history of clotting disorders, a tendency towards clot formation, previous instances of thrombophlebitis, history of stroke, age over 60, or being overweight. Cancer and smoking further increase the risk.
If you have any of these risk factors, it’s essential to discuss preventive measures with your doctor before long flights or road trips, or before undergoing elective surgery requiring immobility during recovery.
Diagnosis
To diagnose thrombophlebitis, your doctor will inquire about your symptoms and examine veins near the surface of your skin. They may also recommend an imaging test, such as an ultrasound, to assess for superficial or deep vein thrombosis in your leg. Additionally, a blood test can detect elevated levels of clot-dissolving substances, helping to rule out deep vein thrombosis and assess your risk of recurrent thrombophlebitis. Your doctor may choose one of the following tests to confirm the diagnosis:
- Ultrasound. A transducer, resembling a wand, is passed over the affected area of your leg, emitting sound waves into the leg tissue. These waves bounce back and are converted by a computer into a dynamic image displayed on a video screen. This ultrasound test confirms the diagnosis and distinguishes between superficial and deep vein thrombosis.
- Blood test. The majority of individuals with a blood clot exhibit elevated levels of D dimer, a naturally occurring substance that dissolves clots. However, elevated D dimer levels can also occur in other medical conditions. Therefore, while a D dimer test is not definitive, it can suggest the necessity for additional testing.
Additionally, it serves to exclude the presence of DVT and to identify individuals prone to recurrent thrombophlebitis.
Treatment
Superficial thrombophlebitis management often involves applying heat, elevating the affected leg, taking medications to alleviate swelling and discomfort, and wearing compression stockings. This condition typically resolves on its own.
For both superficial thrombophlebitis and DVT, blood-thinning medications may be prescribed to dissolve clots. Prescription compression stockings can aid in preventing swelling and complications associated with DVT. If blood thinners are unsuitable, a filter can be inserted into the main abdominal vein to prevent clots from reaching the lungs. Surgical removal of varicose veins may be recommended in some cases.
Compression stockings
Support stockings, another name for compression pantyhose, apply pressure on the legs to increase blood flow. Putting on the stockings could be assisted by a stocking butler.
The following therapies may also be suggested by your doctor for either kind of thrombophlebitis:
- Blood-thinning medications. An injection of a blood-thinning (anticoagulant) drug, such as fondaparinux, apixaban, or low molecular weight heparin, can help stop clots from getting larger if you have deep vein thrombosis. You will probably be instructed to take rivaroxaban or warfarin for several months after the initial therapy to continue stopping the formation of clots. Anticoagulants may result in severe bleeding. Always pay close attention to what your doctor tells you.
- Clot-dissolving medications. Thrombolysis is the term for the drug-assisted clot-dissolving treatment. Those with significant DVT, particularly those with pulmonary emboli (blood clots in the lungs), can take the medicine alteplase to dissolve the clots.
- Compression stockings. Compression stockings with prescription strength help stop swelling and lower the risk of DVT consequences.
- Vena cava filter. If you are unable to take blood thinners, your abdomen’s major vein (the vena cava) may need to have a filter placed in it to stop blood clots that break loose in leg veins from getting into your lungs. When the filter is no longer required, it is usually removed.
- Varicose vein stripping. Varicose veins that hurt or return frequently can be surgically removed. A lengthy vein is cut out during the treatment using tiny incisions. Blood flow in your leg won’t be impacted by vein removal because larger blood volumes are handled by veins further down your leg.
