Thrombophlebitis is a blood clot (thrombus) inside an inflamed vein. It mainly affects the body's superficial veins -- those that are seen easily near the surface of the skin, especially in the legs. Thrombophlebitis is very common in people who have varicose veins. However, it also can occur in people with medical conditions that lead to sluggish blood flow in the legs, especially pregnant women and people who are immobilized because of stroke or cancer. People who receive injections or medications intravenously (into a vein) also are more likely to get thrombophlebitis because their veins can become irritated by the tubes used or by the medication itself. Intravenous drug users are at high risk of a very serious type of thrombophlebitis that can develop into a vein infection.
Thrombophlebitis in a superficial leg vein is not the same as deep vein thrombosis. Deep vein thrombosis is a serious condition that is not treated with simple local therapy. It requires administration of anti-clotting drugs, usually heparin and warfarin (Coumadin).
Thrombophlebitis causes pain in the area of the clotted vein, together with redness and sometimes swelling in the surrounding skin.
Your doctor looks for redness, warmth, swelling and tenderness in the affected vein and in the surrounding skin. The clotted and inflamed vein also can be very firm and can feel like a hard line or string under the skin.
Your doctor usually can diagnose thrombophlebitis with a simple physical examination. In people with many episodes of thrombophlebitis, or with thrombophlebitis involving more than one vein, further tests may be necessary to check for problems with blood flow in the veins.
With treatment, most episodes of thrombophlebitis resulting from varicose veins, sluggish blood flow or irritation from administration of intravenous medications typically heal quickly, usually within a few days. Thrombophlebitis resulting from vein infection requires longer treatment.
If you are pregnant or have varicose veins, you can help to relieve sluggish blood flow in your legs by wearing elastic support stockings or graduated compression stockings, as your doctor directs. Avoid prolonged periods of standing and, if possible, elevate your legs when you sit. Regular exercise, especially walking, also can help to improve blood flow.
To prevent thrombophlebitis from infection, avoid injecting illegal drugs into your veins.
Treatment is very effective for most simple cases of thrombophlebitis. For leg vein thrombophlebitis, treatment includes bed rest, elevating the legs and applying warm compresses. In some cases, wrapping the legs with an elastic bandage and taking nonsteroidal anti-inflammatory drugs (NSAIDs) also can help. In patients with varicose veins who have had several episodes of thrombophlebitis, the affected veins can be surgically "stripped," a procedure in which the vein is tied off, cut and removed through a small incision.
If the vein becomes infected, you will be treated with antibiotics. Mild cases can be treated with oral medications, but more severe cases usually require antibiotics given intravenously (into a vein) or by injection.
In patients with superficial thrombophlebitis that is not improving with standard therapy, anticoagulant (anti-clotting) medication sometimes is used to prevent blood clots from extending into the deeper leg veins. Blood clots in the deep leg veins, a condition called deep vein thrombosis, can lead to blood clots, called emboli, that float in the bloodstream. These blood clots can travel to the lungs, which can be life threatening.
Call your doctor whenever you have pain, redness or swelling along the length of a vein.
In pregnant women, thrombophlebitis is often a short-term condition that doesn't return after delivery. In people with varicose veins, thrombophlebitis may not return as long as the patient wears support stockings, walks regularly, and elevates the legs while sitting.
American College of Cardiology
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