Treatment of thrombophlebitis

Pain, redness, swelling, or a lump in the area of a vein should not be left without attention. Such changes may indicate inflammation of the vein and the formation of a blood clot. This is not always an emergency condition, but it is necessary to consult a vascular surgeon in the near future to assess the risk of complications and begin treatment in a timely manner.

At the Oxford Medical medical center, an examination, the necessary tests, and treatment of thrombophlebitis are carried out in accordance with current clinical recommendations. The doctor selects an individual strategy to reduce inflammation and pain, prevent further progression of the disease, and restore normal blood circulation. To book a consultation, submit a request through the online booking form on the website or contact the contact center by phone.

Thrombophlebitis is a disease accompanied by inflammation of the vein wall and the formation of a blood clot in its lumen. A blood clot may partially or completely block the vessel, resulting in impaired normal blood outflow. Without timely treatment, the risk of deep vein thrombosis and pulmonary embolism, which may pose a threat to life, increases.

Venous thrombophlebitis most often develops in superficial veins located under the skin. In this case, the vessel wall becomes inflamed, and a blood clot forms in its lumen. This condition is also called superficial vein thrombosis.

If inflammation of the venous wall occurs without the formation of a blood clot, phlebitis is diagnosed. When a blood clot forms in a deep vein, deep vein thrombosis is diagnosed, which is also called phlebothrombosis. Distinguishing between these diseases is important because they have different risks and require different approaches to treatment.

Depending on the location, the following are distinguished:

• thrombophlebitis of the lower extremities — damage to the veins of the foot, lower leg, or thigh;
• thrombophlebitis of the arms — damage to the veins of the hand, forearm, or upper arm;
• thrombophlebitis of other areas — less commonly, an inflammatory process with the formation of a blood clot develops in the veins of the chest, neck, or pelvis.

According to the nature of the course, the following are distinguished:

• acute thrombophlebitis — begins suddenly, and pain, redness, and swelling may rapidly intensify;
• subacute — symptoms are moderately pronounced and gradually decrease;
• recurrent — the disease occurs again in the same or another vein.

During the examination, the doctor also takes into account whether the blood clot formed in a varicose or externally unchanged vein, how extensive the affected area is, and where it is located. These features influence the assessment of risks and the choice of further treatment strategy.

A blood clot in a superficial vein usually forms not because of one cause, but as a result of a combination of several factors. This may be slowed blood flow in varicose veins, prolonged restriction of mobility, or an increased tendency of the blood to clot.

According to Thrombosis Canada, the risk of developing thrombophlebitis is increased by:

• varicose vein disease — the most common risk factor, since blood moves more slowly in dilated veins;
• previous thrombophlebitis or other venous thromboses;
• prolonged bed rest or restriction of mobility, including after surgery or injury;
• oncological diseases and some methods of their treatment;
• pregnancy and the first weeks after childbirth;
• taking hormonal contraceptives or medications for hormone replacement therapy;
• hereditary or acquired blood clotting disorders;
• placement of an intravenous catheter, injections, and other manipulations that may irritate the vein wall;
• obesity and insufficient physical activity;
• long journeys and flights during which a person remains in one position for a long time.

The more factors are combined, the higher the probability of blood clot formation may be.

Doctors at “Oxford Medical” warn: if the redness spreads rapidly, the pain intensifies, the entire limb swells, or the body temperature rises significantly, you should consult a doctor as soon as possible. Such changes may indicate the spread of thrombosis or the development of complications.

Diagnosis begins with a consultation with a phlebologist or vascular surgeon. The doctor assesses the condition of the skin, determines the boundaries of redness, tenderness, and the lump, and also clarifies when the symptoms appeared.

The main examination method is duplex ultrasound of the veins with Doppler imaging. It makes it possible to detect the blood clot, determine its location and extent, and assess blood flow. Based on the examination data, the doctor determines:

• in which vein the blood clot formed;
• the length of the affected area;
• how close the blood clot is located to the deep veins;
• whether there are signs of the spread of thrombosis.

The need for laboratory tests is determined individually. The doctor may prescribe a complete blood count, a coagulation test, and other tests. If thrombophlebitis recurs or develops without an obvious cause, tests are performed as indicated to detect blood clotting disorders.

In most cases, superficial thrombophlebitis responds well to treatment. However, the thrombus can increase in size and extend into the deep vessels. This increases the risk of serious complications, the most dangerous of which is pulmonary embolism — a condition that can pose a threat to life.

Possible complications include:

• deep vein thrombosis — a thrombus from a superficial vein extends into a deep vein, disrupts blood outflow, and can cause swelling of the entire limb;
• pulmonary embolism — part of the thrombus breaks off, travels with the bloodstream to the vessels of the lungs and blocks them, as a result of which shortness of breath, chest pain, rapid heartbeat, dizziness, and sudden weakness may occur abruptly;
• purulent inflammation — a bacterial infection joins the inflammatory process, causing pain and redness to intensify, body temperature to rise, and general well-being to worsen;
• post-thrombotic syndrome — after the deep vessels are affected, the venous valves are damaged and venous insufficiency develops, which may manifest as persistent swelling, pain, heaviness in the legs, changes in skin color, and, in severe cases, trophic ulcers.

According to National Center for Biotechnology Information (NCBI), superficial thrombophlebitis can be complicated by deep vein thrombosis and pulmonary embolism. Therefore, it is important to perform an ultrasound examination in a timely manner, determine the extent of the thrombosed area and its proximity to the deep veins.

The diet should be varied. It is important to follow a balanced diet.

The basis of nutrition for thrombophlebitis should consist of:

• fresh vegetables, fruits, berries, and greens;
• whole-grain cereals, bread, and pasta made from durum wheat;
• fish, lean meat, eggs, legumes, and fermented dairy products;
• nuts, seeds, and vegetable oils.

It is worth reducing the amount of salt, sausages, smoked foods, canned foods, sweet drinks, and dishes with a large amount of saturated fats. Excess salt contributes to fluid retention in the body and can increase swelling.

The main preventive measures:

• move sufficiently every day, walk regularly, and take breaks during prolonged work while sitting or standing;
• during long journeys and flights, periodically stand up, stretch the legs, and perform foot movements to maintain blood circulation;
• examine and treat varicose veins in a timely manner;
• wear compression garments if recommended by a doctor, having correctly selected the size and degree of compression;
• maintain a normal body weight;
• give up smoking.

Doctors at «Oxford Medical» recommend not postponing a visit to a vascular surgeon if pain, redness, or a dense lump appears over a varicose vein. Early examination makes it possible to detect a thrombus in time and prevent it from extending into the deep veins.

The cost of treatment depends on the location and extent of the thrombosed area, the required scope of examinations, and the chosen treatment strategy. First, the patient needs a consultation with a phlebologist, during which the doctor conducts an examination and determines which tests are necessary.

The cost also depends on whether the patient needs:

• duplex ultrasound examination of the blood vessels;
• laboratory tests;
• medication therapy or surgical intervention and a hospital stay.

Current prices for doctors’ consultations and other medical services can be viewed here. To make an appointment in Kyiv, submit a request through the online appointment form on the website or call the medical center’s contact center.

The information is for informational purposes and does not replace a doctor’s consultation.

Sources:

• European Society for Vascular Surgery
• Thrombosis Canada
• National Center for Biotechnology Information