Thrombophlebitis

Written by Gretchen Holm and Erica Roth | Published on July 19, 2012
Medically Reviewed by George Krucik, MD

Thrombophlebitis

Thrombophlebitis is an inflammation of a vein, usually in your legs, that becomes swollen due to a blood clot. A blood clot is a solid formation of blood cells that stick together. Blood clots can interfere with the normal flow of blood throughout your body. Thrombophlebitis can occur in veins near the surface of your skin or deeper down in one of your muscles.

Although his condition usually occurs in your legs, it is possible to develop thrombophlebitis in other parts of your body. Blood clots can cause swelling in the veins of your neck or arms, but this is rare.

Deep vein thrombosis (DVT) is a condition in which you develop a blood clot in a vein deep in your body. This is one of the two types of thrombophlebitis. Thrombophlebitis that affects veins closer to the surface of your skin is called superficial thrombophlebitis.

If you have thrombophlebitis, you might not notice any major or seemingly serious symptoms. Minor swelling in the leg or a reddened, tender vein may cause discomfort. This does not mean that it is safe to ignore the condition. If it is not treated, deep vein thrombosis can lead to a pulmonary embolism, meaning you have a blood clot in your lungs. A pulmonary embolism can be fatal.

What Causes Thrombophlebitis?

Thrombophlebitis is caused by a blood clot. Inactivity is a major cause of blood clots. Being bedridden can cause a clot. Similarly, you might develop one if you sit still for too long, such as during a plane ride or in the car. Standing up, stretching, and moving your feet periodically during long flights or car rides can help reduce your risk of blood clots. Movement promotes circulation, which discourages the blood cells from sticking together.

You might also develop blood clots if you have somehow injured your blood vessels. Trauma to the limb in question may cause injury to a vein. You may also sustain injury to a blood vessel from intravenous needles or catheters during a medical procedure. This type of injury, however, is a less common cause of blood clots.

Some people have diseases or disorders that cause the blood to clot more easily, such as fractures, HIV, or inflammatory bowel syndrome. This makes thrombophlebitis more likely.

Pregnancy, obesity, and hormone therapy (including some birth control pills), also put an individual at a higher risk for blood clots. In some cases, cancer can lead to deep vein thrombosis as well.

What Are the Symptoms of Thrombophlebitis?

The symptoms of thrombophlebitis depend partly on which kind you have.

With either kind of thrombophlebitis, you can experience the following symptoms near the affected area:

  • pain
  • warmth
  • tenderness
  • swelling
  • redness

Superficial thrombophlebitis sometimes causes the affected vein to become visibly engorged and red.

Deep vein thrombosis is less visible on the surface because the affected vein is further from the skin. However, you will likely still experience the other symptoms of thrombophlebitis. Additionally, your toes or fingers on the affected limb may become discolored and turn blue. The pain will probably be worse when you put weight on your leg. In rare cases, you might develop a fever with chills.

How Is Thrombophlebitis Diagnosed?

In some cases, your doctor will not need to do any major tests to identify the problem. The appearance of the area and your description of your symptoms may be enough to diagnose this condition.

If this is not enough, your doctor will generally try to use one of several kinds of imaging techniques to visually see whether a clot is present. Options include an ultrasound, a computed tomography (CT) scan, and magnetic resonance imaging (MRI).

In other cases, your doctor might choose to perform a venogram. This involves injecting a dye (which shows up on X-rays) into your vein. Your doctor will then take X-ray images to see whether you have a clot.

How Is Thrombophlebitis Treated?

If you have superficial thrombophlebitis, your doctor might simply recommend that you take care of your condition at home. He or she will give you instructions that may include applying heat, wearing support stockings, keeping the limb elevated, and using anti-inflammatory medications, such as ibuprofen.

If the vein involved in superficial thrombophlebitis becomes permanently unsightly or painful, or if you have this condition in that vein more than once, your doctor might choose to remove the vein. This is called varicose vein stripping. This type of procedure should not affect your circulation, as there are a number of veins deeper in the leg that can handle the increased amount of blood flow. The blood will simply begin to flow through those.

In other cases, especially if you have deep vein thrombosis, you might need to take medications. These are typically designed to thin your blood (anticoagulants) or to dissolve clots (thrombolysis). Sometimes the doctor may inject the medication directly into your vein.

Some individuals may not be able to take blood-thinning medications, so the doctor may need to insert a permanent filter into the abdomen’s main vein to prevent loose clots from reaching the lungs and causing a pulmonary embolism.

In some cases, your doctor may need to remove the clot or open up your blocked vein through bypass surgery or angioplasty.

Bypass surgery involves taking a piece of healthy vein and attaching it to the blocked vein through two small holes. The blood will then flow through this newly attached vein, bypassing the blocked one.

In angioplasty, a balloon-tipped tube is inserted into the blocked vein. Once the tube reaches the blockage, the balloon is inflated to open up the vein. Then the tube is removed. Sometimes the doctor may insert a wire mesh tube (stent) into the vein to keep it permanently open.

How Can I Prevent Thrombophlebitis?

Stretch or walk around regularly if you are taking a long trip in the car or by airplane. This also applies to those who work at their desks for long periods. Sitting still for too long can lead to thrombophlebitis.

If you are in the hospital, your doctor should change your intravenous (IV) lines regularly. Depending on your condition and other factors, he or she might also give you medications that are designed to help prevent this condition.

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