Thrombophlebitis is inflammation of a vein due to the formation of a clot inside the vessel.
The condition most frequently occurs in a vein in the leg, but it can also affect veins in the neck or arms on occasion. The condition typically presents as painful red knots under the skin and often appears where a varicose vein used to be.
Thrombophlebitis may impact veins closer to the skin’s surface, in the fat or skin. This condition is known as superficial venous thrombosis or SVT. It may also be referred to as superficial thrombophlebitis or STP. The location of the clot is important, because SVT is not as dangerous as clots that form in the deeper veins of the legs.
Thrombophlebitis and Deep Vein Thrombosis
When the blood clot forms in a deep vein of the leg inside the muscle layer, it is known as deep vein thrombosis or DVT. DVT can become dangerous if the blood clot breaks free from its original location in the leg vein and travels through the bloodstream to the lungs. This can lead to a pulmonary embolism, a life-threatening condition that requires emergency medical treatment. Symptoms of pulmonary embolism include:
- Chest pains
- Shortness of breath
- Cough that may produce bloody sputum
If DVT is diagnosed before a pulmonary embolism occurs, steps can be taken to prevent the blood clot from reaching the lungs.
Potential Complications of SVT
While SVT is less dangerous, it isn’t a condition to ignore. A small percentage of patients that develop SVT may develop DVT and pulmonary embolism within 3-6 months. If SVT is assessed by ultrasound, as many as 25-30 percent of patients may also be found to have a clot in a deeper vein as well.
SVT can also originate in one area of the vein and then seemingly begin to spread. The movement can be up the leg or down the leg. When this occurs, it may mean the clot is continuing to grow, which can put a patient at higher risk for DVT and pulmonary embolism. The condition usually requires the use of blood thinners to dissolve the clot before the condition becomes more critical.
In addition to varicose veins, there are a number of reasons why thrombophlebitis might occur:
- History of blood clots
- Injury to the leg near a varicose vein
- Use of birth control pills or hormone replacement therapy
- Long periods of bedrest due to illness, injury or surgery
- Long periods of sitting, such as during a long flight or car ride
- Dehydration, which makes blood more concentrated and sluggish
While no one is completely immune from thrombophlebitis, some are more vulnerable to the condition than others. Risk factors for this condition include:
- Extended bedrest
- Frequent air travel or long car trips
- History of stroke that involved paralysis
- Personal or family history of a blood-clotting disorder
- History of birth control or hormone therapy use
- Over the age of 60
These risk factors do not mean you will definitely develop thrombophlebitis. However, if you have one or more risk factors, you may want to talk to your doctor about steps you can take to bring down your risk. For example, some individuals may find compression stockings are helpful for improving blood flow and reducing the likelihood a blood clot will form.
Symptoms of thrombophlebitis may differ somewhat, depending on whether the blood clot is located in a superficial vein or a deeper vein. In addition to the appearance of painful red knots along the vein, other symptoms of superficial thrombophlebitis might include:
- Skin redness or irritation
- Skin that is warm to the touch
- Pain and swelling in the affected area
- Possible darkening of skin around the vein
- Hardening of the vessel
When thrombophlebitis occurs in a deeper vein, there may not be as many noticeable symptoms. However, some sufferers may experience a degree of pain and swelling in the affected area. Some may also have some redness or skin warmth in the affected area as well.
Diagnosing the Condition
If you suspect you have thrombophlebitis, it is important to make an appointment with a vein specialist. Other physicians often confuse thrombophlebitis with cellulitis, which is an infection of the skin and tissues. Instead of getting treatment for a blood clot, you could be given antibiotics. Some doctors also prescribe antibiotics even if they believe thrombophlebitis is present.
When you make an appointment with a vein specialist to assess your condition, you will likely undergo a duplex ultrasound examination first. This painless, non-invasive test uses sound waves to create an image of the affected vein so your doctor can check blood flow inside the vessel and look for any potential clots. The procedure may be performed while you are sitting or lying down, but is often done with the patient standing to get a better indication of how blood is moving through the veins.
While you are waiting for your doctor appointment, you can relieve discomfort of thrombophlebitis at home by placing warm compresses on the leg. Elevating the leg may also help relieve symptoms, particularly if the clot is in a deeper vessel. Over-the-counter pain medication can also be used to reduce discomfort while you wait for your examination and treatment.
Treatment Options for SVT
In most cases, SVT will resolve on its own over time. When this occurs, the vein may be absorbed by the body and disappear. The body may also dissolve the clot, leaving the vein open for uninterrupted blood flow.
In the meantime, patients can use the methods listed above to relieve discomfort while they wait for the condition to resolve. In addition to elevation, heat and medication, your doctor may advise you to wear compression stockings for a period of time to relieve symptoms and encourage healing of the vein.
There is also a treatment that can be used to treat severe pain associated with SVT, but most doctors in the United States are not familiar with the procedure. This treatment involves eliminating or draining the clot, much like an abscess is drained. The procedure requires a bit of numbing medicine and a needle or small blade and is offered by some vein specialists like Dr. Draughn.
If DVT is present, treatment will primarily focus on preventing the blood clot from moving through the bloodstream to the lungs. Treatment options include:
- Blood-thinning medications to prevent clots from enlarging
- Clot-dissolving medication to eliminate the blood clot
- Insertion of a filter into the main vein of the body to prevent clots from reaching the lungs
- Surgical removal of the blood clot (and possibly the vein)
If you have SVT, you already know all too well just how uncomfortable this condition can be. While the condition is not usually serious, seeing a vein specialist will help you get a prompt and accurate diagnosis and treatment options. Contact Vein Specialists of the Carolinas today to learn more about SVT and DVT.