Blood Clots

Thrombophlebitis

Thrombophlebitis is inflammation of a vein caused by a blood clot (also known as a thrombus). Thrombophlebitis is an inflammatory process that causes a blood clot to form and block one or more veins, usually in your legs. The less specific term, “superficial phlebitis” is typically used as an initial, provisional diagnosis until further tests/imaging studies have been completed. Superficial phlebitis does relate to the clinical findings of pain/redness/inflammation of the vein without the confirmed presence of a clot. There are three specific kinds of thrombophlebitis, diagnosed by location:

  • Superficial thrombophlebitis (STP)
  • Superficial Venous Thrombosis (SVT)
  • Deep vein thrombosis (DVT)

What Are the Symptoms?

There are a variety of symptoms that may accompany thrombophlebitis including:

  • Swelling – Recent swelling of the limb
  • Pain – Unexplained limb pain or tenderness
  • Warmth – Skin that may be warm to the touch
  • Redness — Redness of the skin

When a vein close to the surface of your skin is affected, you might see a red, hard cord just under the surface of your skin that’s tender to the touch. When a deep vein in the leg is affected, your leg may become swollen, tender, painful, and is usually difficult to walk on.

Superficial Thrombophlebitis (STP) usually occurs in surface-layer veins (usually located in the legs) and are often located in large caliber, dilated varicose veins. Superficial venous thrombosis (SVT), means the finding of thrombus involving the larger superficial saphenous veins, such as the great saphenous vein. Depending on location, SVT may extend (propagate) into the deep venous system, resulting in a more serious deep venous thrombosis (DVT), when the deep veins of the legs (deep to the muscle layer) develop a thrombus. When a DVT develops, there is a chance that a clot can break off and enter the pulmonary vasculature, known as a pulmonary embolus (PE) - which can be a life-threatening complication.

We understand the serious impact that thromboembolic disease has on our patients and their families. As underlying venous disease can play a significant role in the majority of patients who have been affected by thrombophlebitis, we will collaborate with your referring physician to determine the best care plan for you.

Deep Venous Thrombosis (DVT)

What is a Deep Vein Thrombosis (DVT)?

When a clot forms in the deep vein system it is called a deep vein thrombosis, or DVT.  DVTs usually occur in the lower extremities, but they can appear in other parts of the body. The venous system of the lower extremity is divided into the superficial veins, which include the great and small saphenous veins and their associated accessory tributaries and the deep venous system, which includes the femoral and popliteal veins. Intermediate veins called perforators connect them. DVT can lead to partial or complete blockage of circulation which can cause serious medical problems. Nearly 2 million Americans are affected by DVT each year.

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Sometimes there are no warning signs or symptoms of DVT.

As much as 50% of patients with a DVT show no symptoms at all. These silent DVTs can resolve without treatment or may lead to complications such as a Pulmonary Embolism (PE).  A PE is a dangerous condition because it can damage the lungs and other organs and is life-threatening.

Contact your doctor if you experience any of the following:

  • Pain or tenderness
  • Warmth
  • Swelling (edema)
  • Redness

Reduce Your Risk of DVT

Vacations are a particularly dangerous time for DVT. Travel on an airplane, car, bus or train increases your risk, especially if you have recently had surgery, are pregnant, are overweight or have a history of blood clots.

Risk of DVT should not keep you from traveling if you take these simple steps:

  • Wearing compression stockings while traveling can significantly reduce your risk for DVT. These stockings help increase the circulation in your legs. Make sure to purchase medical grade stockings.
  • Stay hydrated. Drink lots of water and avoid caffeine or alcohol because both are dehydrating.
  • Wear loose, comfortable clothes during the trip.
  • Get up out of your seat every hour or two. In an airplane, it is helpful to request an aisle seat, so it is easier to stretch out and move around. In a car, stop at a gas station or rest area and walk around every couple of hours.
  • While seated, rotate your ankles, draw circles on the ground with your toes, flex your feet and toes and raise your legs slightly and holding them in the air for a few seconds.

Diagnosis and Treatment

The veins of the legs are classified anatomically.  The “deep” veins are within and below the muscles and the “superficial” veins are above the muscles.  DVT (Deep Vein Thrombosis) is where a thrombus or clot obstructs a vein.  It is a serious condition that can lead to disability and even death if the thrombus travels through the bloodstream to the lungs.  When this happens, it is called a Pulmonary Embolus (PE).

Diagnosis of DVT:

lower extremity ultrasound exam

Diagnosis of Pulmonary Embolus:

CT Scan, Ventilation Perfusion Scan

Treatment:

  1. Anticoagulation with oral or injectable medication (“blood thinners”). This is the most common treatment.
  2. Pharmacologic thrombolysis (infusion of drugs directly into the thrombus through a catheter that dissolve the clot)
  3. Surgical or minimally invasive interventions to physically remove the clot
  4. Compression stockings (used for small, below the knee thrombus)
  5. Ambulation
  6. IVC Filter (a small mesh filter surgically placed into the vein to prevent the clot from traveling to the lungs) if patient cannot be on blood thinners

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Wednesday: 7:30am - 4:30pm
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Sat and Sun: Closed

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