Superficial Thrombophlebitis - Inflammation of Superficial Veins

What Is Thrombophlebitis?

Thrombophlebitis refers to ‘thrombo’ meaning a blood clot or thrombosis, and ‘phlebitis’ means inflammation. Thrombophlebitis can be defined as blood clot formation in the veins, usually in the legs, and sometimes it is seen over the arms as well; it can affect any part of the body leading to pain and inflammation. The clot formation causes a restriction to the blood flow leading to swelling and irritation over the skin. There are three main types of thrombophlebitis - deep vein thrombosis, superficial thrombophlebitis, and migratory thrombophlebitis.

What Is Superficial Thrombophlebitis?

Superficial thrombophlebitis is a condition in which there is an inflammation of the superficial veins, especially in the legs, and can also happen in the other part of the body. In superficial thrombophlebitis, clot formation occurs in the superficial veins, which are present just beneath the skin layers, and can be seen by the naked eyes. However, the involvement of the superficial vein is not very serious as the involvement of the deep veins because the chances of blood clots forming into pulmonary emboli are less and superficial thrombophlebitis is very painful. However, it can also be settled in five to six weeks with supportive treatment.

What Are the Causes of Superficial Thrombophlebitis?

Superficial thrombophlebitis can be caused by associated conditions such as:

1. Inheritance of the disease.

2. Obesity.

3. Tobacco smoking.

4. Stroke.

5. An injury.

6. Cancer.

7. Deep vein thrombosis. (blood clot in the deep vein).

8. Administration of oral contraceptives.

9. Prothrombin gene mutation.

10. Administration of hormone replacement medication.

11. Disorders that affect blood clotting.

12. Antithrombin III deficiency.

13. Deficiency of proteins C and S.

14. After surgery.

15. Pregnancy.

16. Placement of pacemaker or central venous catheter.

17. Overweight.

18. Sitting habit for a longer time period.

19. Age above 50 years.

What Are the Clinical Features of Superficial Thrombophlebitis?

Superficial thrombophlebitis has the following clinical features:

1. Blood clotting.

2. Redness, swollen and inflamed area over the affected part.

3. Hyperpigmentation over the skin.

4. Tenderness present.

5. Hardening of veins.

What Are the Investigations for the Diagnosis of Superficial Thrombophlebitis?

Superficial thrombophlebitis can be diagnosed by the following investigations:

1. Recording the patient’s medical and family history.

2. Conducting the physical examination by evaluating pulse, temperature, blood flow, and blood pressure.

3. Inspecting the site of inflammation.

4. Doppler Ultrasound - In doppler ultrasound investigation, sound waves are used to determine the blood flow and pressure.

5. Duplex Ultrasound - This investigation is a combination of Doppler ultrasound and ultrasound sonography.

6. Venography - It is a type of X-ray that captures the image of the blood flow.

7. MRI (Magnetic Resonance Imaging) - It is advised to determine the conditions of clots and blood flow.

8. CT scan (Computerized Tomography) - It is done to check the blood flow and venous involvement.

9. Skin and blood culture.

10. MR Angiography (Magnetic Resonance Angiography) - In this investigation, doctors inject a dye into the vein, capture a detailed picture through the MRI machine, and study the blockage.

11. D-Dimer - It is a protein present in the body and gets elevated at the time of inflammation.

What Is the Treatment for Superficial Thrombophlebitis?

Superficial thrombophlebitis can be cured in five to six weeks even without any specific medical attention, only by the administration of painkillers. But in some cases, proper treatment is also required.

Superficial thrombophlebitis can be treated by the following treatments:

1. Practicing an active lifestyle.

2. The affected leg should be raised up to 45 degrees to avoid blood accumulation and clotting.

3. Applying the heat at the site of the inflammation reduces the pain.

4. Antibiotic therapy for infections.

5. Administration of Non-steroidal anti-inflammatory drugs (NSAIDs) for reduction of pain. For example, Ibuprofen, Paracetamol.

6. Administration of blood thinners like Heparin, Enoxaparin, and Warfarin is advised. In superficial thrombophlebitis, blood thinners are not always required as there is less risk of causing life-threatening conditions like pulmonary embolism.

7. Application of anti-inflammatory creams or gels at the site of inflammation.

8. Compression stockings in superficial thrombophlebitis, it is advisable to wear compression stockings during the treatment for the application of pressure over the inflammation to avoid the reoccurrence of the clot.

9. Filters are generally not used; these are used in patients with an increased risk of developing superficial thrombophilic to deep vein thrombosis. It is inserted into the vein and dissolves the clots.

10. Varicose vein stripping is a surgical process also called phlebectomy; it involves the removal of the superficial inflamed vein. However, it does not affect the blood flow in the legs because there are many other bigger veins for the blood supplement.

What Is the Difference Between Superficial Thrombophlebitis and Deep Vein Thrombosis?

Superficial thrombophlebitis and deep vein thrombosis belong to the same classification of thrombophlebitis. Thrombophlebitis refers to clot formation and inflammation.

In superficial thrombophlebitis, clot formation is present in the superficial vein, just beneath the skin surface, and it is not a very serious condition. It can subside in five to six weeks with supportive treatment. No surgical treatment is required.

In deep vein thrombosis, the clot is formed in the deep veins of the lower extremities due to several causes. Deep vein thrombosis can lead to serious complications like pulmonary emboli, strokes, ischemia to certain internal organs, and many more life-threatening conditions. It can be treated by medical and surgical intervention.

How to Prevent Superficial Thrombophlebitis?

Superficial thrombophlebitis is not a very serious condition, and it is curable. To prevent superficial thrombophlebitis, it is essential to lead an active and fit life by having a proper nutritional diet. Exercising regularly, keeping moving, avoiding long sittings, wearing loose clothing, and staying hydrated will help the prevention of diseases.

Conclusion

Superficial thrombophlebitis is a condition in which the clots are in the superficial veins and can affect the blood flow. It is a short-term condition that may not cause severe complications and can be cured in five to six weeks by taking painkillers, applying heat, or keeping the affected leg at a certain elevation. Living with superficial thrombophlebitis can be manageable as it does not cause major issues and can be prevented by leading an active lifestyle. However, it is also advisable if any individual suffering from superficial thrombophlebitis should go and consult a specialist to obtain a proper line of treatment and to avoid other underlying conditions and other risk factors.