Management of Thrombophlebitis in Older People - An Overview

What Happens to the Elders During Thrombophlebitis?

The name thrombophlebitis can be broken down into the following components:

• Thrombo - blood clot formed inside the blood vessel.

• Phleb - related to veins.

• Itis - inflammation.

It can happen in either of the following ways:

• Clot First and Inflammation Later: In this case, the clot may be formed first within the veins and may cause irritation. The irritation will gradually lead to inflammation.

• Inflammation Before Clot Formation: In this case, inflammation may occur inside the vein, attracting blood clots and attaching them to the inner wall.

What Is Superficial and Deep Thrombophlebitis?

Superficial thrombophlebitis is the inflammation of the vein due to the blood clot formed just below the skin's surface. It occurs more in females than males and rarely travels to the lungs from the superficial area. Because of this reason, it is not considered a severe condition.

Deep thrombophlebitis is the blood clot formed within a deep vein that must be treated fast as it can progress to severe complications. The physician can examine superficial thrombophlebitis by physical examination. However, deep thrombophlebitis can only be diagnosed by ultrasound scanning.

What Are the Causes of Thrombophlebitis in the Elderly?

The causes of thrombophlebitis are:

• Injuries- Injuries due to recent injections, IV (intravenous) drug deliveries, or catheters may cause superficial thrombophlebitis.

• Obesity- Obesity increases inflammation and can reduce fibrinolysis (the ability to break down clots).

• Smoking- Smoking promotes the aggregation of platelets (cells responsible for forming clots) and may increase the chance of thrombophlebitis.

• Age- With age, the amount of coagulating proteins may increase, leading to the formation of clots within the veins.

• Immobilization- Lack of movement due to prolonged rest, hospitalization, injuries, or surgeries can decrease the blood flow, causing thrombophlebitis.

• Varicose Vein- Varicose is a superficially twisted and enlarged vein causing severe pain. Individuals with varicose veins may also experience thrombophlebitis.

• Blood Clotting Disorder- Individuals with a previous history or family history of a blood clotting disorder may also experience thrombophlebitis.

Symptoms of Thrombophlebitis in the Elderly:

Superficial thrombophlebitis may show symptoms like:

• Pain.

• Discoloration or redness of the skin.

• Swelling.

• Warm skin.

• Hardening of the area or the vein.

Deep thrombophlebitis may show symptoms like:

• Pain.

• Swelling and pain in the extremities, like arms or legs.

• Warmer swollen areas.

• Enlarged and superficially visible veins.

• Abdominal pain in case of the blood clot forming deep within the abdomen.

• Severe headaches and seizures when the veins in the brain get affected.

Who Is at Risk of Thrombophlebitis?

• Those who were inactive for a prolonged period.

• Obese or overweight individuals.

• Individuals with a habit of smoking frequently.

• Those who have a varicose vein.

• Those who have artificial pacemakers or catheters.

• Those who have a previous history or family history of blood clotting disorder.

• Those who have or had cancer or stroke.

Why Is It Essential to Treat Thrombophlebitis?

If left untreated, thrombophlebitis may lead to many complications:

• Pulmonary Embolism - It is a condition in which a dislocated clot causes an obstruction in the blood vessel to the lungs. This condition is severely life-threatening.

• Post Phlebitic Syndrome - It is the prolonged swelling and pain in the arms and legs, which may get converted to a disability.

How Is Thrombophlebitis Treated in the Elderly?

• Pain Medication - Pain medications may be given to control and relieve the pain. Drugs like Acetaminophen, Non-steroidal anti-inflammatory drugs (NSAID) may relieve the pain.

• Blood Thinning Medicines - Since thrombophlebitis is related to blood clot formation, blood thinners may prevent complications like pulmonary embolism. It will be given as an injection in case of deep thrombophlebitis. Heparin and Warfarin are examples of such medications. Since such drugs can increase bleeding, it is necessary to follow the guidelines provided by the doctor.

• Clot-Busting Drugs - These are thrombolytic drugs that can melt down the clot formed. Drugs like Alteplase may be given for this purpose. It may either be given through an IV (intravenous) or directly delivered to the clot using catheters.

• Antibiotics - Antibiotics may be given in case of thrombophlebitis caused by infections.

• Mechanical Thrombectomy - The surgeon may physically remove the blood clot from the vein in this procedure.

• Vein Removal - Through this procedure, the surgeon cuts the affected veins and carefully removes the part of the vein.

• Bypass - In the case of thrombophlebitis, blood flow may get seriously impaired. By bypass procedure, a part of the blood vessel will be taken from a different part of the body to build a bypass path in the affected area to promote blood flow.

• Sclerotherapy - In this procedure, the surgeon may inject a solution into the vein, which may prevent the development of clots.

• Compression Items - The health care provider may ask to wear compression items like socks or stockings, which may apply pressure and reduces the chance of developing a clot. It will also relieve pain and swelling.

How to Reduce the Risk of Thrombophlebitis?

• Quit Smoking - Limiting and gradually stopping the use of tobacco or smoking can be considered.

• IV Drug Use - Quitting injectable drugs can prevent the injury caused to the veins and reduces the risk of clot formation.

• Keep Moving - Finding ways to move the body between prolonged sitting, lying down, or car rides may reduce the risk of thrombophlebitis.

• Stay Hydrated - Drinking lots of fluids may reduce the chance of clot formation.

• Take the Medications - If the doctor has prescribed blood thinning medications, following the dosage and guidelines may reduce the complications.

• Checkups - Getting an annual checkup may help diagnose the issue or risk factors and can help treat the problem fast.

• Lifestyle Changes - Eating healthy food and physical activities may help maintain weight, reduce fat accumulation, improve circulation, and decrease the chances of thrombophlebitis.

Conclusion

A healthy lifestyle modification and annual medical check-ups can reduce the risk of developing thrombophlebitis. With age, the risk of developing clots in the blood vessel may rise. Older individuals should consider following the instructions and taking appropriate medications provided by the doctor.