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Phlebitis

Phlebitis Risks, Symptoms and Treatment Options

Superficial Venous Thrombophlebitis

What is Superficial Venous Thrombophlebitis?

Definition: Phlebitis or SVT is a formation of a clot in a superficial vein.

This is an important distinction from the commonly discussed Deep Venous Thrombosis or DVT that occurs in the deep vein system. Deep vein Thrombosis is a serious medical condition and requires blood thinners (anticoagulation) and other possible intervention.

Phlebitis is not a life or limb threatening condition, but it can be quite painful due to the inflammation that occurs around the vein. The only time SVT can becomes a more serious problem is if it worsens and extends into a deep vein.

There are two sets of veins in our extremities.
Superficial veins lie between your skin and the muscles.
The Deep veins are beneath the muscles near the bones
in your arms and legs.

All superficial veins eventually drain into a deep vein.
This is something that we are aware of as Vascular
Surgeons.

What are the SIGNS AND SYMPTOMS?

When a superficial vein develops a clot in it, it usually
causes:

  • pain in the area
  • redness
  • tenderness
  • some swelling in the area
  • usually you can palpate a “cord” in the area
  • there can be a significant amount of pain due to
    the inflammation

Risk Factors

Know your RISK FOR SVT

Varicose veins: these tend to be the most common area that Phlebitis or SVT occur

  • Having an intravenous (IV) access in the arm
  • Trauma
  • illness
  • hypercoagulable states
  • malignancies
  • oral contraceptives
  • hormonal replacement
  • prolonged immobilization

If you have one or more risk factors, discuss prevention strategies with your doctor before taking long flights or road trips or if you’re planning to have elective surgery, recovery from which will require you not to move much.

How do you DIAGNOSE SVT?

  • Usually, a good history and physical exam can elicit the diagnosis
  • Duplex ultrasound can confirm the diagnosis and give us important information that we need to determine treatment options like the volume of SVT or its proximity to the deep veins.

Treating SVT

What are the TREATMENT OPTIONS

  • Apply a warm compress to the area.
  • Elevate the limb when resting.
  • Compression stockings: this might be uncomfortable, but it does help with resolution of the SVT
  • NSAIDs: Ibuprofen or Aspirin can help with the inflammation that occurs in the area.
  • Anticoagulation: Your surgeon will determine this. If the superficial clot is close to the area where the superficial vein joins the deep vein, the addition of a blood thinner can help prevent progression to a DVT. Additionally, if the amount of clot or SVT is extensive, blood thinners can stop the progression of the SVT and also help relieve the pain. Your vascular surgeon will advise you after your ultrasound.

Some ways you can help PREVENT SVT

Sitting during a long flight or car ride can cause your ankles and calves to swell and increases your risk of thrombophlebitis. To help prevent a blood clot:

  • Take a walk. If you’re flying or riding a train or bus, walk up and down the aisle once an hour or so. If you’re driving, stop every hour or so and move around.
  • Move your legs regularly. Flex your ankles, or carefully press your feet against the floor or footrest in front of you at least 10 times each hour.
  • Drink plenty of water or other nonalcoholic fluids to avoid dehydration.