What is thrombophlebitis?

Thrombophlebitis is an inflammation of a vein, accompanied by thrombosis - the development of a blood clot in the lumen of the vein. The process can develop in any vein, although thrombosis and thrombophlebitis of the deep veins of the extremities are more characteristic.

Depending on the cause, severity of the condition, and location of the damaged vein, sometimes life-threatening complications can develop.

The mechanism of development of thrombophlebitis can go in two directions:

• First, the development of a blood clot and then inflammation of the vein – occurs when a formed blood clot blocks the vein and causes an inflammatory process in its wall.
• The development of inflammation, with subsequent thrombosis – an inflammatory process developing in the vein wall, in which the inner layer of the wall – the endothelium – is involved, leads to a disruption of the properties of blood flow and the formation of a thrombus.

Thrombophlebitis is mainly a local problem, although it can progress, in particular as a result of the migration and spread of thrombi, leading to the development of deep vein or pulmonary artery thrombosis.

What is the difference between venous thrombosis and thrombophlebitis?

Thrombophlebitis and thrombosis are related processes, but they are not the same. Thrombosis is a condition in which a blood clot forms in a blood vessel and obstructs blood circulation. Thrombophlebitis is often, but not always, a concomitant process of thrombosis, when inflammation develops in the blood vessel wall as a result of impaired blood circulation.

Deep vein thrombophlebitis

It mainly develops in the deep veins of the lower extremities. This condition requires immediate treatment to prevent complications such as pulmonary embolism, which is a life-threatening condition.

Superficial vein thrombophlebitis

It develops in the smaller, superficial veins of the upper and lower extremities, or in the branches of the veins. It is less likely to be severe, although superficial venous thrombophlebitis may indicate a risk of developing the same process in the deep veins.

Migratory thrombophlebitis

As the name suggests, migratory thrombophlebitis is a condition in which thrombosis and associated thrombophlebitis develop in one vein, followed by migration (movement) of the thrombus to different veins, often causing simultaneous thrombosis and subsequent damage to several veins. The larger the caliber of the blood clot that migrates to, the greater the risk of life-threatening complications.

Septic thrombophlebitis

Septic thrombophlebitis develops when the infectious process spreads to the blood vessels, specifically the walls of the veins.

The development of septic thrombophlebitis is a warning sign because it indicates the spread of infection throughout the body. This can lead to sepsis, which requires immediate medical intervention.

Thrombophlebitis incidence

The disease can develop in anyone, at any age, but the risk of thrombophlebitis is greatly increased by:

• After the age of 45
• In the presence of metabolic disorders (obesity, diabetes)
• In the absence of physical activity
• In diseases with blood clotting disorders (hypercoagulation)
• Against the background of taking specific medications and others

Symptoms of thrombophlebitis

 Edema – this symptom develops suddenly and is especially pronounced when superficial veins of the extremities are damaged.

• Pain – Thrombophlebitis is always accompanied by pain in and around the affected vein. The pain is especially severe when multiple thromboses of small-caliber veins develop.
• Structural changes in superficial veins – inflammatory damage causes the vein wall to harden and become tight
• Discoloration – This symptom develops with superficial vein thrombophlebitis. The skin in the area of ​​the thrombosed vein is dark red or cyanotic.
• Temperature – The skin over the damaged blood vessel is hot to the touch and tense.

Causes of thrombophlebitis

Thrombophlebitis can occur for various reasons:

• Genetic pathologies that cause increased clotting processes (hypercoagulability), contributing to the development of thrombosis and inflammation in the veins
• Varicose veins. Enlarged, deformed veins in the lower extremities contribute to slowing blood flow and the development of thrombosis.
• Trauma that damages the veins along with the soft tissues contributes to their infection and inflammation.
• Medical procedures and medications. Intravenous injections and catheters sometimes cause vein clots, infections, and inflammation. Corticosteroids, oral contraceptives, and other medications increase the risk of blood clots.
• Intravenous drug abuse – poor hygiene and sharing needles contribute to the development of intravenous infections and blood clots.
• A sedentary lifestyle, as well as long flights or long-distance travel, especially in the presence of varicose veins of the lower extremities, disrupts blood flow in the deep veins of the extremities and contributes to the formation of clots. Diseases that limit a person's ability to move also contribute to the development of thrombosis and thrombophlebitis.
• Other diseases – cancer, obesity, lupus, tobacco, and other bad habits often damage the walls of blood vessels, which causes thrombosis and inflammation of the veins.
• Dehydration, pregnancy, postpartum state – are conditions that carry a risk of developing thrombosis.

Diagnosis of thrombophlebitis

Diagnosis of thrombophlebitis is based on physical examination, imaging, and laboratory findings.

Laboratory tests are important for identifying the degree and nature of blood clotting disorders, including the study of clotting factors, their activators and inhibitors, and other indicators, which is important for determining the course of treatment.

Migratory thrombophlebitis may be a symptom of other diseases, especially certain types of tumors and clotting disorders caused by genetic mutations.

Treatment of thrombophlebitis

Treatment is aimed at dissolving the clots that have formed, relieving pain, and reducing other symptoms.

• Thrombolytic agents
• Nonsteroidal anti-inflammatory drugs
• Anticoagulants and antithrombotic medications
• Antibiotics

In rare cases, especially in cases of deep vein thrombophlebitis of the lower extremities, surgical intervention is necessary:

• Mechanical thrombectomy – removal of a clot from a damaged vein, restoring blood flow
• Venectomy – excision of a thrombosed and damaged vein and its removal from circulation
• Sclerotherapy - injecting a sclerosing substance into a vein to stop it from functioning
• Venous anastomosis - creating a connection between healthy veins, bypassing the damaged area, to restore blood flow
• Ablation – thermal or laser coagulation of the damaged surface of a vein. It is especially used in varicose veins.

Laboratory "Synevo" offers diagnostic tests for diseases associated with blood clotting disorders:

 Laboratory "Synevo" We offer diagnostic tests for diseases associated with blood clotting disorders.: 

Health care starts with accurate analyzes

Resources

https://www.healthline.com/health/blood-tests

https://my.clevelandclinic.org/health/diseases/23311-thrombophlebitis

n.manjaparashvili@synevo.ge