Learn about the disease, illness and/or condition Superficial Thrombophlebitis (Deep Vein Thrombosis) including: symptoms, causes, treatments, contraindications and conditions at ClusterMed.info.
Superficial Thrombophlebitis (Deep Vein Thrombosis)
|Superficial Thrombophlebitis (Deep Vein Thrombosis)|
Superficial Thrombophlebitis (Deep Vein Thrombosis) Information
Deep vein thrombosis (DVT) definition and facts
Medications to treat blood clots in the leg
Anticoagulation prevents further growth of the blood clot and prevents it from forming an embolus that can travel to the lung. The body has a complex mechanism to form blood clots to help repair blood vessel damage. There is a clotting cascade with numerous blood factors that have to be activated for a clot to form. There are difference types of medications that can be used for anticoagulation to treat DVT:
Side effects and risks of anticoagulation therapy
Patients who take anticoagulation medications are at risk for bleeding. The decision to use these medications must balance the risk and rewards of the treatment. Should bleeding occur, there are strategies available to reverse the anticoagulation effects.Some patients may have contraindications to anticoagulation therapy, for example a patient with bleeding in the brain, major trauma, or recent significant surgery. An alternative may be to place a filter in the inferior vena cava (the major vein that collects blood from both legs) to prevent emboli, should they arise, from reaching the heart and lungs. These filters may be effective but have the potential risk of being the source of new clot formation. An IVC filter is NOT recommended for patients who are also taking anticoagulation medications.
Signs and symptoms of DVT
The signs and symptoms of DVT are related to obstruction of blood returning to the heart and causing a backup of blood in the leg. Classic symptoms include:
Signs and symptoms of superficial blood clots
Blood clots in the superficial vein system (closer to the surface of the skin), most often occur due to trauma to the vein, which causes a small blood clot to form. Inflammation of the vein and surrounding skin causes the symptoms similar to any other type of inflammation, for example,
Warfarin (Coumadin, Jantoven)
Warfarin (Coumadin, Janotven) is an anti-coagulation medication that acts as a Vitamin K antagonist, blocking blood clotting factors II, VII, IX and X. Historically, it was a first-line medication for treating blood clots, but its role has been diminished because of the availability of newer drugs. While warfarin may be prescribed immediately after the diagnosis of DVT, it takes up to a week or more for it to reach therapeutic levels in the blood so that the blood is appropriately thinned. Therefore, low molecular weight heparin (enoxaparin [Lovenox)] is administered at the same time. Enoxaparin thins the blood almost immediately and is used as a bridge therapy until the warfarin has taken effect. Enoxaparin injections can be given on an outpatient basis. For those patients who have contraindications to the use of enoxaparin (for example, kidney failure does not allow the drug to be appropriately metabolized), intravenous heparin can be used as the first step in association with warfarin. This requires admission to the hospital. The dosage of warfarin is monitored by blood tests measuring the prothrombin time (PT), or INR (international normalized ratio).
Does DVT require surgery?
Surgery is a rare option in treating large deep venous thrombosis of the leg in patients who cannot take blood thinners or who have developed recurrent blood clots while on anti-coagulant medications. The surgery is usually accompanied by placing an IVC (inferior vena cava) filter to prevent future clots from embolizing to the lung.Phlegmasia Cerulea Dolens describes a situation in which a blood clot forms in the iliac vein of the pelvis and the femoral vein of the leg, obstructing almost all blood return and compromising blood supply to the leg. In this case surgery may be considered to remove the clot, but the patient will also require anti-coagulant medications. Stents may also be required to keep a vein open and prevent clotting. May Thurner Syndrome, also known as iliac vein compression syndrome, is a cause of phlegmasia, in which the iliac vein in the pelvis is compressed and a stent is also needed.
How can blood clots in the legs be prevented?
What are the complications?
Pulmonary embolism is the major complication of deep vein thrombosis. With signs and symptoms such as chest pain and shortness of breath, it is a life-threatening condition. Most often pulmonary emboli arise from the legs.Post-phlebitic syndrome can occur after a deep vein thrombosis. The affected leg or arm can become chronically swollen and painful with skin color changes and ulcer formation around the foot and ankle.
What are the treatment guidelines for DVT?
The treatment for deep venous thrombosis is anticoagulation or "thinning the blood" with medications.The recommended length of treatment for an uncomplicated DVT is three months. Depending upon the patient's situation, underlying medical conditions and the reason for developing a blood clot, a longer duration of anticoagulation may be required. At three months, the doctor or other health care professional should evaluate the patient in regard to the potential for future blood clot formation. If the decision is made to continue anticoagulation over the long term, the risk/reward decision of preventing clots versus bleeding risk should occur every year to decide if anticoagulation is still a reasonable treatment.There are times when anticoagulation may have increased bleeding risk, for example, if the patient has had recent major surgery (anticoagulation thins all of the blood in the body not just the DVT). Other bleeding risks occur in patients with liver disease and those who take medications that can interact with the anticoagulation medicines.
What causes DVT?
Blood is meant to flow. If it becomes stagnant, there is a potential for it to clot. The blood in veins constantly forms microscopic clots that are routinely broken down by the body. If the balance of clot formation and clot breakdown is altered, significant clotting may occur. A thrombus can form if one or a combination of the following situations.Immobility
What does a blood clot in the leg look like?
Picture of how red blood cells and platelets form a blood clot
What is DVT?
A deep vein thrombosis, or DVT describes a blood clot (thrombosis) that forms in the deep veins located in the arm or leg. It is important to know the body's anatomy and function to understand why clots form in veins and why they can be dangerous.
What is the treatment of superficial blood clots?
Treatment for superficial thrombophlebitis treating the symptoms with:
What tests diagnose the condition?
The diagnosis of superficial thrombophlebitis usually is made by the doctor at the bedside of the patient, based upon history, potential risk factors present, and findings from the physical examination. Further risk stratification tools may include scoring systems that can help decide whether a DVT is likely.If the probability of a leg thrombosis is low, a D-dimer blood test may be ordered.
Which types of doctors treat DVT?
People with a swollen extremity or concern that a DVT exists may be cared for by a variety of health-care professionals. Both the primary care provider (including internal medicine and family medicine specialists) and a health care professional at in an urgent care (walk in) clinic or emergency department are able to recognize and diagnose the condition. Some people go to the hospital and the diagnosis is made there.Treatment is usually started by the doctor who makes the diagnosis, but long-term treatment decisions, risk stratification, and follow-up usually is be done by the person's primary care doctor. Depending upon the situation, a hematologist (specialist in blood disorders) may be consulted. If there is need for the clot to be removed or dissolved, an interventional radiologist may also be involved.Depending upon the medication used to anticoagulate the blood, pharmacists and anticoagulation nurses may also be involved on your treatment team.
Who is at risk?
There are a wide variety of people who are at risk for developing blood clots. Some risk factors include:
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