Phlebitis means inflammation of the vein. It can affect the superficial veins or the deep veins. Thrombus means clot. Because thrombus is almost always associated with phlebitis, some doctors use the terms thrombosis, phlebitis, and thrombophlebitis interchangeably. If a clot is in a vein, it causes stretching and inflammation of the vein. If a clot is in one of the superficial veins it is called superficial thrombophlebitis and if a clot is in one of the deep veins it is called deep vein thrombosis (DVT).
Superficial thrombophlebitis (ST) often develops in a varicose vein where the blood flow has become sluggish. Although it can occur in people who have varicose veins, most people with varicose veins do not develop ST. There are a variety of causes for superficial thrombophlebitis and include trauma, intense exercises, prolonged sitting, associated medical or surgical diseases (e.g. genetic blood clotting disorders). The symptoms include a tender, cord-like vein that is sensitive to pressure, redness, and warmth in the area from the inflammation and swelling around the affected vein.
Even a slight injury can cause a varicose vein to become inflamed. This sudden inflammation causes a small clot to adhere to the vein wall. Unlike deep veins, the superficial veins do not have surrounding muscles to squeeze and dislodge the clot (thrombus). For this reason, ST rarely causes a life threatening blood clot, a sometimes serious condition when the clot is dislodged to other parts of the body.An ultrasound may be able to detect a clot in the vein. Treatment may include taking anti-inflammatory drugs such as aspirin or ibuprofen; warm, moist compresses to the area (be careful to avoid burning the skin); and elevation of the leg. Occasionally the clot may be removed with a simple in office procedure, using local anesthesia followed by wearing compression stockings. With proper treatment, ST usually resolves in one to two weeks. If you have varicose veins that predisposed you to ST, treating the varicose vein with e with endovenous laser or radiofrequency ablation can help prevent recurrent ST.
Deep vein thrombosis (DVT) occurs when a clot develops in a deep vein. Unlike ST, in deep veins little inflammation occurs with the clot formation. Therefore, the clot is less likely to adhere to the vein wall and more likely to break loose, travel downstream, become lodged in an artery, and block blood flow (an embolus) – which is a serious condition. In addition, deep veins are surrounded by muscles. The squeezing action of the muscle can cause the clot to break loose and become an embolus. Therefore, DVT can be a potentially serious situation. Because blood from the legs drains directly into the heart and lungs, an embolus from the legs could become a pulmonary embolism.
There are many causes of DVT: injury to the vein (which may occur during surgery), decreased blood flow, or a genetic tendency to form clots, certain medical conditions, certain medications, dehydration, prolonged bedrest, prolonged sitting, smoking and more.
Because DVT usually causes little inflammation, pain and redness over the skin are usually minimal. 50% of the people with DVT have no symptoms at all. However, when the DVT blocks a large leg vein, swelling may occur in the foot, calf, leg or thigh, depending on where the blockage occurs. The area may become painful, tender to the touch and warm.
DVT can be difficult for doctors to diagnose, but most often an ultrasound can frequently detect a clot. Treatment is aimed at preventing the clot from enlarging and from becoming an embolus. Occasionally people need to be hospitalized, but some can be treated at home. Swelling of the leg can be helped with bedrest, leg elevation and sometime compressions bandages. Medications to prevent clot formation and sometimes medications to dissolve the clot may also be used. In more complicated cases, filters may be placed inside the large veins to prevent the vein from dislodging to the heart or lungs.