From the Guidelines
Thrombophlebitis is another term for phlebitis, which refers to inflamed veins, often associated with a blood clot in the vein. This condition can be categorized into superficial phlebitis, which affects veins near the skin surface, and deep vein thrombophlebitis (DVT), which affects deeper veins, typically in the legs, and poses greater health risks 1. The symptoms of phlebitis include pain, tenderness, redness, warmth, and swelling along the affected vein. According to the study published in the Mayo Clinic Proceedings 1, superficial phlebitis is common, with an incidence of approximately 125,000 annually, and most events can be treated conservatively without anticoagulant therapy owing to the low risk of PE (1.3%).
Some key points to consider in the management of phlebitis include:
- Assessing patients with iliac vein thrombosis for thrombolysis and mechanical thrombectomy candidacy 1
- Recommending prophylactic dose fondaparinux or LMWH for 45 days for superficial phlebitis exceeding 5 cm in length, with fondaparinux (2.5 mg daily) preferred to LMWH 1
- Using ultrasound imaging to confirm the diagnosis and exclude subclinical DVT 1
- Considering the use of anti-inflammatory medications, warm compresses, and elevation of the affected limb to reduce pain and inflammation, and improve circulation in the affected area.
From the Research
Definition and Terminology
- Another term for phlebitis (inflamed veins) is thrombophlebitis, which refers to a condition characterized by thrombotic inflammation of a previously healthy superficial vein 2.
- Thrombophlebitis can also be used to describe a minimally thrombotic process of superficial veins associated with inflammatory changes and/or infection 3.
- Phlebitis is sometimes referred to as superficial thrombophlebitis, which is a localized inflammatory condition of the venous vessels underlying the skin 4.
Related Conditions
- Phlebosclerosis is a frequent, age-dependent fibrotic degeneration of one or all three wall layers of the veins, which can impair venous function and contribute to the development of thrombosis 5.
- Phlebothrombosis represents a serious circulatory disorder that may be due to a variety of factors, including phlebitis 5.
- Varicophlebitis is a type of thrombophlebitis that occurs in varicosities and is responsible for the majority of thrombotic venous occlusions 2.
Clinical Presentation and Diagnosis
- The clinical presentation of thrombophlebitis includes a tender, hardened superficial vein, which may be very painful in the presence of inflammation 2.
- Differential diagnostic considerations include bacterial cellulitis and lymphangitis 2.
- A biopsy may be performed if the clinician suspects an underlying systemic disease, and the pathologist must be aware of the different types and their etiology 6.