Ascending thrombophlebitis of the great saphenous vein. Superficial thrombophlebitis of the lower extremities - symptoms and treatment of thrombosis of the great and small saphenous veins. The main causes of thrombophlebitis

Thrombophlebitis of the saphenous veins of the lower extremities or superficial thrombophlebitis is a disease in which blood clots appear in the lumen of the saphenous veins. Since the veins are located close to the skin, this phenomenon is accompanied by inflammation - redness of the skin, pain, local swelling.

In fact, saphenous vein thrombophlebitis is a “double” disease. Because, firstly, the venous walls themselves become inflamed. And secondly, a blood clot forms in the vein - a thrombus.

Superficial thrombophlebitis in the vast majority of cases manifests itself as an acute disease. More often, varicose-transformed tributaries of the great (and/or small) saphenous vein, as well as perforating veins, are thrombosed.

Important! If left untreated, thrombosis spreads to the largest (small) saphenous vein itself and further to the deep veins.

Causes of thrombophlebitis of superficial veins

The cause of any thrombosis is a combination of three factors:

change in the configuration of the vein (for example, varicose transformation) and, as a result, “swirling” of blood in the lumen of the vessel;
“thickening” of the blood – a tendency (hereditary or acquired) to thrombosis;
damage to the vein wall (injection, trauma, etc.).

The main and most common cause of superficial thrombophlebitis is considered to be varicose veins. Also, the most common risk factors are:

genetic predisposition;
pregnancy and childbirth;
obesity, physical inactivity;
endocrine and oncological diseases.

Superficial thrombophlebitis: symptoms and manifestations

In the initial stages, superficial thrombophlebitis of the lower extremities may not be very noticeable in its manifestations. Mild redness of the skin, burning, minor swelling - many patients simply do not pay attention to all this. But the clinical picture changes very quickly, and the signs of thrombophlebitis of the superficial veins become noticeable and very uncomfortable:

the appearance of “nodules” and compactions in the vein;
edema;
acute pain;
local increase in temperature;
change in skin color in the area of the inflamed vein.

Treatment of superficial thrombophlebitis

To treat thrombophlebitis of the superficial veins, different techniques and their combinations are used.

More often this may be conservative treatment:

compression therapy – wearing compression stockings, special elastic bandaging;
taking non-steroidal anti-inflammatory and painkillers;
locally, in the area of inflammation - cold;
according to indications - taking medications that “thin” the blood.

Emergency surgical treatment of acute thrombophlebitis of the saphenous veins is prescribed , as a rule, in cases where thrombosis does not affect the tributaries, but directly the large or small saphenous veins. Thus, with ascending thrombophlebitis of the great or small saphenous vein, the trunk of the main saphenous vein is thrombosed directly. When thrombosis of the great saphenous vein spreads to the thigh, thrombophlebitis is considered ascending. For the small saphenous vein, this is the middle and upper third of the leg.

In this case (if technically possible), either endovenous laser obliteration or crossectomy is used - ligation of the great (small) saphenous vein along with its tributaries.

If ascending thrombophlebitis has already led to the penetration of a blood clot into the deep veins, this is fraught with the occurrence of a pulmonary embolism - detachment of a blood clot and blockage of the pulmonary artery. This situation occurs when thrombosis spreads from the saphenous veins to the deep (“muscular”) veins.

In this situation (if technically possible), the blood clot is removed from the deep veins and crossectomy is performed - ligation of the saphenous vein at the mouth.

Many scientific works and encyclopedic data are devoted to the disease ascending thrombophlebitis. People want to know about the nature of the disease and methods of treatment.

Ascending thrombophlebitis is a lesion of the walls of blood vessels, where blood clots form, blocking the lumen in the arteries and vessels. More often, a disease that affects the veins in the legs or other parts of the body is a consequence of varicose veins. The diagnosis is established if the disease of the saphenous vein of the thigh or groin area is transformed from the pathology of the low-lying veins of the legs. When the disease passes from a small saphenous vein to large vessels, there is a risk of a blood clot breaking off and moving, which provokes a pulmonary embolism. This development option ends in death.

Symptoms of the disease are often clearly presented and do not cause difficulties in diagnosis.

Common symptoms:

The constant presence of a feeling of fullness in the thigh, lower leg;
Feeling of heaviness;
The skin along the length of the affected leg vein is red and inflamed;
Pain in the lower leg, thigh, worsens with movement;
Weakness, constant feeling of malaise;
Increase in temperature.

The clinical picture is determined by the condition of the saphenous vein, the location of blood clots, their number, and mobility. Importance is given to inflammation in the tissues of the lower extremities located near the damaged vein. Based on the symptoms and these factors, the disease is divided into types and forms. Ascending thrombophlebitis is often clearly presented along the vein and can appear in small areas. A disease that develops in the great saphenous vein is considered dangerous. There is a high probability of a blood clot moving into a deep vessel, for example, in the thigh area. There is a risk of pulmonary embolism.

With such vascular damage, swelling of the lower extremities rarely appears. To the touch, an infiltrate is felt along the affected area, resembling a dense cord, creating pain. When diagnosing, it is important to determine the presence of a blood clot in a vein and its exact location.

The disease is life-threatening, so it is important to seek medical help from a phlebologist in a timely manner. They will help cope with the disease and prevent complications in time.

Acute form of leakage

Acute ascending thrombophlebitis is a complex consequence of varicose veins. This form of the disease carries a risk of death - it is observed in the vein, the disease from the small saphenous vein quickly moves to the deep vein of the thigh. This threatens to damage the pulmonary artery.

Signs of an acute form of ascending thrombophlebitis:

Symptoms, inflammation of the veins - swelling, redness, pain, hyperemia, lymphangitis, infiltrates of the affected veins of the lower extremities.
Constant weakness, frequent feeling of malaise.
Near the affected vein, the presence of infiltrate in the form of a cord is felt.
Increased body temperature.

Risk group

There are people prone to developing ascending lower limbs. They have a high risk of developing the disease.

People who sit most of the time.
People who are forced to lie in bed for a long time after surgery.
People with varicose veins.
People suffering from hyperhomocystoinemia, antiphospholipid syndrome.
Pregnant women, especially during childbirth.
Overweight people.
Elderly people who prefer a sedentary lifestyle.

If a person finds himself on the list, he should pay close attention to the condition of his veins and make adjustments to his lifestyle.

Basic principles of treatment

At the first manifestations of ascending thrombophlebitis of the saphenous vein, you should contact a medical institution - doctors will diagnose and prescribe treatment. The fight against the disease is carried out:

In a conservative way;
Surgical intervention.

Sometimes complex treatment of thrombophlebitis of the veins of the lower extremities is advisable.

Basic principles of therapy

The only way to radically combat the disease is surgery. Thanks to the operation, it is possible to stop the development of the disease and prevent relapses. For pathology of permanent veins of the lower extremities, conservative treatment is effective. If the great or small saphenous vein is damaged, an operation is prescribed, performed as quickly as possible. The goal is to stop the spread of the lesion to the deep veins, in particular the thighs.

Treatment of ascending thrombophlebitis is complex.

After diagnosing the disease, the patient is placed in a hospital with bed rest.
Legs in a constant elevated state.
An elastic bandage is used to secure the blood clot.
Anticoagulants and phlebotonics are prescribed.
A course of anti-inflammatory drug therapy is prescribed.
Local therapy is carried out using ointments and gels with heparin.
Sometimes treatment includes a course of UHF therapy.

In case of pathology of the great saphenous vein, when the clot is located above the middle of the thigh, or in case of damage to the small saphenous vein, treatment in the form of surgery is prescribed.

Treatment of acute forms of the disease

The following factors influence the treatment of the acute form of the disease:

Condition of the vessels of the lower extremities;
Location of the thrombus;
Location of affected veins.

Conservative treatment with medication and local therapy is often used, often in a hospital.

Local therapy includes:

Use of ointments with heparin.
Semi-alcohol, cold compresses.
Fixation with an elastic bandage.
Taking medications that stabilize blood circulation.
Taking inhibitors.
Painkillers.

After relief of the acute form of inflammation, treatment continues using physiotherapy. UHF therapy, treatment with a Sollux lamp, diametric current therapy, and iontophoresis with heparin are used. In the first two months after therapy, fixation of the lower extremities in the area of the affected vein with an elastic bandage and administration of phlebodynamic medications are prescribed.

The operation is performed in the following cases:

Dissolution of the thrombus.
Risk of developing pulmonary embolism.
Damage to the acute form of the great, small saphenous vein, with the thrombus located above the middle of the thigh.

To remove a thrombus, laser obliteration is often used, based on heating the vessel wall above the location of the thrombus. A crossectomy operation is performed - ligation of the superficial vessel at the point of transition to the deep one, carried out under local anesthesia.

Preventive actions

People at risk of developing ascending thrombophlebitis should listen to the recommendations of a phlebologist:

Lead an active life.
Regularly perform a set of exercises for the lower extremities, which are preventive measures for the development of venous disease.
Walk more.
Maintain vascular tone - drink vitamin drinks, for example, cranberry juice, St. John's wort tincture.
Do not stand in one position for a long time.
Do not get carried away with baths and saunas.
Do not expose the body to dehydration.
Choose comfortable shoes, without high heels.
Use orthopedic insoles.
Organize your rest in a lying position, with your legs slightly elevated.
Wear compression garments.

When thrombosis occurs, the vein becomes blocked and blood flow becomes obstructed. Thrombosis of the great saphenous vein most often occurs due to damage to the venous wall. The most difficult and dangerous option in terms of the development of complications is considered to be acute ascending thrombophlebitis of the great saphenous vein. There are three options for the course of events with blood clots:

possible blockage of the vessel and disruption of blood circulation;
can break off and pass with blood to other organs;
may resolve.

The disease requires immediate treatment under regular supervision of a specialist.

In Europeans, thrombosis of the saphenous veins of the lower extremities occurs much more often than in Asians. After forty years, this disease is observed in every fifth woman and every fourth man. In obese people, the risk of thrombophlebitis is significantly higher.

Thrombophlebitis of the saphenous veins - treatment is prescribed only by a phlebologist based on the individual characteristics of the patient. If thrombophlebitis appears at the level of the lower leg, then treatment can occur at home under the supervision of a doctor. If ascending thrombophlebitis occurs, treatment is carried out strictly in a hospital; thrombosis in this case can create serious risks to life.

During the examination, the doctor compares the two limbs completely and, if necessary, measures the inflamed leg in diameter. The doctor also evaluates the skin, swelling and pain. An ultrasound scan of the leg veins is required.

Using elastic compression garments;
To reduce pain, the doctor may prescribe ice compresses (apply for 20 minutes throughout the day);
Use of antigulant therapy: nadroparin, enoxaparin;
Non-steroidal anti-inflammatory drugs: Diclofenac, ketoprofen;
Angioprotectors – improve the condition of the venous wall: rutoside, diosmin;
Antibiotics;
Antiplatelet drugs: Dipyridamole, acetyl acid;
Blood thinning drugs: Fragmin, Phlebodia;
The use of ointments containing heparin, which has an anti-inflammatory effect and relieves swelling: heparin ointment, ketonal 5%, lyoton gel and others;
Physiotherapy: ultraviolet radiation, infrared radiation, electrophoresis, magnetic therapy, laser therapy, DArsonval, barotherapy.

My patients used a proven remedy that allows them to get rid of varicose veins in 2 weeks without much effort. If conservative therapy is unsuccessful, the doctor may prescribe surgery. The essence of this operation is to prevent blood from moving from deep to superficial. The veins located below the knee are ligated. Surgery is safe and is most often performed under local anesthesia.

There are several types of surgical intervention:

Venectomy – removal of a vein;
Removal of thrombosed vein nodes;
Thrombectomy;
Crossectomy – ligation of the great saphenous vein;
Removal of the trunk of the great saphenous vein using a Babcock probe.

Causes

Thrombophlebitis of the great saphenous vein is formed due to inflammation of the vein. Also the reasons for the occurrence:

Deep vein thrombosis;
Heredity;
Varicose veins;
Tuberculosis;
Cancerous formations;
Change in blood, stagnation;
Antiphospholipid syndrome;
Obesity;
Surgical interventions;
Pregnancy;
Administration of drugs intravenously;
Sedentary work, passive lifestyle.

There are three main causes of venous thrombosis, and they are called “Virchow’s triad”:

increased blood clotting;
violation of the integrity of the walls;
slow blood flow in the vessels.

Contribute to the implementation of Virchow's triad:

inactivity (long flights, bed rest, office work, long hours of driving),
high body weight,
surgeries, fractures,
varicose veins of the extremities,
smoking,
taking medications that thicken the blood,
pregnancy,
oncological diseases,
hormonal disorders
infections
heavy physical activity.

When certain conditions occur, the disease thrombophlebitis can be localized in veins throughout the body, but most often in the legs.

People who overload the body with physical activity every day are at risk of injury. This can occur during sports training, work that requires significant effort, and so on. But this does not mean that the disease only affects active people. There are many reasons that lead to the development of the disease.

Advanced thrombophlebitis

According to statistics, in 15% of cases, thrombophlebitis affects veins that are located in the depths.

There are some factors that provoke the development of thrombophlebitis:

changes in the properties and composition of blood, increased clotting,
slow blood flow.
injury to the venous wall of blood vessels.

A danger to human health arises when:

varicose veins and complications;
purulent processes on the skin;
diseases of the heart and blood vessels in acute and chronic form;
blood diseases;
period after surgery;
period after childbirth;
all types of leg injuries;
low-quality tumors;
when the catheter is in the vein for a long time;
infectious diseases.

What exactly leads to thromboembolic complications?

Venous thrombosis occurs when a number of unfavorable circumstances coincide, which lead to a slowdown in blood flow through the veins of the legs, increased blood clotting and damage (often microscopic) to the venous wall. The speed of blood flow through the veins slows down sharply when people's mobility is limited due to bed rest, long air travel, or when driving in a car.

The coagulation potential of the blood increases in response to injury, bleeding, surgery, infection, dehydration, the development of malignant neoplasms, and uncontrolled use of female sex hormones for contraception or for the purpose of replacement. The genetic predisposition of a number of people is also important - the presence of so-called congenital thrombophilias.

What is the catalyst for the development of thrombosis?

Such a “catalyst” is often various injuries, surgical operations and, unfortunately, even childbirth.

What measures should a doctor take to minimize the risk of venous thrombosis?

Firstly, it is important to reduce the patient’s compliance with bed rest to a minimum; it is advisable to activate the patient within the next few hours after surgery. Secondly, reducing the duration and morbidity of surgical intervention, including with the help of new technologies, are important components of preventing thrombotic complications.

As one of the methods to combat mortality from thromboembolism, in 2009 the Russian Society of Surgeons, the Association of Phlebologists of Russia and the Research Institute of Preventive Medicine developed a nationwide educational medical and social project “Territory of Safety”. The goal of the project is to reduce patient mortality from venous thromboembolic complications (VTEC).

As part of the project, doctors assessed the risk of these complications using electronic assessment sheets for all hospital patients and prescribed, where necessary, effective preventive measures that made it possible to reduce the in-hospital mortality rate from thromboembolism by 10 times in hospitals that took part in the project over 5 years.

As already mentioned, a favorable condition for the development of thrombophlebitis is varicose veins of the legs. In this case, there is stagnation of blood in the veins, weakness of the venous walls, venous insufficiency, increased venous pressure and deformation of the venous walls. All of these factors are enough for any infection to penetrate the vessel wall and cause inflammation.

Reduced immunity, thickening of the blood caused by illness or medication also facilitate the establishment of infectious pathogens on the vascular wall.

Thrombophlebitis can be triggered by injury to the venous wall, a medical procedure (intravenous injection, catheterization of a vein, vascular surgery, etc.), an infectious disease, for example, influenza, ARVI, pneumonia, tonsillitis, tuberculosis and even caries.

Superficial vein thrombosis of the lower extremities: symptoms, treatment

Ascending thrombophlebitis is diagnosed in situations where thrombophlebitis from part of the great saphenous vein of the leg moves to the area of the inguinal folds.

Ascending thrombophlebitis of the great saphenous vein can be complicated by the acute form of the disease. When inflammation of the deep veins occurs, there is a huge risk of blood clot rupture. The worst outcome is inflammation of the pulmonary artery.

The most common form of the disease is superficial vein thrombosis; as a rule, the vessels of the legs are affected. The reason is that the veins in this area experience the greatest load - this is the most distant part of the riverbed, and the veins have difficulty pumping blood from bottom to top. Varicose changes, if any, are more pronounced on the legs.

Thrombosis of the saphenous veins is much easier to detect than deep veins. When a blood clot forms

the vein becomes dense and painful to the touch,
redness of the skin in the affected area is visually observed,
local temperature rises,
the limb swells slightly below the location of the blood clot.

Treatment of superficial thrombosis is usually conservative, unless there is a risk of thrombosis spreading to the deep vein system.

Fixation of a blood clot. If it is possible to diagnose thrombosis in the acute period, there is a danger of fragmentation of the blood clot and removal of pieces of the clot with the blood flow to the heart. Therefore, bed rest is prescribed for a week, complete rest of the affected limb, and local use of anti-inflammatory and absorbable ointments.
Fighting the inflammatory process. Non-steroidal anti-inflammatory drugs and drugs to normalize metabolic processes are prescribed - troxevasin, aescusan, ascorutin.
Prevents thrombus formation. Aspirin is used as a disaggregant.

In the future, the motor regime is gradually expanded, carrying out mandatory compression of the saphenous veins using special stockings or elastic bandages. Surgical removal of varicose veins is recommended after 2-3 months. after thrombosis.

Superficial thrombi, which are dangerous in terms of complications, are located in the thigh area in the great saphenous vein and in the popliteal region in the small saphenous vein. These cases are subject to surgical treatment - either the blood clot is removed or the mouth of the saphenous vein is ligated where it flows into the deep vein.

How does thrombophlebitis manifest? Symptoms of thrombophlebitis

Thrombophlebitis begins with pain in the legs. The intensity of the pain may or may not be very strong, but in any case it intensifies when walking. Patients note soreness of the skin along the saphenous veins when touched.

You can see that the skin over the inflamed veins has turned red. Over time, this redness gives way to a bluish tint, and then the skin turns brown. The temperature of the skin area above the inflamed vein is higher than in other areas.

The skin over the veins, in which blood clots appear, thickens and a painful cord can be felt along the vessels. It should be noted that the apex of the blood clots is most often located 15-20 cm above the area of visible redness and cord.

There is often an increase in body temperature, but after about a week or less the temperature returns to normal. Sometimes there may not be an increase in body temperature with thrombophlebitis.

A slight swelling of the leg develops, on which the veins are inflamed.

The biggest nuisance is the spread of inflammation to the deep veins, thrombosis of which is fraught with serious complications.

What could be the complications of thrombophlebitis on the legs?

We have explained what thrombophlebitis is, but why is it dangerous?

Modern medical practice speaks of the danger and unpredictability of this disease, which manifests itself through:

Postthrombophlebitic syndrome, manifested by venous insufficiency, and leads to the formation of ulcers. This complication occurs in 70% of cases. This condition occurs with: prolonged swelling of the extremities due to damage to the deep veins, damage to the valves in the veins, and impaired blood flow.
Blood clot detachment. Blood clots are weakly attached to the walls of blood vessels, which can lead to their rupture. This condition is very dangerous. The blood clot travels with the bloodstream and can lead to blockage of the pulmonary artery (pulmonary embolism). This leads to sudden death, pneumonia, and heart failure.
Blood poisoning is a very rare complication. Occurs when a secondary infection occurs. People with weakened immune systems are at risk, most often these are people suffering from diabetes and cancer.
The appearance of cellulitis or abscess. This complication most often results from improper treatment or the use of traditional methods.

Venous thrombosis (phlebothrombosis) is a condition when the lumen of a vein is filled with blood clots that interfere with blood flow. Often phlebothrombosis is accompanied by inflammatory phenomena of the venous walls, then they speak of thrombophlebitis.

The favorite localization of venous thrombi is the lower extremities:

superficial network of veins, especially varicose veins;
deep veins.

Thrombosis is classified according to the location of the blood clot inside the vessel.

parietal - the thrombus is located near the wall of the vein, blocking the lumen only partially;
occlusive - blocks blood flow, occupying the entire lumen of the vessel;
floating – part of an extended thrombus is fixed to the wall of the vein, the other part fluctuates in the bloodstream;
mixed - can spread - grow both from bottom to top and in the opposite direction;
multifocal - multiple blood clots form throughout the venous system.

The danger of venous thrombosis is that 80% of its cases develop gradually and secretly. It is often diagnosed when life-threatening complications develop.

Thromboembolism

Complete or partial detachment of a blood clot from the venous wall and its removal by the blood flow to the heart and further into the pulmonary artery. Blockage of its small branches by a thrombus leads to the death of part of the lung, inflammation of the lung, and blockage of the main trunk often ends in the sudden death of the patient.

Blocking the venous outflow causes circulatory disorders in the area below the thrombus, the development of inflammatory and degenerative changes in the veins, skin and surrounding tissues. Trophic ulcers appear and gangrene may develop. The higher the level of thrombosis, the more serious the changes in the distal part of the limb.

Thrombosis at the level of the iliac arteries can lead to severe circulatory disorders not only in the veins, but also in the arteries - due to the increase in edema, they spasm and are compressed.

Thrombosis of deep veins to the level of the iliac veins is the cause of white phlegmasia of the extremities, and if thrombosis of the superficial veins is added - blue phlegmasia, which can lead to death, gangrene or amputation of the leg.

The most dangerous complication of thrombophlebitis occurs when the thrombus is not firmly attached to the vascular wall and its tip floats in the lumen of the vein. In this case, they say that the top of the thrombus floats. At some point, part of such a blood clot may break off, travel through the bloodstream into the heart and cause an embolism (blockage) of the pulmonary artery.

Sepsis (blood poisoning) is an equally serious condition, which quite often ends in death.

If thrombophlebitis is not treated or treated inadequately, for example, when self-medicating only with folk remedies, then the inflammation can move to the surrounding tissues and become purulent - an abscess or phlegmon of the leg tissue develops.

First, let's figure out how varicose veins and thrombophlebitis are related to each other. Formally, we are talking about two different ailments. In practice, thrombophlebitis of the deep veins of the lower extremities in many cases turns out to be a logical development of varicose veins. The deformation of the veins that accompanies it creates conditions suitable for the settling of infectious agents (their source can be any purulent process in the body). In addition, injuries to the lower extremities and increased blood clotting can lead to the development of thrombophlebitis.

The impact of an infectious agent on the vessel wall causes inflammation and, over time, the formation of a blood clot. Under certain conditions, it can break off and begin to gradually move along the bloodstream until it reaches the heart. The situation is fraught with blockage of the pulmonary artery, and this leads to a heart attack or even instant death.

Thrombophlebitis usually affects the superficial veins. This course of the disease is considered the most favorable, since these vessels account for only 10% of the blood flow in the legs. Thrombosis in the deep veins is much more dangerous, and if such a development of events looks real, the patient is immediately referred for surgery.

Possible complications of thrombophlebitis include:

formation of trophic ulcers, which can be a source of constant bleeding;
sepsis, that is, general blood poisoning, and gangrene;
spread of the inflammatory process to neighboring tissues.

From the data presented, it becomes obvious that thrombophlebitis requires immediate treatment. To see a doctor promptly, it is important not to ignore any of the symptoms. Among them:

aching pain in the legs;
persistent swelling of the lower extremities;
prominence of veins;
change in skin tone to reddish or even bluish;
a slight increase in temperature that goes away without any treatment.

Today it is quite possible to defeat thrombophlebitis, provided that the fight against the disease begins in a timely manner. Therapy is complex. It is based on the patient taking drugs that have an anti-inflammatory and thrombolytic effect, as well as promoting blood thinning.

Only in cases where the patient’s life is in real danger is surgical intervention resorted to. One of the 100% indications for surgery is the presence of a so-called floating thrombus. In other circumstances, conservative treatment is often sufficient.

Hello, Elena Olegovna!

1. Acute occlusive thrombosis of the superficial femoral vein to the mouth of the deep femoral vein - is this generally considered a large thrombus or a small one? I just looked at these veins in a picture on the Internet, but I still didn’t understand.

2. There is a possibility that in my case there will be no consequences after undergoing thrombosis, taking into account the fact that my leg did not turn red (did not change color at all, it was the usual color), the veins did not swell, there were no varicose veins - that this thrombosis will pass without a trace ? My leg was just swollen and painful. When I left the hospital and to this day there is no swelling at all and my leg doesn’t hurt.

3.Is there a chance of recurrent thrombosis if I take warfarin constantly?

5.Can I drink alcohol while taking warfarin? (I have a wedding in January)

Thanks for the answer.

Good luck to you!

Irina, Moscow, 29 years old

Hello Irina.

1. Your blood clot is dangerous, since it is located high (in the femoral vein). But big or small, it doesn’t matter.

2. This possibility exists due to the fact that you were prescribed treatment on time. However, the consequences of thrombosis in the veins remain extremely rare.

3. There is a danger of repeated thrombosis; with warfarin (if you take it in the correct dose - that is, your INR is in the range from 2 to 3) the danger is reduced.

4. Standard terms are really 3-6 months. Testing for genetic thrombophilia can help determine the timing.

5. While taking warfarin, drinking alcohol may weaken the effect of the drug. By January, your 3 months will already be over, as I understand it.

Contact a hemostasiologist in person to determine the timing of taking warfarin and testing for thrombophilia. You can stop warfarin immediately. Before canceling, you need to get tested for D-dimer. If it is not increased, you can cancel it calmly.

Good luck to you too.

Sincerely, Belyanina Elena Olegovna.

Circulatory disorders due to venous pathology are quite common. Research shows that approximately a quarter of the world's population is at risk of venous thrombosis. Some cases pass without a trace and are asymptomatic, but in other situations, blood clots significantly disrupt blood flow and can lead to dangerous complications.

Thromboembolism

Thrombophlebitis is an inflammatory process of the venous wall, leading to the formation of a blood clot. During the development of the pathological process, the integrity of the venous wall is disrupted, as a result of which the lumen of the vein is blocked by a blood clot.

Thrombophlebitis is a rather dangerous disease, especially in the acute stage, when there is a high probability of a blood clot breaking off and developing dangerous complications such as myocardial infarction or pulmonary embolism. Below we will talk about the dangers of thrombophlebitis of the lower extremities in more detail.

Signs and treatment

Acute thrombophlebitis of the saphenous veins develops suddenly due to sudden blood clotting. The reasons can be very different - infection, injury, pregnancy and others. Signs of acute ascending thrombophlebitis:

Varicose veins become painful and dense;
The leg swells and increases in size;
Sharp pain may occur when walking;
Chills and fever appear;
General weakness persists;
Lymph nodes enlarge.

With ascending thrombophlebitis of the saphenous vein, there may be no edema. Most often, heaviness is felt when palpating the inflamed vein, and the skin has a reddish tint. There is a feeling of heaviness in the lower leg. However, with the acute form of the disease and further spread of the disease, damage occurs:

Great saphenous vein;
Common femoral vein;
Sapheno-femoral anastomosis.

How to provide first aid? What to do and what not to do

If symptoms of acute thrombophlebitis appear, the first thing to do is call a doctor. Then you should lie down in bed and elevate the sore leg by placing a pillow under it.

Under no circumstances should you perform any mechanical manipulations on the sore area - do not massage, do not rub in ointments and creams, even if you think they are very useful. This treatment will not make you feel better, and the risk of a blood clot breaking off increases significantly.

It is better to wait with folk remedies and start using them only when there is a positive effect from the main treatment prescribed and supervised by a doctor.

How to recognize thrombophlebitis? Diagnostic methods

Since only half of venous thrombosis gives the classic picture of the disease with swelling and pain, patients at risk should be very attentive to any manifestations of ill-health and discomfort in the legs:

pain in the lower leg muscles, aggravated by palpation and movement;
increasing swelling;
heaviness in the limbs, feeling of fullness;
local or general increase in temperature.

To make sure that minor symptoms do not hide a dangerous disease, you need to consult a doctor.

The doctor will conduct an examination and prescribe an examination to reliably identify the presence of thrombosis.

Duplex scanning. Ultrasound examination with color mapping of blood flow is most informative for identifying thrombosis. Allows you to determine the size, structure, and presence of a floating thrombus.
X-ray contrast venography. A study in addition to duplex scanning if the thrombus is located in a place difficult to reach for ultrasound - above the inguinal fold. X-ray with contrast reveals the location of the thrombus, its extent, and the condition of the venous wall.
Tomography. Computed tomography or magnetic resonance imaging more accurately shows the location, structure of the blood clot and the degree of blockage of blood flow.
Laboratory diagnostics. In the presence of thrombosis, fibrin breakdown products appear in the blood - D-dimers.

To make a diagnosis, doctors use data obtained during the examination of the patient, and the results of laboratory tests and instrumental diagnostics.

The most informative are instrumental techniques, including:

Ultrasonography. Ultrasound allows you to find out the location of the blood clot, its size, and the degree of blockage of blood flow. Using ultrasound, you can reliably study the condition of the venous valves.
Phlebography. The technique allows you to detect blood clots in the saphenous veins.
Radionuclide research. A radioactive substance is used and injected into a vein. Radionuclide diagnostics makes it possible to detect a blood clot and assess the nature of damage to the veins.
Magnetic resonance phlebography. The technique is expensive, but allows you to most accurately determine the degree of damage to the veins, including deep ones.
Impedance plethysmography. Using this type of study, the nature of the filling of the veins with blood is determined.

Thrombophlebitis is treated using conservative or surgical methods. The choice of a specific treatment method depends on the stage of the pathological process and the general condition of the patient.

Thrombophlebitis takes a long time to treat - at least six months. The patient is prescribed medication (heparin injections). The course of treatment with heparin is 10 days or more. The patient is prescribed thrombolytic and anti-inflammatory drugs.

If thrombophlebitis is severe, the patient is prescribed bed rest for the first week. When the acute stage of thrombophlebitis subsides, the doctor prescribes the patient a course of therapeutic exercises.

There are four types of surgical intervention for thrombophlebitis:

Fogarty catheter. During surgery, a probe is inserted into the veins to remove the clot. The method is used at the initial stage of thrombophlebitis (up to 5 days from the moment of exacerbation of the disease).
Installation of a vena cava filter in the inferior vena cava. The filter is designed in such a way that it does not allow the blood clot to move through the veins.
Plication. The task of plication is to stitch the vein with special metal staples.
Thrombectomy. The most common method of surgical treatment of thrombophlebitis. During the operation, the clot is removed from the vein. In order to prescribe the operation, a mandatory condition must be met - the blood clot occurred no later than 7 days ago. If the thrombus is older, deformations have already occurred on the vein walls and venous valves, which will greatly reduce the effectiveness of the operation.

The main purpose of instrumental diagnostic studies for thrombophlebitis is to establish the nature and level of location of blood clots. For this purpose, the following are used: rheovasography, Doppler ultrasound, X-ray contrast venography.

Prevention of thrombosis

The main goal of preventing thrombophlebitis is timely and adequate treatment of exacerbations in the chronic form of the disease. Acute forms of thrombophlebitis must be detected promptly and treated without delay.

You should not start treatment for varicose veins of the legs; you should promptly identify and eliminate foci of infection in the body, for example, foci with suppuration, sinusitis, tonsillitis, caries.

If treatment with intravenous infusions is necessary, it is necessary to make injections into different veins so that the damage has time to heal.

An active lifestyle, proper nutrition, and giving up bad habits are also important components in the prevention of thrombophlebitis.

If you suffer from varicose veins, it is recommended to sleep with your legs elevated. Waking up in the morning, without getting out of bed, you need to perform several swings of your legs alternately up and down and in a “scissors” manner. Without lowering your legs, form a bandage from elastic bandages, or pull on medical knitwear.

Thrombophlebitis is an insidious and dangerous disease that requires immediate treatment.

Preventive measures are as follows:

wearing special elastic underwear.
physiotherapy.
taking medications that reduce the likelihood of blood clots.
limited consumption of fried and salty foods.
eliminating bad habits.

To avoid thrombosis, you must initially adhere to simple rules:

To live an active lifestyle;
Drink at least 2 liters of clean water per day;
To refuse from bad habits;
Establish proper nutrition (eat more garlic and onions);
Monitor your weight;
At night, keep your legs elevated for better blood flow;
If varicose veins appear, lubricate your legs with heparin ointment;
When working sedentarily, do exercises and warm up for at least 15 minutes.

A proven method of treating varicose veins at home in 14 days!

Preventive measures for thrombosis include compliance with the following recommendations:

Wearing compression stockings. Special shapewear allows you to improve blood flow in the affected veins. The degree of compression is determined by the attending physician.
If there is no risk of blood clot detachment, the patient is prescribed therapeutic exercises or other types of moderate physical activity (walking, swimming).
Taking medications that reduce the intensity of blood clots in the veins.
Special diet (similar to the diet for varicose veins). Salt intake should be limited and fatty foods should be avoided. The diet should contain a sufficient amount of foods rich in salicylates (raisins, garlic, ginger, etc.).
Quitting bad habits, including smoking and drinking alcohol.

Complications of thrombophlebitis are extremely dangerous for the patient’s health. It is recommended to conduct regular examinations of the condition of the veins, and if the first signs of complications are detected, immediately seek medical help.

Life with thrombophlebitis

Physical activity during thrombophlebitis is of great importance, since it prevents blood stagnation and reduces the likelihood of blood clots.

If thrombophlebitis has spread to the deep veins, then you will have to limit yourself in movement, since even minor physical activity can cause a blood clot to break off.

Nutrition for thrombophlebitis is also important. Animal fats will have to be limited and preference given to vegetable oils. To strengthen the walls of blood vessels and make the blood more fluid, you should add to your diet vegetables and berries rich in vitamin C and rutin, for example: rose hips, sea buckthorn, chokeberries, black currants, sweet peppers, dill, parsley, Brussels sprouts.

Deep vein thrombosis of the lower extremities: symptoms, treatment

A blood clot located near the wall may not manifest itself in any way and may be diagnosed simultaneously during another examination. If a thrombus has blocked the lumen of a large vein, then the disease is characterized

the appearance of sharp pain, heaviness and distension in the affected limb;
swelling of the limb - the skin is stretched, shiny, warmer to the touch, visually the color of the skin is cyanotic;
when the swelling becomes less intense, dilated compensatory saphenous veins appear.

If thrombosis has affected the iliac veins, pain appears in the groin and pelvic area. In this case, the legs become very swollen and gangrene may develop.

Treatment tactics depend on the severity of the process, the embologenicity of the thrombus, its location and tendency to spread.

Fresh thrombotic deposits with a floating part and blood clots prone to upward spread are subject to surgical treatment. In this case, the blood clot is removed, the vessel is sutured with paper clips, or an umbrella filter is placed in a large vein.

Conservative therapy, as in the case of superficial thrombosis, involves

fixation of the blood clot - initially, complete rest of the affected limb is created - for at least 2 weeks, so that the blood clot attaches to the wall of the vein;
dissolving thrombotic masses, preventing further thrombus formation - in case of acute thrombosis, thrombolytics, fibrinolysin with heparin, and other anticoagulants are administered; later they are not used so as not to destroy the thickened thrombus;
elimination of inflammation.

Treatment of thrombosis of the veins of the lower extremities is not a short-lived process. It is important to follow the treatment regimen and not stop it as soon as the pain subsides and the swelling goes away. It is necessary to ensure that there are no conditions for blood stagnation in the vessels, so in the future you will have to wear compression stockings and monitor blood clotting.

Clinical picture

Thrombophlebitis is divided into three forms:

Acute (purulent and non-purulent) - the stage lasts 2 weeks.
Subacute - develops from 2 to 8 weeks.
Chronic - enters this stage after 2 months from the onset of the disease.

The acute stage of thrombophlebitis is characterized by an increase in subfebrile temperature. At the same time, a pain syndrome occurs in the vein area, especially aggravated by physical activity. Swelling begins on the affected limb. The skin along the veins becomes thick and painful, and signs of cyanosis appear.

Acute thrombophlebitis can also take a purulent form. This nature of the course of thrombophlebitis is very dangerous, since the pathological process affects not only the veins, but also nearby tissues. The result is septicopyemia.

Thrombophlebitis is classified according to the localization of the process:

skin (manifestation of pathology in the form of dermatitis, eczema or trophic ulcers);
subcutaneous tissue or in the form of phlegmons and abscesses;
blood vessels (the process leads to damage not only to superficial, but also to deep veins);
lymphatic system;
peripheral system (with such localization, ischemic neuritis is possible).

The following factors lead to thrombophlebitis:

Traumatic damage to the venous wall.
Impaired or slow blood flow. Disorders can be caused by insufficient motor activity, prolonged compression of the veins of the lower limb (for example, due to wearing a cast). Improper circulation occurs as a result of heart failure, when the heart does not pump enough blood. With impaired and slow blood flow in the lower extremities, stagnation occurs.
High blood clotting. The reason most often lies in genetic predisposition. However, other factors may also influence, including cancer and infectious diseases. Some medications can thicken the blood.

In addition to direct ones, there are also indirect reasons that contribute to the development of thrombophlebitis:

age factor (people over 45 years of age are more often susceptible to this pathology);
diseases of the cardiovascular system;
excessive body weight;
diabetes;
pregnancy (hormonal changes combined with excess weight).

The following symptoms correspond to the acute and subacute stages of thrombophlebitis:

rapid development of symptoms without any obvious reason;
increased body temperature;
pain syndrome (acute bursting pain);
severe swelling of the lower limb (may reach the groin area);
feeling of heaviness in the legs;
when palpating the leg, an increased local temperature is felt;
pain increases with physical activity;
palpation causes increased pain;
the skin becomes bluish, and if the thrombus covers the femoral or iliac vein, it becomes blackish;
cyanosis (when a blood clot moves up the lower limb).

Severe thrombophlebitis is characterized by the appearance of blisters with hemorrhagic filling. This complication can lead to venous obstruction and gangrene.

Note! If the pelvic vein is blocked, swelling and cyanosis can spread to the healthy leg.

Chronic thrombophlebitis is characterized by a calmer course. Periods of exacerbation of the disease are followed by remission. When the exacerbation returns, the symptoms of the disease in the chronic phase become the same as in the acute stage. During the period of remission of thrombophlebitis, symptoms may practically not manifest themselves at all.

What is the danger of blood clots?

In the story about the dangers of thrombophlebitis, we should focus on three factors that have a particularly strong impact on the state of the venous system:

Poor blood flow. Slow blood circulation has a particularly adverse effect during pregnancy, fractures, and in people suffering from cardiovascular diseases.
Increased blood viscosity. This factor leads to the formation of blood clots. Bedridden patients with cancer are at greatest risk.
Increased venous trauma. In pregnant women, this can lead to bleeding during childbirth and gynecological procedures.

Below we will talk about the main complications that can develop as a result of thrombophlebitis.

Bleeding

Typically, bleeding from thrombophlebitis is localized in the lower leg area. The intensity of blood loss may vary, but with the body in an upright position, bleeding will always be more profuse.

If there is bleeding, the patient is transferred to a horizontal position. The problematic limb is placed on an elevation, after which a bandage is applied. After this, you need to call an ambulance to take the patient to the inpatient department of the hospital.

Sometimes bleeding in small superficial veins is practically not felt by the patient for a long time, but subcutaneous hematomas indicate damage to the veins. As a rule, such bruises are very pronounced.

If the bleeding affects the deep veins, the patient's condition inevitably worsens, since blood loss is more significant. In this case, the patient needs emergency help, otherwise his life is at risk.

Thromboembolism

This complication is the most undesirable and the most dangerous. Thromboembolism is the detachment of a blood clot with further blocking of blood flow in the pulmonary artery. The result of embolism is myocardial infarction, venous insufficiency, or even death for the patient.

The size of the detached blood clot has a decisive influence. If we are talking about a large blood clot, most patients die within the first 30 minutes. As a rule, in this case, doctors simply do not have time to provide medical assistance. If the patient is in an inpatient department at the time of the development of pulmonary embolism, his chances of survival increase significantly.

Therapeutic measures are aimed at improving blood circulation and maintaining bed rest. Blood clots must be removed from the circulatory system. For this, thrombolytic treatment or surgery is used. Infusion treatment is carried out to thin the blood and prevent further blood clots. Surgical intervention is decided upon if conservative methods do not produce results.

Phlebosclerosis

The pathological process during which the walls of the veins undergo changes (become thicker and denser) is called phlebosclerosis. The main danger of phlebosclerosis is that due to the thickening of the vein wall, a narrowing of the lumen in the bloodstream occurs, which entails stagnation. As a result of the development of pathology, the wall can grow so large that blood flow through the vein stops completely.

Upon external observation, veins affected by phlebosclerosis look like rope-like thickenings. Their color is whitish. However, this symptom is noticeable only from the outside, and changes in the veins under the skin are almost invisible.

The lymphatic system negatively responds to the development of thrombophlebitis in the lower extremities. We are talking about lymphangitis, which is an inflammatory process in the lymphatic vessels. Lymphangitis is not an independent disease, but only a consequence of the infectious process.

Lymphangitis is characterized by intoxication, which is manifested by the following symptoms:

increased body temperature;
headache;
fever;
fast fatiguability;
general weakness.

Lymphangitis is treated with antibiotics and non-steroidal anti-inflammatory drugs. If treatment is carried out on time, the prognosis is usually favorable.

Note! If you suspect lymphangitis, you should not massage or heat the veins of the lower limb, as such actions will complicate the course of the disease.

Elephantiasis

The pathology is a painful thickening of the skin and subcutaneous tissue. The development of the pathological process is associated with a disruption of the normal outflow of lymph. Elephantiasis is accompanied by persistent swelling of the lower extremities; pain syndrome is often absent.

Patients turn to doctors primarily because of a cosmetic defect, and not because of physical discomfort. Over time, in addition to swelling, an erysipelas inflammatory process on the skin is added to the symptoms of the disease.

In the treatment of elephantiasis (except for treatment of the underlying disease), diuretics and lymphatic drainage are used. If medication and other methods of conservative therapy do not bring results, surgical treatment is prescribed.

The peripheral nervous system refers to that part of the nerve endings that is located outside the brain and spinal cord. Due to the peripheral system, the relationship between the central nervous system and human organs and limbs is ensured.

The peripheral nervous system is injured both as a result of mechanical influences and under the influence of intoxication. As a result, an inflammatory process and other pathological processes develop.

Ischemic neuritis

The inflammatory process in the veins - ischemic neuritis - is directly related to pathologically abnormal blood flow. Due to nutritional deficiency, peripheral nerves stop functioning fully, which is expressed in the following symptoms:

decreased reflexes;
dystrophic processes in muscles;
reduction of skin sensitivity in the area of development of the disease.

Ischemic neuritis is often accompanied by very severe pain.

Note! A feature of ischemic neuritis is a sharp exacerbation of the disease as a result of alcohol intake.

If the patient does not receive timely treatment, general purulent complications may develop. The process is provoked by purulent melting of a blood clot in the vein and the presence of accompanying pathogenic microflora. The name of the pathology is septicopyemia.

During the pathological process, pus often metastasizes, which leads to intoxication of the entire body. It should be understood that the spread of pus is not a self-sufficient process. The root cause of the development of complications is an inflammatory reaction in the area through which the infection entered the body.

Septicopyemia usually does not occur very violently, but over a long period of time. This is explained by the fact that, as a rule, the body is able to extinguish too intense inflammatory processes.

With septicopyemia, the lungs and cardiovascular system are affected. There may also be problems with the genitourinary system, which sharply reduces the body’s ability to excrete urine.

The septic process is associated with blood infection. The infection enters the bloodstream from tissues. Typically, sepsis develops as a result of complications of thrombophlebitis, such as peritonitis, an abscess, or some other inflammatory reaction, during which pyogenic microorganisms are released. Sepsis is a very dangerous condition that can be fatal if left untreated.

increased body temperature;
fever;
increased level of leukocytes in the blood;
tachycardia;
arrhythmia;
delayed urine formation.

If sepsis is suspected, the patient needs immediate medical attention. Treatment is carried out exclusively in inpatient settings.

According to medical practice, most blood clots can resolve on their own over time. Sometimes they simply scar, with little or no disruption to blood flow. With prolonged blockage of blood vessels, which leads to poor circulation, irreversible disorders occur.

Normal blood flow is ensured by valves. These are some kind of partitions between the walls of blood vessels. If the blood rises, the valves open; reverse flow of blood is impossible, since the valve is closed. If a vein is blocked by a blood clot, the supply to the valves is disrupted, which affects their function.

After some time, the clot may dissolve, but the function of the valves will not be restored.

Treatment of thrombophlebitis is carried out both surgically and conservatively, depending on the cause of inflammation and its degree. Only a doctor, after an examination, can determine which method is most effective in this case.

Removal is a last resort, carried out when there is a possibility of a blood clot breaking off.

Thrombophlebitis is an inflammation of the venous wall with the formation of a blood clot in the lumen of the vein. Thrombophlebitis is usually called inflammation and thrombosis of the superficial, saphenous veins. The most common cause of thrombophlebitis is varicose veins and chronic venous insufficiency.

What is the difference between varicose veins and thrombophlebitis?

Many patients, discovering varicose veins in themselves, believe that these are blood clots. In fact, it is easy to determine the difference between varicose veins and thrombophlebitis. Varicose nodes are soft, painless, and the skin over them is not thickened and has a normal color. With thrombophlebitis, there is a sharp hardening of the varicose node, redness and soreness of the skin. Superficial thrombophlebitis with varicose veins can recur, and can also progress and cause serious complications. Sometimes body temperature rises. The clot will usually spread up and down the vessel. Thrombophlebitis is a dangerous disease and, without proper treatment, sometimes leads to complications: pulmonary embolism and blood poisoning (sepsis).

The main causes of thrombophlebitis

Varicose veins.

Large varicose veins contain thick, slow-moving blood. In the presence of varicose veins, thrombosis and inflammation of the vessel wall may occur. Thrombophlebitis is accompanied by thickening of the venous wall, pain and fever. It can be life-threatening if a blood clot grows along the main venous trunks.

Intravenous injections.

The third most common cause of the development of thrombophlebitis should be recognized as various medical procedures associated with intravenous administration of drugs. In most cases, this happens on the upper limbs. It should be recognized that these thrombophlebitis are very benign and in most cases do not require any treatment. The administration of certain medications and drugs greatly irritates the vein wall and causes inflammation and swelling. Blood flow through the vein slows down, and thrombosis occurs. A painful cord forms along the vein. It is usually not life-threatening. She is being treated on an outpatient basis.
Systemic inflammatory diseases - systemic lupus erythematosus, endarteritis and many other diseases of the immune system damage the vascular wall. Antibodies are produced to one's own blood vessels, which attack the inner lining of the blood vessels and cause inflammation and the formation of blood clots. Treatment of the underlying disease contributes to the treatment of thrombophlebitis.

Heredity

A hereditary tendency to form blood clots (thrombophilia) can cause thrombophlebitis, especially with varicose veins. A number of people have congenital deficiencies of various factors of the blood anticoagulation system. These patients are characterized by frequent thrombophlebitis and deep venous thrombosis. They often have to take medications that reduce blood clotting for life.

Oncology

Oncological pathology also leads to significant disruption of blood clotting. Thrombophlebitis is often one of the first signs of cancer. A thorough examination of the patient (cancer search) allows one to identify a tumor at an early stage and radically cure it. If thrombophlebitis develops in a vessel unaffected by varicose veins, this may be the first sign of the so-called paraneoplastic syndrome - a thrombotic process that develops against the background of cancer. Very often, thrombophlebitis occurs when the pancreas is damaged. And this is one of the reasons why thrombophlebitis should not be treated as a mild disease; at the first signs of thrombophlebitis, you should immediately see a phlebologist.

Local factors

Conditions under which thrombophlebitis often develops include trauma, surgery, immobilization, and prolonged bed rest. Thrombophlebitis without varicose veins can often occur after visiting steam rooms, saunas and other similar “thermal” procedures. The medical literature has repeatedly raised the issue of the development of varicothrombophlebitis in women taking hormonal contraceptives. In general, in women, hormonal levels greatly affect blood vessels, which is why pregnancy, childbirth, and abortions are often complicated by thrombophlebitis of the lower extremities.

Among other things, the location of the veins directly under the skin predisposes them to the possibility of injury in public transport or during sports. The more advanced a person’s varicose veins are, the greater the likelihood of thrombophlebitis.

Flow

Most often, superficial thrombophlebitis develops against the background of existing varicose veins of the lower extremities. There is a special term for this disease - varicothrombophlebitis. Unlike varicose veins, thrombophlebitis is 10 times less likely to occur against the background of postthrombotic disease of the lower extremities. Thrombophlebitis with varicose veins also has very clear symptoms, which makes it different from post-injection and other forms of phlebitis.

Complications

Most often, thrombophlebitis is complicated by the spread of blood clots to the deep veins with the development of deep vein thrombosis and thromboembolism. The frequency of this complication is about 10% of all patients.

Purulent thrombophlebitis develops when an infection joins the inflammatory process. Suppuration is characterized by a sharp increase in temperature, chills, and a change in the number of leukocytes in the blood. Purulent thrombophlebitis can lead to the development of sepsis - a general blood infection and therefore requires emergency surgical care.

Thrombophlebitis is inflammation of the venous wall with the formation of a blood clot in the lumen of the vein. Thrombophlebitis is usually called inflammation and thrombosis of the superficial, saphenous veins. The most common cause of thrombophlebitis is untreated varicose veins and chronic venous insufficiency. Superficial thrombophlebitis with varicose veins can recur, and can also progress and cause severe complications. The main complaints with thrombophlebitis are compaction in the vein area, redness and pain. Sometimes body temperature rises. The thrombus tends to move and usually spreads upward and downward, sometimes penetrating into deep veins. Thrombophlebitis is a dangerous disease and without proper treatment sometimes leads to complications: pulmonary embolism, blood poisoning (sepsis), deep vein thrombosis.

In the medical field, the term “ascending thrombophlebitis” usually means inflammation of the vein walls and the appearance of a blood clot, as a result of which the lumen of the vein is blocked and blood flow is disrupted. The most common cause of this disease is a complicated form of varicose veins.

The main risks of the disease are excess weight, significant regular physical activity on the lower extremities, old age, pregnancy and childbirth, leg injuries, the postoperative period, and taking hormonal medications.

Ascending thrombophlebitis is diagnosed in situations where thrombophlebitis from part of the great saphenous vein located on the lower leg moves up to the inguinal folds.

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During the period of the disease, when inflammation extends to the deep veins, the greatest risk occurs for the blood clot to break off and move. And this, in turn, can cause a life-threatening complication - pulmonary embolism.

Acute form

A fairly common form of complication of varicose veins is acute ascending thrombophlebitis.

This stage of the disease carries a significant risk to the patient’s life, as it allows for the possibility of an immediate transition of inflammatory processes to the deep veins of the legs and the detachment of a blood clot.

A floating thrombus in the veins can soon lead to blockage of the arteries.

Symptoms

Often, the symptoms of ascending thrombophlebitis are pronounced. For this reason, diagnosing this disease is not a difficult task.

The clinical picture is determined by the localization of the inflammatory process, its duration, and the scale of its spread. In addition, special attention is paid to the damage to muscle tissue adjacent to the site of the disease.

Taking into account all these symptoms, doctors determine the form of the disease - from minor inflammatory processes to clearly defined ones. The most risky manifestation is considered to be the manifestation of disease of the great saphenous veins.

With ascending thrombophlebitis of the saphenous vein, edema of the lower extremities does not occur, and the disease manifests itself as follows:

when palpating the inflamed areas, a compaction is felt, and the patient experiences pain;
skin temperature rises;
the subcutaneous tissue is thickened and the skin has redness;
while walking, the pain intensifies, a constant heaviness is felt in the legs;
the patient complains of general malaise and weakness.

However, in the event of further spread of the inflammatory process through the blood vessels, damage occurs to large veins, namely the great saphenous, common femoral, and saphenofemoral anastomosis.

In such a situation, the symptoms will be quite pronounced. Swelling of the lower extremities occurs from the feet to the lower back, accompanied by heaviness and pain.

The attending physician conducts a visual examination of the patient and studies the medical history in detail. In modern medicine, ultrasound is considered the most accurate examination of blood vessels.

This type of diagnosis allows:

assess the condition of the veins;
determine the presence of blood clots;
study the patency of both superficial and deep veins.

In addition, additional examination of ascending thrombophlebitis can be carried out using radiopaque venography.

After establishing a diagnosis of ascending thrombophlebitis, comprehensive treatment of the disease is prescribed. An active regimen is recommended for the patient. Limbs should not be left immobile for long periods of time.

During the treatment process, regular doses are prescribed that prevent the formation of blood clots and restore the tone of blood vessels, as well as anti-inflammatory drugs. For severe symptoms, they are prescribed.

Conservative therapy

In the first stages of the disease, doctors recommend doing elastic compression on the legs so that the blood clot cannot move into large blood vessels.

For this purpose, a bandage made of medium-tensile bandage is used. The leg is wrapped for 10 days completely from the foot to the groin. After inflammation has reduced, the bandage is replaced with compression stockings.

In order to reduce pain in the initial days of illness, you can resort to an ice compress. Ice is applied several times during the day for 15-25 minutes.

In addition, a number of medications can be prescribed to prevent the formation of blood clots and restore blood vessels:

Venoruton	restores the tone of blood vessels and has a protective effect on them; this drug is used in the form of soluble tablets, capsules and ointments; tablets and capsules are intended for oral use, and ointment is for rubbing only; Venoruton helps reduce blood flow and eliminate stagnation, helps normalize blood flow and saturate small capillaries with oxygen.
Troxevasin	Helps restore the walls of blood vessels. This drug strengthens capillaries, relieves inflammation and reduces swelling of the lower extremities. Also, the drug is prescribed to patients with chronic venous insufficiency. This medicine allows you to reduce pain and get rid of cramps in a short time. Thanks to Troxevasin, you can restore normal blood circulation, prevent blood clots and blockage of blood vessels. This drug is contraindicated for women in the early stages of pregnancy and nursing mothers, people suffering from intestinal or stomach diseases. Anti-inflammatory drugs prescribed by doctors for this disease include Ibuprofen and Diclofenac.
Ibuprofen	Allows you to reduce the temperature in case of fever, reduce inflammation and pain. The drug should be taken only after meals, in order to avoid side effects such as flatulence, nausea, vomiting, and allergic skin rashes. People with liver disease, gastrointestinal tract, gastritis and chronic hepatitis should be careful in the dosage of this medicine.
Diclofenac	In ampoules it is intended for intramuscular injection. It helps reduce the inflammatory process in varicose veins and ascending thrombophlebitis, relieve painful swelling both during illness and in the postoperative period. The course of treatment with this drug should be no more than five days. If the patient continues to feel unwell, the ampoules are replaced with capsules or tablets. At the beginning of the treatment course, one ampoule of medication is injected per day. If the disease continues to progress, the dose is doubled. There are often cases when rubbing with ointments and gels, as well as UHF therapy, are prescribed to treat this disease. Basically, ointments and gels containing heparin are used, which helps relieve inflammation. The most famous drug of this type is Lyoton gel. Use it twice a day, applying a thin layer to painful areas. The gel helps eliminate swelling and reduce the feeling of heaviness in the legs. After applying ointments, you must wear compression stockings.

All medications, elastic bandages and compression hosiery are selected individually by the attending physician - phlebologist

Surgical intervention

Treatment with conservative methods is appropriate only in cases where there is no risk of inflammatory processes moving to the deep veins and only when the disease is localized in the lower leg area.

In the event of a possible threat of inflammation spreading to a deep vein, an operation for ascending thrombophlebitis is performed as soon as possible using surgical intervention.

Crossectomy is considered the most effective method of surgical treatment. The essence of this operation comes down to ligation and intersection of the large saphenous veins and their main tributaries in the part where they connect to the deep vein of the thigh.

To perform this operation, a small incision is made in the area of the inguinal fold. Upon completion, a suture is applied. After healing, the scar is almost invisible.

Very often, after the inflammation is relieved, doctors resort to phlebectomy - surgery to remove varicose veins.

Prevention

Ascending thrombophlebitis is considered a dangerous disease of the circulatory system. Treating this disease requires a lot of time and effort. Therefore, people prone to this disease should remember about preventive measures to prevent the development of this disease.

You need to lead an active lifestyle and do gymnastics regularly. To avoid stagnation of blood in the vessels of the lower extremities, you should rest with your legs elevated (you can use a small pillow for this). In case of long trips or flights, it is recommended to drink plenty of fluids, change body position more often, and move your limbs.

We should not forget about proper nutrition: eat more fresh vegetables and fruits, limit the consumption of animal fats as much as possible.

To prevent a relapse of the disease, it is necessary to constantly use medical compression stockings, take vitamins and anticoagulants, limit yourself from heavy physical activity, and refuse to visit the bathhouse and sauna, as well as take hot baths.