Symptoms and Complications
The area around the vein is red, warm, swollen, and often painful. Because the blood in the vein tends to clot, the vein often feels hard, not soft like a normal vein. The vein may even feel like a "rope" with knots along its length. When the superficial veins in the legs develop phlebitis, swelling of the ankle or foot is commonly experienced. Long-standing phlebitis of the leg veins can lead to discoloration around the ankles.
Although uncommon, untreated superficial phlebitis can spread to deep veins. The most serious complication of a DVT is when a blood clot breaks free from a deep vein and moves towards the lungs. The moving blood clot, called an embolus, can block blood flow to the lungs and is known as a pulmonary embolus.
Making the Diagnosis
The doctor can tell that someone has phlebitis by examining the veins. An ultrasound scan or a Doppler test may be performed to see if there is a blood clot in the deep veins.
Treatment and Prevention
Superficial phlebitis usually improves on its own in a few days, although it may take a few weeks for the lumps and pain to disappear. Treatment usually consists of warm soaks, rest, leg elevation, and a non-steroidal anti-inflammatory drug (NSAID) such as aspirin* or ibuprofen. If there is evidence of an infection, a short course of antibiotics may also be prescribed.
For superficial phlebitis and DVT, your doctor may suggest that you wear elastic compression stockings. For people who have blood clots in the superficial veins (e.g. veins of the leg) the doctor may suggest removal of the vein. Rarely, the doctor may remove the blood clot from a superficial vein under local anesthesia.
For DVT, medications such as heparin or warfarin may be used to prevent blood clots from getting bigger.
Doctors might also suggest placing a filter (an umbrella-like device) in a vein to prevent clots that break off from reaching the lungs. Rarely, surgery may also be recommended to remove a blood clot from the lung.
To prevent phlebitis, avoid smoking and participate in moderate physical activity to maintain muscle tone and promote circulation. When traveling for long periods of time, walk around every hour or so and move your legs frequently. Compression stockings may also be helpful. For some people (especially those who have had a blood clot in the past), your doctor may recommend a blood thinning medication to reduce your chances of developing a blood clot.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
Shabir Bhimji MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Meadville, PA. Review provided by VeriMed Healthcare Network.