Thrombophlebitis of the lower extremities
Thrombophlebitis of the lower extremities is not just ugly protruding veins that can spoil the appearance of the legs. We will tell you who is at risk and whether it is possible to get rid of thrombophlebitis without surgery

What is thrombophlebitis of the lower extremities

This is a disease of the circulatory system, which is characterized by inflammation of the venous walls, as well as the formation of blood clots and circulatory disorders. The disease most often affects the veins of the lower extremities: first, superficial veins are affected (phlebitis, superficial vein thrombosis), and if treatment is not started, the disease will also move to deep veins (thrombophlebitis, deep vein thrombosis).

Causes of thrombophlebitis of the lower extremities

Most often, thrombophlebitis of the lower extremities occurs for the following reasons:

  • damage or injury to the vascular wall (inflammatory process, installation of a venous catheter, intravenous injections, operations, injuries, fractures, etc.);
  • bleeding disorders (thrombophilia, oncology, myocardial infarction, stroke or long-term use of hormonal contraceptives, chemotherapy);
  • varicose veins disease (the speed of blood flow is greatly reduced, the lumen of the veins narrows).

Serious risk factors for the development of thrombophlebitis of the lower extremities include: smoking, obesity, a sedentary lifestyle, sedentary work, a hereditary factor, age over 45 years, as well as a long forced position in one position – for example, after a serious injury. It is also not uncommon for thrombophlebitis of the lower extremities to develop in pregnant women, so they should immediately consult a doctor if their legs begin to swell and hurt a lot.

Treatment of thrombophlebitis of the lower extremities

If you notice heaviness in the legs, pain and swelling, you need to see a doctor who will prescribe treatment. After all, thrombophlebitis of the lower extremities is not just an external defect, but a serious disease requiring medical intervention.

Diagnostics

As a rule, the diagnosis of thrombophlebitis of the lower extremities does not cause any difficulties for a specialist. The doctor carefully asks the patient how long the swelling, redness and pain in the legs appeared, what kind of pain is and where it is localized. The final diagnosis is made after the following studies:

  • Ultrasound of the veins of the lower extremities. It helps to assess the condition of blood vessels, superficial and deep veins, as well as the presence and size of blood clots.
  • Rheovasography. Helps to identify disorders of the blood supply to the tissues of the lower extremities and blood flow.
  • Doppler ultrasound. In the smallest detail, it allows you to assess the blood flow and the condition of the vessels.
  • Ultrasound duplex angioscanning with color coding of blood flow1. The most modern way to diagnose thrombophlebitis of the lower extremities. It helps to assess the state of blood vessels, the speed and direction of blood flow (general and in individual areas), the condition of veins, the presence of blood clots, their size, mobility, etc.

From laboratory tests, the doctor may prescribe a complete blood count and a coagulogram (blood clotting test). If necessary, a consultation with a surgeon, therapist or cardiologist is scheduled.

Preparations

Treatment of thrombophlebitis depends on the severity and stage of the disease. As a rule, drug treatment is prescribed, which helps to relieve inflammation and promotes the resorption of blood clots. The doctor usually prescribes the following drugs for thrombophlebitis:

  • anticoagulants (drugs that reduce blood clotting, minimizing the risk of blood clots);
  • thrombolytics (drugs that break down blood clots);
  • herbal phlebotonics (improve the condition of veins, blood vessels and lymph nodes, restore blood flow and lymph outflow)2;
  • antibiotics (with the addition of purulent processes).

Ointment

Ointments are often used to treat thrombophlebitis of the lower extremities. Usually these are non-steroidal anti-inflammatory drugs that relieve inflammation and swelling, and relieve pain. These include Diclofenac, Voltarene, Fastum Gel.

In acute thrombophlebitis of the lower extremities, bed rest is prescribed. The sore leg should be bandaged with an elastic bandage and kept in an elevated position. If there is a risk of deep vein thrombosis, surgical treatment is prescribed – ligation or removal of the affected veins.

show more

Surgery for thrombophlebitis of the lower extremities

As a surgical treatment, the following can be prescribed:

  • Embolectomy. Removal of an embolus (broken blood clot) from the bloodstream.
  • Phlebectomy. Removal of the affected vein or varicose vein.
  • Stenting of the bloodstream (a special stent is installed in the place of narrowing of the lumen of the bloodstream, which restores the disturbed blood flow).

Prevention of thrombophlebitis of the lower extremities at home

To avoid the formation of blood clots, thrombophlebitis, varicose veins and many other diseases affecting the veins and blood vessels, you should follow a few simple rules. Watch your lifestyle: stop smoking, consult your doctor about taking oral contraceptives (maybe there is some alternative), do not forget about jogging and walking in the fresh air (this is clearly more useful than spending the evening on the couch watching TV ). If you work a lot in a sitting position, then every hour you spend a short “physical education” – get up, warm up, walk around the office. Review your diet, because cholesterol is the main enemy of blood vessels and veins. Eat more fresh vegetables and fruits, rather than lean on junk food and red meat.

Since thrombophlebitis of the lower extremities often develops after injuries, fractures, operations and, as a result, prolonged immobilization (being in a state of forced rest), care must be taken to avoid stagnation and blood flow disturbance. You need to wear compression stockings or bandage your legs with elastic bandages. If possible (or with outside help), you need to return to physical activity as soon as possible. This will help improve blood flow and reduce the risk of blood clots. Your doctor may prescribe blood thinners (anticoagulants) before or after surgery.

Popular questions and answers

What complications can lead to thrombophlebitis of the lower extremities?

A serious complication of deep vein thrombosis is the occurrence of pulmonary embolism (PE), which is comparable to a stroke or heart attack and can lead to death or disability. Another consequence of previous deep vein thrombosis is post-thrombotic disease, which, without special treatment and prevention, will persist as chronic edema of the limb, explains phlebologist, vascular surgeon Denis Ibragimov.

Who is prone to thrombophlebitis?

– The tendency to develop thrombophlebitis (venous thrombosis) is associated with impaired blood supply, damage to the vascular wall, increased blood clotting, and their combination. The key role remains with the activator of the process – it can be trauma, surgery or the presence of thrombophilia. Risk factors include stroke (prolonged bed rest), cancer, hormonal (including oral contraceptives) and chemotherapy, vein compression, age over 40 years, obesity, varicose veins, central vein catheter, pregnancy and the immediate postpartum period, says vascular surgeon.

In what cases is surgery indicated for the treatment of thrombophlebitis of the lower extremities?

Surgical treatment may be recommended in the absence of the effect of conservative therapy or with the prevalence of thrombosis, the severity of the patient’s condition, explains phlebologist Denis Ibragimov.

Sources:

  1. Nurgalieva A.M. Ultrasound diagnosis of thrombophlebitis and thrombosis of the veins of the lower extremities in patients undergoing hip arthroplasty // Bulletin of Surgery of Kazakhstan. 2012. No. 4 (32). https://cyberleninka.ru/article/n/ultrazvukovaya-diagnostika-tromboflebitov-i-trombozov-ven-nizhnih-konechnostey-u-bolnyh-perenesshih-endoprotezirovanie-tazobedrennyh
  2. Shulikovskaya I. V., Kyshtymov S. A., Shinkevich E. V., Bogdanova M. G., Kutorkin V. G., Makeev A. G. Treatment of acute thrombophlebitis of the great saphenous vein // Acta Biomedica Scientifica. 2007. No. 4S. https://cyberleninka.ru/article/n/taktika-lecheniya-ostrogo-tromboflebita-bolshoy-podkozhnoy-veny

Leave a Reply