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thrombophlebitis
Phlebitis Overview
Phlebitis -inflammation of a vein.
Thrombophlebitis -a blood clot in the
vein causes the inflammation.
Thrombophlebitis usually occurs in leg
veins, but it may occur in an arm. The
thrombus (clot) in the vein causes pain
and irritation and may block blood flow
in the veins.
Phlebitis can occur in both the surface
(superficial) or deep veins.
Causes
Phlebitis may occur spontaneously or
as a complication of a medical
procedure. Local trauma and injury to
a vein also increase the risk of
forming a blood clot
Superficial phlebitis
There is usually a slow onset of a tender red area along the superficial
veins on the skin. A long, thin red area may be seen as the
inflammation follows the path of a superficial vein.
This area may feel hard, warm, and tender. The skin around the vein
may be itchy and swollen.
A low-gradefevermay occur.
Treatment
In general, treatment may include
support stockings and wraps to reduce
discomfort as well as medications such
as:
Analgesics
Antibiotics (if infection is present)
Anticoagulants (blood thinners) to
prevent new clots from forming
:
Elevate the affected area to reduce swelling.
Keep pressure off of the area to reduce pain
and decrease the risk of further damage.
Apply moist heat to reduce inflammation and
pain.
Surgicalremoval, stripping, or bypass of the
vein is rarely needed but may be
recommended in some situations.
RISK FACTORS
Symptoms
Most asymptomatic
Intermittant claudication
Rest pain
Ulcers and gangrene
INTERMITTENT CLAUDICATION IS
INDICATIVE OF SYSTEMIC
ATHEROSCLEROSIS
40-60% of patients with intermittent
claudication have concomitant CAD
PRIMARY SITES
OF INVOLVEMENT
Femoral & Popliteal
arteries: 80-90%
Tibial & Peroneal
arteries: 40-50%
Aorta & Iliac arteries:
30%
DIAGNOSIS
History taking
Careful examination of leg
Pulse evaluation
Ankle-brachial index (ABI):
SBP in ankle (dorsalis pedis and posterior
tibial arteries)
___________________________________
SBP in upper arm (brachial artery)
GOALS OF TREATMENT
To relieve exertional symptoms
and improve walking capacity
To improve quality of life
To reduce total mortality as well
as cardiac and cerebrovascular
morbidity and mortality
MANAGEMENT
Thank you