30.09.2020

Thrombophlebitis of the veins of the lower limb: causes, symptoms, treatment

Thrombophlebitis of lower limb veins is the inflammation of the venous wall on the background of developing blood clots. In this pathology pathological thrombus formation complicated by inflammation, which aggravates the course of the main process.

In most cases, localized thrombophlebitis in the superficial veins of the lower extremities. In 95% of cases the disease develops into the great saphenous vein and small saphenous vein is much rarer.

Causes of thrombophlebitis

Primary in this disease is the pathology of blood coagulation system (thrombosis) in the background of the weak tone of the venous vascular wall.

A mandatory condition to ensure that the clot was formed in Vienna, is to increase the coagulability of blood (congenital or acquired due to hormonal shifts, cancer pathology or infectious diseases, after taking certain medications).

The tone of the veins may be low, the blood flow slows down, and develop congestion – fertile ground for blood clots, for example, in chronic heart failure.

Often there is thrombophlebitis of superficial veins as more susceptible to pathological effect of environment. There are also iatrogenic thrombophlebitis, i.e. developed as a result of medical procedures (catheterization of the veins in the long term, the introduction of concentrated solutions).

The nature of inflammation distinguish aseptic thrombosis and purulent (when joins bacterial flora).

Symptoms of thrombophlebitis of superficial veins

Depending on the nature of the pathological process in medicine distinguish acute and chronic thrombophlebitis. But whatever the thrombophlebitis, it is always a complication of varicose veins.

Acute thrombophlebitis

Acute thrombosis, usually develops suddenly on the background of complete well-being. Very rarely, a patient may remember that he was once a trauma to the affected limb. Other causes of acute thrombophlebitis are considered viral infections and intake of contraceptives affect the blood coagulation system.

All the symptoms of acute thrombophlebitis can be divided into General and local, the latter always prevail, and the health of the patient does not suffer.

  • Patients complain of severe pain along the affected vein, movements in the foot is hampered. Localization of the area of the pathological focus, the skin reddens, becomes hot to the touch, there appears tight painful cord – trombirovanny inflamed vein.
  • Appear intense pain in the course of thrombosed veins, restriction of movement of limbs. In the area of the affected vein is marked redness, which the disease progression becomes more extended. Leg moderately swollen.
  • Common symptoms include malaise, chills and increased body temperature to 38 degrees.
Chronic thrombophlebitis

In chronic thrombosis of the pathological process runs for a long time, occasionally escalates with the appearance of characteristic symptoms.

If the inflammation appears periodically in the different veins unchanged, this is called migratory thrombophlebitis (may be accompanied by cancer).

Chronic thrombophlebitis is prolonged, with intermittent exacerbations. During exacerbation of the disease occur the above symptoms, exacerbation of external symptoms may be absent.

The disease
For thrombophlebitis are two possible options:
  1. On the background of treatment subsides inflammation, stops the growth of the thrombus. If the clot completely blocks the vessel wall, the vessel collapses. The probability of detachment of a blood clot is minimal. This is a favorable outcome.
  2. An unfavorable option, when inflammation continues, and the clot continues to grow and becomes “floating”. Such a clot loose, it is attached to one side of the vascular wall, and the other freely floats in the lumen of the vessel and may at any time break away, in consequence of which develops this unpleasant complication like pulmonary embolism (PE). This complication often ends in patient’s death as a blood clot, clog the pulmonary vessels, leads to the development of acute pulmonary insufficiency. During germination of a blood clot in the communicating veins may be a phlebothrombosis of deep veins of lower extremities with chronic venous insufficiency.

For the diagnosis of thrombosis currently used ultrasound, if necessary, are appointed by radiopaque techniques. Of great importance is the study of the parameters of coagulation.

The treatment of thrombophlebitis of the extremities

The treatment of this disease is complex, involves both conservative and surgical methods.

Conservative treatment of thrombophlebitis is aimed at:
  • Improvement of rheological properties of blood and blood circulation in General. To do this, prescribers from the group of antiplatelet agents (heparin, aspirin, leoton-gel), pentoxifylline, under the control of coagulation parameters.
  • normalization of the functions of platelets.
  • correction of venous blood flow (drugs fibrinolytic action).
  • Strengthening of the vascular wall (Detralex, caffeine, rutin, plaster Basoplast).
  • inhibition of inflammatory reactions (ketotifen diclofenac).

In addition, a mandatory time is elastic compression, which consists in bandaging for seven to ten days. In cases of suspected purulent process are assigned antibacterial drugs.

Some authors consider it advisable to appoint thrombophlebitis enzyme preparations such as Wobenzym. It is assumed that the effect of this drug is aimed at dissolving the clot.

Surgical treatment is indicated in failure of conservative measures (risk of PE). Classic version – this surgery Troyanova – Trendelenburg. Its modification called crossectomy. During surgery, the bandage or remove the diseased vein. In addition, the use of endoscopic techniques for removal of thrombus by a special catheter.

Prevention of pulmonary embolism

This is perhaps the main objective in the treatment of thrombophlebitis. Good effect in our day achieved by the use of Vena cava filters (“traps”). This construction has the form of an umbrella and is injected into a vein through a puncture, then there is revealed, the blood it flows, and a clot catches. Although very often the presence of the filter in the venous line leads to a worsening of the primary process and the spread of inflammation to unaffected areas.

Complications

The major complication of thrombophlebitis is pulmonary embolism.

Second in importance is the development of chronic venous insufficiency.

If the treatment condition is not improving, and there are common symptoms such as chills, fever, pain and swelling in the affected limb, be sure to consult a doctor.

Prevention of thrombophlebitis of the veins

The main method of prevention of any disease is to maintain the vessel walls in the proper tone. This is achieved by performing special gymnastic exercises. Any gym that leads to the improvement of the condition of the bloodstream that is a great prevention of stagnation of blood in small blood vessels. Strengthening the muscles of the lower limbs in addition provides the increase of speed of blood flow through the veins. in conditions of normal blood flow the risk of thrombophlebitis is minimized.

If there are minor deviations from the norm in the indices of blood rheological properties, drug way to achieve the desired results.

Be sure to consult with the vascular surgeons about the right way of life in this pathology

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