Treatment for thrombophlebitis depends on the severity and location of the condition. Options for thrombophlebitis that affect the deep veins may include surgery and medications that help prevent or dissolve blood clots.

Most occurrences of thrombophlebitis affecting veins close to the skin surface resolve without intervention. However, the usual treatment for this involves home care measures, such as elevating the leg, wearing elastic stockings, and applying warm compresses. In more severe cases, people may require medications that help prevent blood clots.

In those with thrombophlebitis of the surface veins, the outlook is generally positive, although there are risks. When the condition affects the deep veins, it leads to a dangerous complication called pulmonary embolism. This involves a blood clot in the lungs and is fatal in 12% of people with this complication.

Keep reading to learn more about treatment for thrombophlebitis, including information about the symptoms, causes, and outlook.

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A thrombus is a blood clot, and phlebitis is the inflammation of a vein, so thrombophlebitis is the inflammation of a vein due to a blood clot.

When the condition occurs in the veins just under the surface of the skin, it is called superficial thrombophlebitis. This usually occurs in the legs, but it affects veins in other parts of the body in 10–20% of cases.

In contrast, when thrombophlebitis develops in a deep vein, it is called deep vein thrombosis. This occurs most often in the lower leg, thigh, or pelvis, but sometimes it may occur in the arm.

Treatment for thrombophlebitis depends on the severity and whether the condition occurs in the surface veins or deep veins.

Home care

Treatment of superficial thrombophlebitis usually involves home care measures, such as:

  • Elevating the leg: Positioning the leg above the heart helps reduce swelling.
  • Applying warm compresses: A person can achieve this by using a blanket with a hot water bottle.
  • Wearing compression or elastic stockings: This helps decrease swelling.
  • Taking medications to reduce pain or inflammation: Options may include a nonsteroidal anti-inflammatory drug, such as ibuprofen (Motrin).

Doctors prescribe antibiotics only if an infection is present.

Anticoagulants

Sometimes, treating people with deep vein thrombosis or more serious cases of superficial thrombophlebitis may involve anticoagulants. These are blood-thinning drugs that can help dissolve existing clots and help prevent further clots from forming.

Common anticoagulants include:

  • Xa inhibitors: These bind to the clotting factor Xa, which plays a critical role in the clotting process. They are newer anticoagulants that do not necessitate dose monitoring, so doctors often prescribe these. One example is rivaroxaban (Xarelto).
  • Heparin: This decreases the clotting ability of the blood. Standard heparin (Hep-Lock) involves administration through an injection into a vein, while low molecular weight heparin, such as enoxaparin (Lovenox), entails administration via an injection under the skin.
  • Warfarin (Coumadin): This oral drug blocks substances necessary for clotting. It usually follows heparin therapy, and a person takes it over 3–6 months. Doctors closely monitor levels of this drug to ensure the dose is high enough to protect against clots but low enough to avoid excessive bleeding.

Thrombolytics

Thrombolytics are another treatment option for deep vein thrombosis or more serious cases of superficial thrombophlebitis. These are clot-dissolving medications that doctors only prescribe if a person has an extremely high risk of developing a pulmonary embolism. Administering the drug involves an injection directly into the clot. An example of a thrombolytic is anistreplase (Eminase).

Surgery

If anticoagulants do not work or a person cannot take them, a vena cava filter can serve as a surgical option. This is a small device that captures most clots in the bloodstream. A doctor inserts this into the main vein of the heart to filter clots before they reach the lungs.

When a person with superficial thrombophlebitis has a bacterial infection in a vein, a doctor may surgically remove the part with the infection.

The following are symptoms and causes of superficial thrombophlebitis and deep vein thrombosis.

Symptoms

Symptoms of superficial thrombophlebitis include:

  • tenderness, redness, and slight swelling along part of a vein
  • other veins in the area appear blue
  • swelling in veins in the ankle, foot, and just above the knee
  • darkened skin if the condition has been present for a time and swelling has disappeared
  • hardened or knobby feel to a vein

In many cases, a deep vein thrombosis develops without symptoms, so it is difficult to diagnose, notes the American Academy of Orthopaedic Surgeons (AAOS). However, symptoms may occur in the leg containing the clot. They include:

  • red or discolored skin
  • swelling
  • pain or tenderness
  • distended, or swollen veins
  • a firmness to a vein, which is called a cord

Sometimes a pulmonary embolism may be the first indication of deep vein thrombosis, adds the AAOS. Symptoms include:

  • coughing
  • shortness of breath
  • sudden chest pain
  • vomiting blood

Causes

Causes of superficial thrombophlebitis may overlap with causes of deep vein thrombosis. They include:

  • trauma to the blood vessel wall
  • prolonged inability to move that stems from a long airline flight or bed rest following surgery
  • increased blood thickness due to factors, such as dehydration

Risk factors for both types include:

  • smoking
  • obesity
  • pregnancy
  • oral estrogens
  • cancer
  • aging
  • fractures
  • orthopedic surgery

The outlook differs for the two types of thrombophlebitis.

Superficial thrombophlebitis

This condition has a generally positive outlook, but it can have risks. Deep vein thrombosis occurs in 6–36% of people with superficial thrombophlebitis, while pulmonary embolism can develop in 2–13% of individuals with the condition.

Deep vein thrombosis

Because this condition carries more health risks, the outlook is more serious. One-third to one-half of people develop long-term complications, such as pain, swelling, discoloration, and scaling in the affected limb.

Although many individuals improve with no complications, 1 month after diagnosis, 6% of people die from deep vein thrombosis and 12% of individuals die due to pulmonary embolism.

Treatment of thrombophlebitis in a person’s superficial veins may involve home care measures, such as applying warm compresses, elevating the leg, and taking ibuprofen (Motrin). In some cases, anticoagulants and surgery are necessary.

For deep vein thrombosis, treatment may entail anticoagulants, thrombolytics, and surgery.

Causes of both types include trauma to the blood vessel wall, prolonged immobility, and increased blood thickness. Some predisposing factors are smoking, obesity, and taking oral estrogens.

Because there are risks relating to even superficial thrombophlebitis, a person with the condition should consult a doctor to discuss lifestyle changes and treatment strategies.