Thrombophlebitis - superficial
Thrombophlebitis is a swollen or inflamed vein due to a blood clot. Superficial refers to veins just below the skin's surface.
Superficial thrombophlebitis is an inflammation of a vein just below the surface of the skin, which results from a blood clot. This condition may occur after recently using an IV line, or after trauma to the vein. Some symptoms can include pain and tenderness along the vein and hardening and feeling cord-like. Superficial thrombophlebitis is usually a benign and short-term condition. Symptoms generally subside in 1 to 2 weeks, but hardness of the vein may remain for much longer.
Shown here is erythema following the vascular pattern on a lower extremity. The superficial veins have become inflamed and dilated, causing the discoloration.
Causes
This condition may occur after injury to the vein. It may also occur after having medicines given into your veins. If you have a high risk for blood clots, you may develop them for no apparent reason.
Risks for thrombophlebitis include:
- Cancer or liver disease
- Deep vein thrombosis
- Disorders that involve increased blood clotting (may be inherited)
- Infection
- Pregnancy
- Sitting or staying still for a prolonged period
- Use of birth control pills
- Swollen, twisted, and enlarged veins (varicose veins)
Symptoms
Symptoms may include any of the following:
- Skin redness, inflammation, tenderness, or pain along a vein just below the skin
- Warmth of the area
- Limb pain
- Hardening of the vein
Exams and Tests
Your health care provider will diagnose this condition based mainly on the appearance of the affected area. Frequent checks of the pulse, blood pressure, temperature, skin condition, and blood flow may be needed.
Ultrasoundof the blood vesselshelps confirm the condition.
If there are signs of an infection, skin or blood cultures may be done.
Treatment
To reduce discomfort and swelling, your provider may recommend that you:
- Wear support stockings, if your leg is affected.
- Keep the affected leg or arm raised above heart level.
- Apply a warm compress to the area.
If you have a catheter or IV line, it will likely be removed if it is the cause of the thrombophlebitis.
Medicines called NSAIDs, such as ibuprofen,may be prescribed to reduce pain and swelling.
If clots in the deeper veins are also present, your provider may prescribe medicines to thin your blood. These medicines are called anticoagulants. Antibiotics are prescribed if you have an infection.
Surgical removal (phlebectomy), stripping, or sclerotherapy of the affected vein may be needed. These treat large varicose veins or to prevent thrombophlebitis in high-risk people.
Outlook (Prognosis)
This is usually a short-term condition that does not cause complications. Symptoms often go away in 1 to 2 weeks. Hardness of the vein may remain for much longer.
Possible Complications
Complications are rare. Possible problems may include the following:
- Infections (cellulitis)
- Deep vein thrombosis
When to Contact a Medical Professional
Contact your provider for an appointment if you develop symptoms of this condition.
Also contact your provider if you already have the condition and your symptoms worsen or do not get better with treatment.
Prevention
In the hospital, swollen or inflamed veins can be prevented by:
- The nurse regularly changing the location of your IV line and removing it if swelling, redness, or pain develop
- Walking and staying active as soon as possible after surgery or during a long-term illness
When possible, avoid keeping your legs and arms still for long periods. Move your legs often or take a stroll during long plane trips or car trips. Try to avoid sitting or lying down for long periods without getting up and moving about.
References
Cardella JA, Amankwah KS. Venous thromboembolism: prevention, diagnosis, and treatment. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:1072-1082.
Wasan S. Superficial thrombophlebitis and its management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 150.
Version Info
Last reviewed on: 5/10/2022
Reviewed by: Deepak Sudheendra, MD, MHCI, RPVI, FSIR, Founder and CEO, 360 Vascular Institute, with an expertise in Vascular Interventional Radiology & Surgical Critical Care, Columbus, OH. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
