What are Deep Vein Thrombosis and Thrombophlebitis?
Deep vein thrombosis (DVT) and thrombophlebitis are conditions that involve blood clot formation in the veins. In 90% of cases, these conditions occur in the leg; however, they also occasionally occur in the arms or, even more rarely, in other parts of the body.

Thrombophlebitis refers to blood clot (thrombus) formation occurring in the superficial veins (those closer to the skin surface). The condition is most often caused by irritation of the lining of the vein such as following phlebotomy or insertion of an intravenous line. While there is a risk of the blood clot traveling into the deep veins, serious complications due to superficial thrombophlebitis are extremely rare. If the blood clot becomes infected, it is called a septic thrombophlebitis. Patients with this condition develop fevers and redness of the skin over the blood clot.

DVT refers to a blood clot occurring in a deep vein within the muscle of the leg. DVT forms most commonly as a result of inactivity due to prolonged bed rest or movement restriction. Other potential contributing causes for DVT are pregnancy, obesity, severe infections, some types of cancers, recent major illness, surgery such as hip or knee replacement or any condition in which the blood is thicker than normal.

The most significant danger of DVT is that the blood clot will break loose and travel through the veins to the heart and vessels going to the lungs. This is called a pulmonary embolism, and while it is an infrequent complication of DVT, a pulmonary embolism can be fatal in 30-50% of people. DVT can result in permanent venous incompetence (damage to the valves in the veins). This produces post-thrombotic syndrome, which may cause varicose veins, leg swelling, leg discomfort and skin ulceration.

How are DVT and Thrombophlebitis Diagnosed?
Thrombophlebitis often causes tenderness and discoloration of the skin over the area of the affected vein. The vein may also feel hard and thick, like a piece of rope. Some people experience localized swelling and redness over the vein. These symptoms may be accompanied by fever if the vein is infected.

Swelling of the leg is the most common symptom of DVT. Some people may also experience a feeling of fullness in the leg. Doctors diagnose DVT with the use of an ultrasound which reveals the location and extent of a DVT. Sudden swelling of a leg or arm is an urgent medical condition and should be evaluated promptly by a physician.

How are Thrombophlebitis and DVT Treated?
Treatment for thrombophlebitis generally involves self-care techniques, such as the application of heat, rest and elevation of the leg. Non-steroidal anti-inflammatory medications such as ibuprofen may be helpful, and antibiotics may be prescribed if signs of infection are present.

“Blood thinners” are often used to treat DVT. Blood thinners are medications that help to prevent the blood clot from enlarging and prevent new clots from forming. They also help to stabilize the blood clot and prevent it from breaking off and traveling to other parts of the body. These drugs may initially be given by injection (low molecular weight heparin). Patients may then have to continue on oral medication. Usually an oral medication (warfarin) is continued for the following three to six months. Patients are encouraged to walk but to avoid prolonged standing or sitting. Elevating the legs also helps to reduce swelling (lying down with feet on pillows so they are higher than the level of the heart). For patients with persistent swelling, compression stockings help to prevent complications of venous stasis disease, such as ulceration.

In some patients, DVT can be treated with thrombolytics (drugs which dissolve blood clots). These drugs are administered through a catheter (small tube) inserted into the vein under fluoroscopic (continuous x-ray) guidance. This technique may help preserve the function of the valves within the veins and help prevent post-thrombotic syndrome. The DVT must be diagnosed early (within two to four weeks of onset) for this type of treatment to be effective.