Thrombosis (phlebothrombosis), thrombophlebitis. Ascending thrombophlebitis of the superficial veins of the lower extremities: what is it? Ascending thrombophlebitis of the great saphenous vein treatment

20.05.2020

What is the difference between varicose veins and thrombophlebitis?

Many patients, finding nodules of varicose veins in themselves, believe that these are blood clots. In fact, it is easy to determine what is the difference between varicose veins and thrombophlebitis. Varicose veins are soft, painless, and the skin above them is not compacted, of a normal color. With thrombophlebitis, there is a sharp hardening of the varicose veins, redness and soreness of the skin. Superficial thrombophlebitis with varicose veins can recur, and can also progress and cause severe complications. Sometimes the body temperature rises. The blood clot usually spreads up and down the vessel. Thrombophlebitis is a dangerous disease and without proper treatment sometimes leads to complications: pulmonary embolism and blood poisoning (sepsis).

The main causes of thrombophlebitis

Varicose veins.

Large varicose veins contain thick, slow-moving blood. In the presence of varicose veins, thrombosis and inflammation of the vessel wall may occur. Thrombophlebitis is accompanied by compaction of the venous wall, pain and fever. Danger to life can be with the growth of a blood clot along the main venous trunks.

Intravenous injection.

The third most frequent cause of thrombophlebitis development should be recognized as various medical procedures associated with intravenous administration drugs. In most cases, this happens on upper limbs... It should be recognized that these thrombophlebitis are very benign and in most cases do not require any treatment. The administration of certain drugs and drugs strongly irritates the vein wall and causes its inflammation and edema. The blood flow through the vein slows down, its thrombosis occurs. A painful cord forms along the course of the vein. Usually it is not dangerous to life. It is treated on an outpatient basis.
Systemic inflammatory diseases - systemic lupus erythematosus, endarteritis and many other diseases of the immune system damage the vascular wall. Antibodies are produced to their own vessels, which attack the inner lining of the vessels and cause inflammation and blood clots. Treatment of the underlying disease contributes to the treatment of thrombophlebitis.

Heredity

A hereditary tendency to form blood clots (thrombophilia) can cause thrombophlebitis, especially with varicose veins. A number of people have congenital deficiencies of various factors of the anticoagulant system of the blood. These patients are characterized by frequent thrombophlebitis and deep venous thrombosis. They often have to use drugs that reduce blood clotting for life.

Oncology

Oncological pathology also leads to a significant violation of blood coagulation. Thrombophlebitis is often one of the first signs of cancer. Thorough examination of the patient (oncoprotection) allows detecting the tumor at an early stage and radically curing it. If thrombophlebitis develops in a vessel unaffected by varicose veins, this may be the first sign of the so-called paraneoplastic syndrome - a thrombotic process that has developed against the background cancer... Very often, thrombophlebitis occurs when the pancreas is affected. And this is one of the reasons why you should not treat thrombophlebitis as a mild disease; at the first signs of thrombophlebitis, you should immediately see a phlebologist.

Local factors

Conditions under which thrombophlebitis often develops include trauma, surgery, immobilization, and prolonged bed rest. Often, thrombophlebitis without varicose veins can occur after visiting steam rooms, saunas and other similar "thermal" procedures. In the medical literature, the question of the development of varicothrombophlebitis in women taking hormonal contraceptives has been repeatedly raised. In general, in women, the hormonal background strongly affects the vessels, which is why pregnancy, childbirth, abortions are often complicated by thrombophlebitis lower limbs.

Among other things, the location of the veins directly under the skin predisposes to the possibility of injury in public transport, or during sports. The more advanced a person's varicose veins, the more likely they are to develop thrombophlebitis.

Flow

Most often, superficial thrombophlebitis develops against the background of existing varicose veins of the lower extremities. There is a special term for this disease - varicothrombophlebitis. Unlike varicose veins, thrombophlebitis occurs 10 times less often against the background of post-thrombotic disease of the lower extremities. Thrombophlebitis with varicose veins also has a very bright symptomatology, which differs from post-injection and other forms of phlebitis.

Complications

Most often, thrombophlebitis is complicated by the spread of blood clots to deep veins with the development of deep vein thrombosis and thromboembolism. The incidence of this complication is about 10% of all cases.

Purulent thrombophlebitis develops when the infection joins the inflammatory process. Suppuration is characterized by a sharp increase in temperature, chills, a change in the number of leukocytes in the blood. Purulent thrombophlebitis can lead to the development of sepsis - a general infection of the blood and therefore requires urgent surgical care.

Thrombophlebitis - inflammation of the venous wall with the formation of a thrombus in the lumen of the vein. Thrombophlebitis is usually called inflammation and thrombosis of the superficial, saphenous veins. The most common cause of thrombophlebitis is untreated varicose veins and chronic venous insufficiency. Superficial thrombophlebitis with varicose veins can recur, and can also progress and cause severe complications. The main complaints of thrombophlebitis are thickening in the vein, redness and pain. Sometimes the body temperature rises. The thrombus is prone to movement and usually spreads up and down, sometimes penetrating deep veins. Thrombophlebitis is a dangerous disease and without proper treatment sometimes leads to complications: thromboembolism pulmonary artery, blood poisoning (sepsis), deep vein thrombosis.

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Endovasal laser coagulation of veins. 1st category of complexity. including anesthetic aid (local anesthesia).

The course of lymphopressotherapy is 10 procedures. Accepted by Phlebologist, Candidate of Medical Sciences

Reception is conducted by a surgeon the highest category Doctor of Medical Sciences, Professor Komrakov. V.E.

A single session of sclerotherapy within the entire lower limb (foam sclerotherapy, microsclerotherapy).

Varicose veins, blood clots, valvular insufficiency, edema in the legs

- all this is a reason to perform ultrasound of the veins of the lower extremities

and consult a phlebologist.

Lymphopressotherapy is indicated for

edema of the lower extremities, lymphostasis.

It is also carried out for cosmetic purposes.

GSV thrombosis

Thrombosis of the great saphenous vein or in contraction thrombosis bvp - occurs very often with varicose veins of the lower extremities. A blood clot forms in the great saphenous vein, which blocks the flow of blood. Blood begins to collect in a specific area and fill the vein.

Causes of thrombosis of the great saphenous vein

The reason thrombosis bvp most often it is the expansion of the veins and their deformation. The blood circulates more slowly and forms clots that block the vein. There are several factors that contribute to the formation of this disease:

Age. The disease often occurs in people over 60;

Obesity. Being overweight is heavy exercise stress for the body. A person is inactive, the blood begins to circulate more slowly and becomes thicker. As a result, blood clots form in the vessels and veins;

Long bed rest;

Serious injuries due to which a person cannot move normally for a long time;

Operations in the lower extremities and pelvis;

Pregnancy, childbirth and the postpartum period;

The body's tendency to thrombosis. This is a congenital disease;

Long-term use of hormonal drugs.

A varicose thrombus can form anywhere in the saphenous vein, very often in the thighs and lower legs. The great saphenous vein is affected by blood clots along with tributaries. The result of thrombosis may vary. In rare cases, it resolves on its own or after therapy. It also happens that a blood clot begins to grow connective tissues and is absorbed, destroying the vein valve apparatus. In some cases, a blood clot completely clogs the vein, resulting in sclerosis, or the clot gradually grows in size and becomes larger. This result of the disease is the most unfavorable, because such thrombosis turns into thrombophlebitis and can spread to the deep venous system, causing pulmonary thromboembolism, a serious illness that very often ends in death.

Signs of the disease

It often happens that thrombosis of the great saphenous vein appears unexpectedly. But there are also classic signs of the disease:

Sharp pain when probing a sore spot;

Redness in the area of \u200b\u200bthe changed vein;

Feeling of heaviness in the affected area;

Vein trauma;

Viral diseases such as influenza.

Symptoms depend on the location of the blood clot, the complexity and neglect of the process. Basically, the patient does not feel bad. He has slight pains and heaviness in his legs, especially when walking, sometimes a little feeling unwell, which is expressed by weakness, chills and a slightly fever. But, in general, there are no serious complaints. The most important thing is to determine the exact location of the blood clot. It should also be taken into account that if thrombosis begins to spread to the popliteal vein, this process often has no symptoms, since the thrombosis is floating. Therefore, when diagnosing it is better to use the instrumental method.

Treatment

Treatment depends on the location of the blood clot. But in any case, the disease is serious, and the patient should be under the supervision of doctors and be in the hospital. But strict bed rest is not provided. Only for those who have relapses of the disease. You can move, you can not run, lift weights, play sports and various types of physical activity.

The most important thing in the treatment process is to prevent the spread of thrombosis as soon as possible. Treatment must be very effective so that there is no recurrence or thrombosis in other areas later. Before prescribing treatment, it is imperative to take into account the place, part of the body on which thrombosis of the great saphenous vein has formed. Several treatments can be combined if needed.

If thrombophlebitis proceeds in a mild form, you can get by with a doctor with medication and compresses. A bandage made of elastic bandage or golf must be applied to the affected limb. If the disease is in an acute phase, dressings can be uncomfortable. If the blood clot in the vein grows in size, an operation is urgently needed. After the operation, you must follow the instructions of the doctor. Our clinic will help you recover and completely get rid of the disease. We will do our best to make you healthy and happy again!

Source: phlebology-md.ru

Ascending thrombophlebitis

A lot of scientific works, encyclopedic data are devoted to the disease ascending thrombophlebitis. People want to know about the nature of the disease, methods of treatment.

Ascending thrombophlebitis - damage to the walls of blood vessels, where blood clots are formed, blocking the lumen in the arteries, vessels. More often, a disease that affects the veins in the legs or other parts of the body is a consequence of varicose veins. The diagnosis is established if the disease of the saphenous vein of the thigh or groin area is converted from the pathology of low veins in the legs. With the transition of the disease from a small saphenous vein to large vessels, there is a risk of separation, movement of a blood clot, which provokes pulmonary embolism. This variant of development ends in death.

Symptoms

The symptoms of the disease are often clearly presented; they do not cause difficulties in diagnosis.

The constant presence of a feeling of distention of the thigh, lower leg;
Feeling of heaviness;
The skin along the length of the affected leg vein is red, inflamed;
Pain in the lower leg, thigh, aggravated by movement;
Weakness, constant feeling of unwell;
Increase in temperature.

The clinical picture is determined by the state of the saphenous vein, localization of blood clots, their number, mobility. Importance is attached to inflammation in the tissues of the lower extremities located near the damaged vein. Against the background of symptoms, these factors, the disease is divided into types and forms. Ascending thrombophlebitis is often clearly presented along the course of the vein, it can manifest itself in small areas. Dangerous is a disease that develops in the great saphenous vein. There is a high probability that a blood clot will move into a deep vessel, for example, in the thigh area. There is a risk of pulmonary embolism.

With such vascular lesions, edema of the lower extremities rarely appears. By touch, along the affected area, an infiltrate is felt, resembling a dense cord, which creates pain. When diagnosing, it is important to determine the presence of a thrombus in a vein, its exact location.

The disease poses a danger to life, so it is important to seek medical help from a phlebologist in time. They will help to cope with the disease, prevent complications in time.

Acute form of flow

Acute ascending thrombophlebitis is a complex consequence of varicose veins. This form of the disease carries a risk of death - there is a floating thrombus in the vein, the disease quickly moves from a small saphenous vein to the deep vein of the thigh. This threatens to damage the pulmonary artery.

Signs of an acute form of ascending thrombophlebitis:

Symptoms, inflammation of the veins - swelling, redness, pain, hyperemia, lymphangitis, infiltrates of the affected veins of the lower extremities.
Constant weakness, frequent feeling of sickness.
Near the affected vein, the presence of a cord infiltrate is felt.
Increased body temperature.

Risk group

There are people prone to developing ascending thrombophlebitis of the veins of the lower extremities. They are highly likely to develop the disease.

People sitting most of the time.
People forced to lie in bed long time after surgery.
People with varicose veins.
People suffering from hyperhomocystinemia, antiphospholipid syndrome.
Pregnant women, especially during childbirth.
Overweight people.
Elderly people who prefer a sedentary lifestyle.

If a person finds himself on the list, it is worth paying close attention to the state of his veins, making adjustments to his lifestyle.

Basic principles of treatment

At the first manifestations of ascending thrombophlebitis of the saphenous vein, you should contact medical institution - doctors will diagnose, prescribe treatment. The fight against the disease is carried out:

In a conservative way;
Surgical intervention.

Sometimes complex treatment of thrombophlebitis of the veins of the lower extremities is advisable.

Basic principles of therapy

The only way to radically fight the disease is through surgery. Thanks to the operation, it is possible to stop the development of the disease, to prevent relapses. With the pathology of unchanged veins of the lower extremities, it is effective conservative treatment... If a large or small saphenous vein is damaged, an operation is prescribed that is performed as quickly as possible. The goal is to stop the spread of the lesion to deep veins, in particular the thigh.

Treatment of ascending thrombophlebitis is complex.

After diagnosing the disease, the patient is admitted to a hospital in bed rest.
Legs in a constant elevated state.
An elastic bandage is used to fix the blood clot.
Appointment of anticoagulants, phlebotonics.
A course of anti-inflammatory drug therapy is prescribed.
Local therapy is carried out using ointments, gels with heparin.
Sometimes treatment includes a course of UHF therapy.

In case of pathology of the great saphenous vein, when the clot is located above the middle of the thigh, or if the small saphenous vein is damaged, treatment is prescribed in the form of an operation.

Treatment of the acute form of the disease

The treatment of the acute form of the disease is influenced by factors:

The state of the vessels of the lower extremities;
The location of the blood clot;
Location of the affected veins.

Conservative treatment with medication, local therapy, more often in a hospital is often used.

Local therapy includes:

Using heparin ointments.
Semi alcoholic, cold compresses.
Fixation with elastic bandage.
Taking drugs that stabilize blood circulation.
Taking inhibitors.
Pain relievers medicines.

After stopping the acute form of inflammation, treatment continues using physiotherapy. UHF therapy, treatment with a Solux lamp, diametrical current therapy, iontophoresis with heparin are used. In the first two months after the therapy, fixation of the lower extremities in the area of \u200b\u200bthe affected vein with an elastic bandage, taking phlebodynamic drugs is prescribed.

The operation is performed in the following cases:

Dissolution of a blood clot.
The risk of developing pulmonary embolism.
The defeat of the acute form of a large, small saphenous vein, when the thrombus is located above the middle of the thigh.

To remove a thrombus, laser obliteration is often used, based on heating the vessel wall above the location of the thrombus. A crossectomy operation is performed - ligation of a superficial vessel at the transition to a deep one, performed under local anesthesia.

Preventive actions

People who are at risk of developing ascending thrombophlebitis should heed the phlebologist's recommendations:

Lead an active life.
Regularly perform a set of exercises for the lower extremities, which are preventive measures for the development of venous disease.
Walk more.
Maintain vascular tone - drink vitamin drinks, for example, cranberry juice, St. John's wort tincture.
Do not stand in one position for a long time.
Do not get carried away by baths, saunas.
Do not dehydrate the body.
Choose comfortable shoes, without high heels.
Use orthopedic insoles.
Organize rest in a lying position, with slightly raised legs.
Wear compression garments.

Source: otnogi.ru

Thrombosis bpv treatment

Discarding unnecessary reasoning about the pathogenesis of these diseases, we note that

in both cases, a thrombus forms in the lumen of a venous vessel and inflammation of the vessel wall and perivasal tissues. The state of the thrombus is of fundamental importance, namely, its fixity and the probability of separation. Currently, thrombophlebitis is customary to denote thrombosis of superficial veins, since inflammation is absolutely clearly defined. And phlebothrombosis - venous thrombosis of the vessels of the deep system. And again, we repeat that in both cases it is possible to have a floating thrombus without signs of inflammation. In clinical practice, controversy and opposition of these two conditions also has negative consequences. The presence of thrombophlebitis of the saphenous veins should not be regarded as a mild pathology, since the spread of a thrombus to the deep system or the parallel independent occurrence of phlebothrombosis and thrombophlebitis pose a real danger of pulmonary embolism and death. It is also important to form a thrombus in the deep vein system with subsequent, in fact, disability of patients. Chronic venous insufficiency and post-thrombophlebitic disease require regular, long-term and expensive treatment.

Factors contributing to the formation of a blood clot.

Disorders in the blood coagulation and anticoagulation system - congenital and acquired coagulopathies - genetic pathology, hypovolemia, medication, etc.

Slowdown of blood flow velocity - varicose veins, prolonged static positions, external vascular compression, etc.

Trauma and other damage to the vessel - operations, increased physical activity, paravasal purulent processes, systemic inflammatory processes, IV injections, etc. Try to imagine situations in which these factors arise - almost always.

Treatment regimens for venous pathology associated with the formation of blood clots.

In the treatment of the developed thrombosis and phlebitis, three main goals can be distinguished: to stop the spread of the thrombus and its migration, thereby minimizing the risk of developing pulmonary embolism (PE); localize and stop inflammatory changes; prevent repeated episodes of thrombophlebitis.

There are as many options for localization, prevalence and intensity of the process as the venous system is rich in highways, tributaries (collaterals) and overflows (perforators). In each case, the scope of treatment, the need for hospitalization and surgery are decided individually. Note that in all cases, it is necessary to prescribe anti-inflammatory and phlebotropic drugs. Rheological, antiplatelet and anticoagulant therapy is carried out according to indications. Antibiotic therapy is ineffective and senseless, because the inflammation is aseptic, except in cases of purulent fusion of a thrombus. The table shows the approximate tactics and treatment regimen (without diagnostic measures).

Localization and spread of thrombus

Tactics and treatment

Segmental thrombophlebitis of the tributaries of the great saphenous vein (GSV) on the lower leg with or without signs of spread to the GSV itself. Thrombophlebitis of GSV up to the knee level without signs of ascent during treatment. Thrombophlebitis of the small saphenous vein (SSV) and / or its tributaries at a distance (n / 3 of the lower leg) from the popliteal region without signs of ascent. No symptoms of deep vein thrombosis or PE.

Perhaps outpatient treatment, Active lifestyle, Elastic bandages or knitwear, Non-steroidal anti-inflammatory drugs (NSAIDs - ketorol, ketonal, diclofenac, nimulide) at the beginning parenteral, then in tablets, Phlebotropic drugs - Detralex (Venorus) up to 6 tablets in the first days, troxevasin , Local NSAIDs and heparin ointments. Planned phlebectomy.

Thrombophlebitis of GSV with the spread of a physically determined thrombus in the lower third of the thigh and above to the middle third of the thigh. Thrombophlebitis of the MPV is not higher than cp / 3 of the lower leg. Signs of a bottom-up process. As well as signs of deep vein thrombosis or PE.

Hospitalization in a hospital, Elastic bandaging for at least 7-10 days around the clock, Non-steroidal anti-inflammatory drugs (NSAIDs - ketorol, ketonal, diclofenac, nimulide) parenterally at the beginning, then in tablets, Phlebotropic drugs - Detralex (venorus) up to 6 tablets in the first days, troxevasin , Local NSAIDs and heparin ointments, Antiplatelet agents - aspirin, pentoxifylline (trental), according to indications anticoagulants - enoxaparin, nadroparin, dalteparin, warfarin, Exanta (melagatran / ximelagatran).

Localization or spread of a thrombus in the GSV at the level of the middle and upper third of the thigh. Localization of a thrombus in the SSV at the level of the popliteal fossa.

Hospital, surgery for urgent indications - Ligation and transection, respectively, of the GSV or the MPV and the tributaries at the place where they enter the femoral vein. Further treatment as in the previous paragraph.

spread of thrombosis through fistulas or perforators to the deep venous system

Cavafilter insertion or plication or clipping of the inferior vena cava, thrombectomy from the great veins or from perforators, transection and ligation of the GSV and SSV at the orifice.

Deep vein thrombophlebitis

Emergency hospitalization, Bed rest

Beller's tire, Reopoliglyukin 400.0 + 5.0 trental,

troxevasin 1 cap x 4 times, aspirin ¼ tab x 4 times, heparins, cavafilter installation, phlebotropic drugs and NSAIDs.

Additionally, it should be noted that to clarify the localization of the thrombus, it is necessary to perform an ultrasound examination of the veins. Elastic bandages for phlebothrombosis should be applied with caution after the ultrasound scan. By compressing the subcutaneous vein system, we either increase the blood volume by 20% in the deep system, or completely block the outflow of blood from the lower extremity. In the first case, the likelihood of a thrombus detachment increases, in the second we aggravate the clinical picture of acute phlebothrombosis.

Source: pro-medica.ru

Thrombosis bpv treatment

A unique case of treatment of acute thrombophlebitis of GSV on the right thigh using the Biolitec EVLK procedure with a 2-Ring radial light guide.

Case history No. 4. (patient B., 59 years old)

This case history presents a unique case of treatment of acute ascending thrombophlebitis in the GSV pool on the right thigh using the EVLK endovenous laser coagulation procedure Biolitec radial light guide 2- Ring and simultaneous endovenous laser coagulation with EVLK Biolitec of the BPV trunk on the left with a radial light guide Classic after a previous acute thrombophlebitis.

Phlebologist consultation and examination

A 59-year-old man came to the innovative phlebological center with complaints of redness and painful induration on the inner surface of the right thigh, which very quickly increased in size and spread up the thigh.

Medical history: varicose veins on both lower limbs appeared more than 25 years ago. They gradually increased in size. I did not go to the surgeon of the polyclinic, because nothing hurt and "nothing bothered at all."

In 2000, for acute ascending thrombophlebitis of the great saphenous vein on the left lower limb, he was operated on in a surgical hospital of a city hospital. An emergency operation was performed: crossectomy on the left (ligation of the GSV at the site of its confluence with the deep femoral vein). The postoperative period was uneventful. The inflammation gradually subsided, and the patient was discharged under the supervision of a polyclinic surgeon with further recommendations: surgical treatment "combined phlebectomy under general anesthesia»Both lower extremities in a planned manner, after complete resorption of thrombotic masses ... However, after being discharged from the hospital, the patient safely forgot about all the recommendations of the doctors, since again “nothing bothered”.

About 2 days ago, there was a slight soreness and redness along the inner surface of the right thigh. He turned to me for examination and treatment.

Acute ascending thrombophlebitis in the basin of the great saphenous vein on the right thigh

Inspection: on the inner surface of the right thigh, from the middle third to the area of \u200b\u200bthe knee joint, the skin is sharply hyperemic, palpation reveals a dense, painful cord of the thrombosed great saphenous vein.

Ultrasound scan of the veins of the lower extremities:

The deep veins of both lower extremities are completely passable, the blood flow is phasic, and there are no signs of blood clots in them.

On right: there is a pronounced varicose transformation of the great saphenous vein throughout. The diameter of the great saphenous vein in the area of \u200b\u200bthe sapheno-femoral junction is 28 mm, then the trunk on the thigh to the middle third has a rectilinear course, with a diameter of 14-18 mm. From the middle third of the thigh to the area of \u200b\u200bthe knee joint, the GSV trunk is filled with dense thrombi, no signs of flotation were revealed, and blood flow in this zone is not localized. The valves of the SPS and the BPV barrel are not consistent.

Left: the stump of the GSV trunk is not determined - crossectomy (2000). Below the inguinal fold, at a distance of 10 cm, the varicose vein of the GSV is located, up to 8 mm in diameter, with dense walls and parietal thrombomasses. Good blood flow is determined in the lumen of the vein. The BPV barrel valves are not consistent.

Clinical diagnosis:

Acute ascending thrombophlebitis of the trunk of the great saphenous vein on the right thigh. Condition after crossectomy on the left (for acute ascending thrombophlebitis of GSV 2000). Varicose veins. Varicose veins of both lower extremities, in the stage of decompensation. Chronic venous insufficiency stage II.

Treatment:

After preoperative preparation, urgently , the patient under local anesthesia and under the cover of low molecular weight heparins was performed endovenous laser coagulation of the trunk of the great saphenous vein on the right using Biolitek technology with radial light guide 2- Ring (above the blood clot level) c varadi miniflebectomy of the GSV trunk and varicose tributaries on the lower leg and endovenous laser coagulation of the left great saphenous vein trunk using Biolitek technology with a radial light guide Classic c miniflebectomy according to Varadi of varicose tributaries on the lower leg .

The following were eliminated at once:

the threat of further spread of the inflammatory process to other veins,
the threat of blood clots entering the deep venous system
the threat of thrombophlebitis on the other lower limb
the threat of thromboembolic complications (PE).

Procedure EVLK Biolitek on both lower extremities was 1 hour 30 minutes, after which the patient was wearing a compression stocking of the II class of compression, and it was recommended after discharge to walk for 1 hour on the street on his own.

Control examination and ultrasonic testing:

The next day when viewing: inflammation and pain sensations decreased. I did not take painkillers. Slept well at night.

UZDS:

The trunk of the great saphenous vein to the right of the sapheno-femoral anastomosis to the middle third of the thigh (upper edge of the thrombus) is completely obliterated.

The trunk of the great saphenous vein on the left thigh is completely obliterated.

The blood flow in the obliterated GSV trunks is not determined.

Results of treatment of acute thrombophlebitis after 2 weeks

Acute thrombophlebitis of the right lower extremity after the Biolitec EVLK procedure with a 2-Ring radial light guide on day 14.

The presented images clearly show that the phenomena of inflammation have practically disappeared, the thrombosed large saphenous vein on the right of the thigh is absorbed.

On examination: changes in the skin and subcutaneous tissue are fully consistent with the transferred procedures. The phenomena of inflammation subsided: the hyperemia on the skin disappeared, the thrombosed trunk of the GSV was palpated in the form of a dense, painless cord. Varicose veins and nodes on both legs are not visualized.

UZDS: deep veins of the right lower extremity are passable, blood flow is phasic, synchronized with the act of breathing.

The trunk of the great saphenous vein to the right of the sapheno-femoral anastomosis to the knee joint area is completely obliterated, decreased in diameter by 2-3 times.

The trunk of the great saphenous vein on the left thigh is completely obliterated, in some areas it is not located. Blood flow in obliterated GSV trunks is not determined.

Results of treatment of acute thrombophlebitis after 1 month

Acute thrombophlebitis of the right lower limb after the Biolitec EVLK procedure with a 2-Ring radial light guide after 1 month

The pictures clearly show that the inflammation has completely disappeared, the thrombosed great saphenous vein on the right thigh is not visualized.

The patient is healthy and discharged under the supervision of a phlebologist. She will come to the innovative phlebological center for the next examination in 2 months.

Conclusion:

This clinical case once again demonstrates the possibility of treating patients with acute ascending thrombophlebitis with endovascular thermoablation methods, without resorting to unnecessary and traumatic surgical interventions.

In just 90 minutes, serious problems were solved at once:

The threat of further spread of the inflammatory process to nearby veins has been eliminated
The threat of thrombotic masses entering the deep venous system has been eliminated
The threat of blood clots rupture with the subsequent development of pulmonary embolism (PE) has been eliminated
The threat of the development of repeated thrombophlebitis on the other lower limb has been eliminated
Removed varicose veins and varicose nodes on both lower limbs.

Venous thrombosis (phlebothrombosis) is an acute disease characterized by the formation of a thrombus in the lumen of a vessel (a blood clot that obstructs the lumen of the vessel) with a more or less pronounced inflammatory process and a violation of normal blood flow.

Thrombosis and thrombophlebitis are often diagnosed in the veins of the thigh. Consider this disease.

Damage to the deep, superficial and perforating veins of the thigh

The entire venous system of the thigh can be subdivided into deep, superficial and perforating (connects deep and superficial). Thrombus formation in the femoral veins most often occurs in the deep system. The defeat of the superficial vein system most often occurs with thrombophlebitis.

For thrombus formation in the femoral veins, the following changes must be:

Slowing down of blood flow in a vessel (stasis). Most often observed with prolonged immobilization of the limb (for example, after an injury).
Changes in the rheological properties of blood (increased coagulability). May be associated with hereditary pathologies (for example, lack of factors that prevent blood clotting) or with previous surgical interventions.
Damage to the inner surface (endothelium) of the vein. It can be triggered by various medical procedures (for example, placement of venous catheters, various surgical interventions).

Distinctive symptoms and signs

For thrombophlebitis of the superficial veins of the thigh, the following points are characteristic:

soreness along the venous vessel (the vein is felt like a cord with nodes);
swelling around the painful area (sweating of the liquid part of the blood into the surrounding tissues);
hyperemia (redness) of the skin over the affected area of \u200b\u200bthe vein (associated with the expansion of the subcutaneous capillaries);
an increase in local temperature over the affected area of \u200b\u200bthe vessel;
an increase in body temperature (the body's response to an existing infectious inflammatory process);
general malaise.

The presence of a thrombus - a blood clot that blocks the lumen of a vessel in the deep vein system can be characterized by:

soreness of a bursting character in the area of \u200b\u200bthe affected segment of the vein;
gradually increasing intensity of pain syndrome;
cyanosis of the skin (occurs due to circulatory disorders, stagnation of blood in the venous vessels);
tension of the skin;
swelling of superficial veins.

Features of central and ascending thrombosis of the femoral veins

Phlebothrombosis can be divided into:

central (originates from the venous system of the pelvis);
ascending (starts from the veins of the lower leg).

With the ascending variety, the veins are affected on both sides with the same frequency. Characterized by a long latent course of the pathological process. The emerging edema is of an "ascending" character (there is a gradual increase in edema, which originates from the foot, gradually spreads to the lower leg and then to the thigh).

Changes during the transition to thrombophlebitis

Thrombophlebitis is an inflammatory process that occurs in the inner wall of a vein. The resulting blood clots attach to the vascular wall. During the first 3-4 days, the forming blood clots are poorly retained on the wall, so their separation and migration along the bloodstream is possible. If this does not happen, then the thrombus is fixed on the vessel wall, which provokes the development of an inflammatory reaction. The latter leads to the formation of new blood clots.

To the clinical picture of phlebothrombosis (swelling, soreness, cyanosis of the skin), manifestations of thrombophlebitis (increased body temperature, increased local temperature, redness) are added.

How to diagnose the disease

The following methods are used for diagnostics:

Physical examination... This includes palpation. A change in the temperature of the skin of the thigh, swelling of the tissues is noted. Skin discoloration is also characteristic.
Duplex ultrasound examination... The analysis of the reflected signal is performed, according to which the nature of the venous blood flow is assessed. It is possible to determine the location of the formed thrombus, its nature and size. With thrombophlebitis, a change in the thickness and structure of the walls of the venous vessel is detected.
Thermography... It is based on the fact that during the formation of thrombosis, the temperature of the tissues becomes higher than in the normal state.
Plethysmography... Its action is based on the fact that in the presence of a blood clot, an increase in blood deposition occurs. This leads to a change in the electrical resistance of tissue structures, which is displayed graphically.
Phlebography... An X-ray contrast agent is injected into the venous bed, followed by its visualization. The presence of an obstructing blood clot is evidenced by the "amputation" of the vein - a break in the shadow of the X-ray contrast agent.
D-dimer analysis... D-dimers are a breakdown product of the fibrinogen protein, which is involved in blood clotting. Its level increases with thrombus formation.

Conservative and surgical therapy

The main objectives in the treatment of deep femoral vein thrombosis are:

restoration of normal venous outflow;
reducing the risk of developing pulmonary embolism - pulmonary embolism;
prevention of further growth of an existing blood clot;
prevention of damage to the valve apparatus of the veins;
prevention of the development of re-development of thrombus formation.

Therapeutic tactics for this pathology is determined directly on the basis of the clinic of pathology and the results of instrumental studies.

For conservative therapy are used:

Anticoagulant drugs (reducing blood clotting ability). Used Heparin, low molecular weight heparins (Enoxaparin, Deltaparin, Fraxiparin).
Fibrinolytic drugs. These are the medicines that are able to dissolve the formed blood clot. They are used in the first few days after thrombosis, after their use is ineffective. These include Alteplaza, Tenekteplaza.
Antispasmodics. Papaverine, Drotaverine.
Venotonics. Detralex, Phlebodia 600.

With an existing inflammatory process affecting the vein wall, the treatment process consists in the use of the following drugs:

Anticoagulants. Most often it is used topically in the form of a heparin ointment.
Venotonics. Troxerutin, Detralex, Phlebodia 600.
Non-steroidal anti-inflammatory drugs. Most often, Diclofenac, Nimesulide are used.
Antibiotic therapy. They resort to it with a pronounced inflammatory process.

Warm compresses and the use of physiotherapy (UHF) are also recommended. You should not stay in bed for a long time, as physical activity improves blood flow, which is the prevention of blood clots. For the period of physical activity, the use of elastic compression (elastic bandaging, compression hosiery) is recommended.

Surgical treatment of thrombophlebitis is indicated only if there is:

ascending thrombophlebitis;
a thrombus formed in the superficial vein system of the thigh.

Possible complications and prognosis

Possible complications of thrombophlebitis and thrombosis of the veins of the thigh include:

chronic venous insufficiency;
TELA;
the formation of trophic ulcers;
lipodermatosclerosis.

Without treatment, the risk of complications is high. In the absence of taking anticoagulant drugs, approximately 30% of patients experience a relapse of the pathology within 3 months, and 70% after a year. After the treatment of thrombosis, the probability of recurrence after 1 year is about 4-5%.

Thrombosis and thrombophlebitis are dangerous pathologies that can cause the development of formidable complications. To avoid this, timely diagnostic procedures are necessary, as well as the correct choice of treatment tactics.

Thrombophlebitis of the superficial veins of the lower extremities is a disease characterized by the formation of blood clots on the wall of these vessels and blockage of their lumen. The disease leads to circulatory disorders, muscle weakness and dysfunction of the lower limb. Pathology should not be ignored, since there is a possible risk of developing serious complications. Consider what superficial thrombophlebitis is - the nature of the pathology and methods of treatment.

How pathology develops

For the development of thrombosis of superficial veins in the legs, a change in blood viscosity, disruption of the vital functions of white blood cells, a decrease in blood flow and damage to the venous wall are necessary. A sediment forms in a certain area, which gradually thickens and forms a clot, which closes the lumen of the vessel. Later, inflammation joins, and signs of the disease appear. Sometimes the thrombus breaks off and acute thrombophlebitis of the saphenous veins is formed.

According to ICD 10, this pathology was assigned the code "I 80".

Etiology

Superficial thrombophlebitis is a complex pathology that progressively progresses. For its development, a single pathological chain is needed, to which the following reasons can lead:

Deep vein thrombosis of the leg - when blood clots appear in these areas, they may migrate with the blood flow to the superficial vessels;
Limb trauma - any damage to the skin, muscles and other tissues destroys the integrity of the saphenous vein wall and can lead to the development of thrombosis;
Complicated heredity - according to scientific data, there is a genetic predisposition to increased "sticking" of white blood cells and the formation of blood clots;
Varicose veins - with this pathology, stagnation occurs in the venous bed, which can provoke thrombophlebitis;
Infections - when the body is infected with microbial agents, complex protective mechanisms of the rapid formation of blood clots at the sites of cell damage are launched in parallel;
Allergies - can trigger an autoimmune attack of white blood cells;
Overeating and excess weight - in this case, the concentration of substances in the blood increases, increasing its viscosity;
Operations - when interfering with the internal environment of the body, the risk of blood clots and vascular damage increases;
Pregnancy period - changes in hormonal levels can negatively affect the regulation of tone vascular system and the qualitative composition of the blood.

In addition to the described reasons, side effects of certain drugs during treatment, various types of poisoning, can lead to disruption of local blood flow in the lower extremities. Increased blood viscosity can also develop when taking contraceptives, plasma transfusions. The vascular wall is damaged with frequent setting of a dropper or during intravenous injections.

Disease classification

In addition to ICD, thrombophlebitis is subdivided into several forms, depending on the severity of symptoms and the nature of local changes.

By severity clinical signs distinguish between:

Acute thrombophlebitis is characterized by rapid progression and severity of symptoms: pain appears sharply, rapidly increases, edema of the lower limb progresses, and its function is impaired. This condition requires urgent treatment;
Chronic thrombophlebitis - develops slowly, there are moderate symptoms, it may take several months before the patient's condition completely worsens.

Depending on the pathogenesis, two forms of vein thrombosis of the lower extremity are distinguished:

Purulent thrombophlebitis - characterized by the involvement of microbes and the development purulent inflammation... A very dangerous condition requiring complementary treatment antibiotics;
Nonsuppurative thrombophlebitis is a classic variant of the pathology, it proceeds with signs of circulatory disorders in the lower limb.

If the patient has a purulent variant of the pathology and there is no open trauma, in parallel with the treatment, it is necessary to be examined for the presence of a chronic focus of infection.

Clinical picture

The first signs of the disease usually develop gradually, when the blood clot slowly increases in size and clogs the lumen of the saphenous vein, causing circulatory disorders in the lower limb. If the clot breaks off the wall, an acute condition occurs that requires immediate treatment.

Classic symptoms of superficial vein thrombophlebitis:

Pain in the affected area, aggravated by movement or touch;
Under the skin you can see the outline of the vein along the "inflated" contour and characteristic cyanotic color - this indicates its blockage when it increases under pressure;
In the course of the vessel, subcutaneous red nodules appear;
Edema of the lower extremity develops, an increase in local temperature;
With prolonged thrombosis, ulcers appear that bleed and hurt.

These lesions are often referred to as ascending thrombophlebitis because the saphenous veins move upward toward the heart and become distended.

The most common are two types of thrombophlebitis of the lower extremity:

Ascending thrombophlebitis of the great saphenous vein (GSV) is characterized by edema mainly on the inner side. Under the skin, you can find a lump that rises upward, around which redness forms, and ulcers later appear. Thrombosis of the great saphenous vein of the thigh develops quite often, requires special attention from the attending physician;
Thrombophlebitis of the small saphenous vein - the symptoms are more blurred than in the previous case. Characterized by classic manifestations of disease and lesion upper divisions lower limb.

With varicose veins, thrombosis of the GSV on the right is very often observed.

Establishing diagnosis

For diagnostics, you need to visit your doctor - the doctor will conduct an external examination and detect subcutaneous changes. You can recognize blood clots on your own if you look at the photo of superficial thrombophlebitis of the lower extremities - the picture will show swelling and discoloration of the skin, along the course of the vein, you can see swollen cyanotic outlines.

For further detection of thrombosis, the following research methods are relevant;

Doppler ultrasound;
Rheovasography;
Ultrasonic duplex angioscanning;
Venography;
Contrast radiography.

Treatment

Treatment of superficial thrombophlebitis of the lower extremities involves strict bed rest and limited mobility. This rule should be observed to reduce the risk of blood clot separation from the subcutaneous vessel wall. For the same purpose, the use of an elastic bandage is shown to reduce congestion.

Drug treatment for thrombophlebitis of the superficial veins of the lower extremities should be comprehensive and include drugs that strengthen the vascular wall, thin the blood and prevent blood clots.

The most famous medicines

Heparin - relieves swelling and inflammation, prevents thrombosis. Rubbed three times a day, is quickly absorbed and acts on the subcutaneous tissue;
Gel Lioton - has similar properties, it is applied 2 times a day;
Ketonal cream - treatment should be carried out twice a day to relieve local symptoms and relieve pain in the affected area.

The second stage of treatment is to strengthen the walls of the subcutaneous vessels. For this purpose, venotonics are used:

Phlebodia - you should drink 1 tablet per day for 2-3 months;
Venarus - used three times a day, it perfectly strengthens the venous wall;
Troxevasin - treatment is allowed both with tablets and the application of ointments to strengthen the superficial veins of the lower limb;
Venoruton is an effective drug, available in capsule or gel form.

To increase the effectiveness of drug treatment of thrombosis, it is allowed to use folk recipes from thrombophlebitis, but only under the supervision of the attending physician.

Physiotherapy

This type of treatment is more likely to prevent the formation of blood clots in the saphenous veins of the lower extremities and is aimed at strengthening their walls. For this purpose, the following is shown:

Medicinal electrophoresis with medicinal ointments;
Warming up;
Laser treatments;
Magnetotherapy;
Shock wave therapy.

Operative treatment

Surgery is indicated if the effectiveness of conservative treatment is weak or if there are serious complications from thrombosis of the superficial vessels of the lower extremity. The following types of operations are shown to remove a thrombus:

Crossectomy - saphenous vein ligation;
Radical intervention - complete removal of the saphenous veins;
Palliative surgical treatment - removal of a thrombus from the lumen of the vessel.

Forecast

If the first signs of the disease are detected, you should immediately seek medical help - if appropriate treatment is available, the clot may dissolve and the function of the lower limb may return. You should also follow the doctor's recommendations for the prevention of thrombophlebitis.

The formation of blood clots in the superficial veins leads to thrombosis, and in the presence of inflammation, to thrombophlebitis of the subcutaneous vessels of the lower extremity. In most cases, the pathology develops gradually and requires examination. Do not delay with treatment, in the early stages it is very effective.

Ascending thrombophlebitis

Symptoms

Feeling of heaviness;
Increase in temperature.

Acute form of flow

Risk group

Basic principles of treatment

In a conservative way;
Surgical intervention.

Basic principles of therapy

The location of the blood clot;
Location of the affected veins.

Local therapy includes:

Fixation with elastic bandage.
Taking inhibitors.

Dissolution of a blood clot.

Preventive actions

Ascending thrombophlebitis

A lot of scientific works, encyclopedic data are devoted to the disease ascending thrombophlebitis. People want to know about the nature of the disease, methods of treatment.

Symptoms

The symptoms of the disease are often clearly presented; they do not cause difficulties in diagnosis.

The constant presence of a feeling of distention of the thigh, lower leg;
Feeling of heaviness;
The skin along the length of the affected leg vein is red, inflamed;
Pain in the lower leg, thigh, aggravated by movement;
Weakness, constant feeling of unwell;
Increase in temperature.

The disease poses a danger to life, so it is important to seek medical help from a phlebologist in time. They will help to cope with the disease, prevent complications in time.

Acute form of flow

Acute ascending thrombophlebitis # 8212; a complex consequence of varicose veins. This form of the disease carries the risk of death # 8212; there is a floating thrombus in the vein, the disease quickly moves from a small saphenous vein to the deep vein of the thigh. This threatens to damage the pulmonary artery.

Signs of an acute form of ascending thrombophlebitis:

Risk group

There are people prone to developing ascending thrombophlebitis of the veins of the lower extremities. They are highly likely to develop the disease.

If a person finds himself on the list, it is worth paying close attention to the state of his veins, making adjustments to his lifestyle.

Basic principles of treatment

At the first manifestations of ascending saphenous thrombophlebitis, you should contact a medical institution # 8212; doctors will diagnose, prescribe treatment. The fight against the disease is carried out:

In a conservative way;
Surgical intervention.

Sometimes complex treatment of thrombophlebitis of the veins of the lower extremities is advisable.

Basic principles of therapy

Treatment of ascending thrombophlebitis is complex.

Treatment of the acute form of the disease

The treatment of the acute form of the disease is influenced by factors:

The state of the vessels of the lower extremities;
The location of the blood clot;
Location of the affected veins.

Conservative treatment with medication, local therapy, more often in a hospital is often used.

Local therapy includes:

Using heparin ointments.
Semi alcoholic, cold compresses.
Fixation with elastic bandage.
Taking drugs that stabilize blood circulation.
Taking inhibitors.
Pain relievers.

The operation is performed in the following cases:

Dissolution of a blood clot.
The risk of developing pulmonary embolism.
The defeat of the acute form of a large, small saphenous vein, when the thrombus is located above the middle of the thigh.

To remove a thrombus, laser obliteration is often used, based on heating the vessel wall above the location of the thrombus. Crossectomy operation # 8212 is performed; ligation of the superficial vessel at the transition to the deep one is carried out under local anesthesia.

Preventive actions

People who are at risk of developing ascending thrombophlebitis should heed the phlebologist's recommendations:

Thrombophlebitis of the saphenous veins

Thrombophlebitis of the saphenous veins

What is saphenous thrombophlebitis?

In fact, saphenous vein thrombophlebitis is a "double" disease. Because, firstly, the venous walls themselves become inflamed. And secondly, in the vein is formed blood clot - thrombus.

Superficial thrombophlebitis in the overwhelming majority of cases manifests itself as an acute disease.

More often thrombosed varicose transformed tributaries of the large (and / or small) saphenous vein, as well as perforating veins. But in the absence of treatment, thrombosis spreads to the largest (small) saphenous vein itself, and further, to the deep veins.

Causes of superficial vein thrombophlebitis

Any thrombosis is caused by a combination of three factors:

Change in the configuration of the vein (for example, varicose transformation) and, as a result, "swirls" of blood in the lumen of the vessel.

- "thickening" of blood - a tendency (hereditary or acquired) to thrombosis

- damage to the vein wall (injection, trauma, etc.)

The main and most common cause of superficial thrombophlebitis is varicose veins. Also, the most common risk factors are:

- pregnancy and childbirth;

- endocrine and oncological diseases.

Superficial thrombophlebitis: symptoms and manifestations

- the appearance of "nodules" and seals in the vein;

- local temperature rise;

- discoloration of the skin in the area of \u200b\u200bthe inflamed vein.

Treatment of superficial thrombophlebitis

For the treatment of thrombophlebitis of superficial veins, different techniques and their combinations are used.

- compression therapy - wearing compression stockings, special elastic bandage;

- taking non-steroidal anti-inflammatory and analgesic drugs;

- locally, in the area of \u200b\u200binflammation - cold;

- according to indications - taking drugs that "thin" the blood.

In this case (if technically feasible), either endovenous laser obliteration or crossectomy is used - ligation of the large (small) saphenous vein along with its tributaries.

In this situation (if technically possible), the removal of a thrombus from the deep veins and crossectomy is performed - ligation of the saphenous vein at the mouth.

In the medical field, the term "ascending thrombophlebitis" is usually understood as inflammation of the vein walls and the appearance of a thrombus, as a result of which the lumen of the vein is blocked and blood flow is disturbed. The most common cause of this ailment is a complicated form of varicose veins.

The main risks of the manifestation of the disease are considered to be overweight, significant regular physical activity on the lower extremities, elderly age, pregnancy and childbirth, leg injuries, postoperative period, taking hormonal drugs.

Ascending thrombophlebitis is diagnosed in situations where thrombophlebitis from the part of the great saphenous vein located on the lower leg moves up to the inguinal folds.

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During the period of the disease, when the inflammation goes to the deep veins, there is the greatest risk of separation and movement of the blood clot. And this, in turn, can cause a life-threatening complication - pulmonary embolism.

Acute form

A fairly common form of complication of varicose veins is acute ascending thrombophlebitis.

This stage of the disease carries a significant risk to the patient's life, since it allows the possibility of an immediate transition of inflammatory processes to the deep veins in the legs and the separation of a blood clot.

A floating clot in the veins can soon lead to blockage of the arteries.

Symptoms

Often, the symptoms of ascending thrombophlebitis have a pronounced character. For this reason, diagnosing this disease is not difficult.

The clinical picture is determined by the localization of the inflammatory process, its timing, as well as the extent of its spread. In addition, special attention is paid to the damage to muscle tissue adjacent to the focus of the disease.

Considering all these symptoms, doctors determine the form of the disease - from minor inflammatory processes to clearly pronounced ones. The most risky is the manifestation of the disease of the large saphenous veins.

With ascending thrombophlebitis of the saphenous vein, edema of the lower extremities does not occur, and the disease manifests itself as follows:

when palpating the inflamed areas, compaction is felt, and the patient experiences pain;
the temperature of the skin rises;
subcutaneous tissue is thickened, and the skin has redness;
while walking, the soreness increases, there is a constant heaviness in the legs;
the patient complains of general malaise and weakness.

However, in the case of further spread of the inflammatory process through the blood vessels, large veins are damaged, namely, the large saphenous, common femoral, and also the sapheno-femorial anastomosis.

In such a situation, the symptoms will be quite pronounced. Edema of the lower extremities occurs from the feet to the lower back, accompanied by heaviness and pain.

The attending physician conducts a visual examination of the patient and examines the medical history in detail. In modern medicine, ultrasound is considered the most accurate study of blood vessels.

This type of diagnostics allows:

assess the condition of the veins;
determine the presence of blood clots;
study the patency of both superficial and deep veins.

In addition, an additional study of ascending thrombophlebitis can be performed using radiopaque phlebography.

After establishing the diagnosis - ascending thrombophlebitis, a complex treatment of the disease is prescribed. The patient is recommended an active mode. Avoid prolonged immobility of the limbs.

In the course of treatment, a regular admission is prescribed, preventing the formation of blood clots and restoring the tone of blood vessels, as well as anti-inflammatory drugs. With severe symptoms, they are prescribed.

Conservative therapy

In the early stages of the development of the disease, doctors recommend doing elastic compression on the legs so that the blood clot cannot move to large blood vessels.

For this, a bandage made of medium elastic bandage is used. The leg is wrapped for a period of 10 days completely from the foot to the groin. After reducing inflammation, the bandage is replaced with compression hosiery.

In order to reduce pain in the early days of the disease, you can resort to an ice pack. Ice is applied several times during the day for 15-25 minutes.

In addition, a number of medications can be prescribed to prevent blood clots and restore blood vessels:

Venoruton	restores the tone of blood vessels and has a protective effect on them; this medication is used in the form of dissolving tablets, capsules and ointments; tablets and capsules are for oral use, and the ointment is for rubbing only; venoruton helps to reduce blood flow and eliminate its stagnation, helps to normalize blood flow and oxygenate small capillaries.
Troxevasin	Promotes the restoration of the walls of blood vessels. This drug strengthens capillaries, relieves inflammation and reduces swelling of the lower extremities. Also, the drug is prescribed for patients with chronic venous insufficiency. This medicine allows you to reduce pain and cramps in a short time. Thanks to Troxevasin, it is possible to restore normal blood circulation, prevent the appearance of blood clots and blockage of blood vessels. This drug is contraindicated in women in the early stages of pregnancy and nursing mothers, people suffering from intestinal or stomach diseases. Anti-inflammatory drugs prescribed by doctors for this disease include Ibuprofen and Diclofenac.
Ibuprofen	Allows you to lower the temperature in case of fever, reduce inflammation and pain. It is worth taking the drug only after eating, in order to prevent such side effectslike flatulence, nausea, vomiting, allergic skin rashes. You should be careful in the dosage of this medication for people with liver disease, gastrointestinal tract, gastritis and chronic hepatitis.
Diclofenac	In ampoules it is intended for intramuscular injection. It helps to reduce the inflammatory process with varicose veins and ascending thrombophlebitis, relieve painful swelling both during the illness and in the postoperative period. The course of treatment with this drug should be no more than five days. If the patient continues to feel unwell, ampoules are replaced with capsules or tablets. At the beginning of the treatment course, one ampoule of medication is injected per day. If the disease continues to progress, then the dose is doubled. There are frequent cases when rubbing with ointments and gels, as well as UHF therapy, are prescribed for the treatment of this ailment. Basically, ointments and gels containing heparin are used, which helps relieve inflammation. The most famous drug of this type is Lioton gel. Apply it twice a day, applying a thin layer to painful areas. The gel helps to eliminate swelling and reduce the feeling of heaviness in the legs. After applying the ointments, it is necessary to wear compression hosiery.

All medications, elastic bandages and compression hosiery are selected individually by the attending physician - phlebologist

Surgical intervention

Treatment with conservative methods is appropriate only in cases where there is no risk of moving inflammatory processes to deep veins and only when the disease is localized in the lower leg region.

In the event of a possible threat of the transition of inflammation to a deep vein, an operation is performed as soon as possible for ascending thrombophlebitis using a surgical intervention.

The most effective method of surgical treatment is crossectomy. The essence of this operation is reduced to ligation and transection of the great saphenous veins and their main tributaries in the part where they connect to the deep vein of the thigh.

To perform this operation, a small incision is made in the groin fold. Upon completion, a suture is applied. After healing, the scar is almost invisible.

Very often, after removing inflammation, doctors resort to phlebectomy - surgery to remove varicose veins.

Prevention

Ascending thrombophlebitis is considered a dangerous disease of the circulatory system. It takes a lot of time and effort to cure this disease. Therefore, people prone to this disease should remember about preventive measures to prevent the development of this disease.

You need to lead an active lifestyle, regularly do gymnastics. To avoid stagnation of blood in the vessels of the lower extremities, you should rest with your legs raised (you can use a small pillow for this). In the case of long trips or flights, it is recommended to drink plenty of fluids, change body position more often, and move limbs.

Do not forget about proper nutrition: eat more fresh vegetables and fruits, limit the intake of animal fats as much as possible.

To prevent recurrence of the disease, it is necessary to use medical compression hosiery on an ongoing basis, take vitamins and anticoagulants, limit yourself from heavy physical exertion, refuse to visit the bath and sauna, as well as take hot baths.

With thrombosis, the vein is blocked and blood flow is obstructed. Thrombosis of the great saphenous vein most often occurs due to damage to the venous wall. The most difficult and dangerous option in terms of the development of complications is considered to be acute ascending thrombophlebitis of the great saphenous vein. There are three options for the course of events with blood clots:

possible blockage of the vessel and impaired blood circulation;
can come off and pass with blood to other organs;
may dissolve.

The disease requires immediate treatment under the regular supervision of a specialist.

In Europeans, thrombosis of the saphenous veins of the lower extremities occurs much more often than in Asians. After forty years, this disease is observed in every fifth woman and every fourth man. In obese people, the risk of thrombophlebitis is much higher.

Thrombophlebitis of the saphenous veins - treatment is prescribed only by a phlebologist based on the individual characteristics of the patient. If thrombophlebitis appears at the level of the leg, then treatment can take place at home under the supervision of a doctor. If ascending thrombophlebitis occurs, treatment is carried out strictly in a hospital, thrombosis in this case can pose serious risks to life.

During the examination, the doctor compares the two limbs completely, if necessary, measures the inflamed leg in diameter. The doctor also evaluates the skin, swelling and soreness. An ultrasound scan of the veins of the legs is prescribed.

Use of elastic compression underwear;
To reduce pain, the doctor may prescribe ice compresses (apply during the day for 20 minutes);
The use of antigulant therapy: nadroparin, enoxaparin;
Non-steroidal anti-inflammatory drugs: Diclofenac, ketoprofen;
Angioprotectors - improve the condition of the venous wall: rutoside, diosmin;
Antibiotics;
Antiplatelet drugs: Dipyridamole, acetyl acid;
Blood thinners: Fragmin, Phlebodia;
The use of ointments containing heparin, which has an anti-inflammatory effect and relieves swelling: heparin ointment, ketonal 5%, Lioton-gel and others;
Physiotherapy: ultraviolet radiation, infrared radiation, electrophoresis, magnetotherapy, laser therapy, DArsonval, barotherapy.

My patients have used a proven remedy, thanks to which you can get rid of varicose veins in 2 weeks without much effort. If conservative therapy is unsuccessful, the doctor may prescribe surgery... The essence of such an operation is to prevent the blood from moving from deep to superficial. The veins below the knee are ligated. Surgery is safe and is usually performed under local anesthesia.

There are several types of surgery:

Venectomy - removal of a vein;
Removal of thrombosed veins;
Thrombectomy;
Crossectomy - ligation of the great saphenous vein;
Removal of the trunk of the great saphenous vein using the Bebcoccus probe.

Causes of occurrence

Thrombophlebitis of the great saphenous vein is formed due to inflammation of the vein. The same reasons for the occurrence:

Deep vein thrombosis;
Heredity;
Varicose veins;
Tuberculosis;
Cancers;
Change in blood, congestion;
Antiphospholipid syndrome;
Obesity;
Surgical interventions;
Pregnancy;
Intravenous drug administration;
Sedentary work, passive lifestyle.

There are three main causes of venous thrombosis, and they are called the "Virchow triad":

increased blood clotting;
violation of the integrity of the walls;
slow blood flow in the vessels.

Contribute to the implementation of the Virchow triad:

lack of mobility (long flights, bed rest, office work, hours of driving),
large body weight,
operations, fractures,
varicose veins of the extremities,
smoking,
taking medications that thicken the blood,
pregnancy,
oncological diseases,
hormonal disorders
infections
heavy physical activity.

When some conditions occur, thrombophlebitis can be localized in the veins throughout the body, but most often in the legs.

At risk of injury are people who overload the body with physical activity on a daily basis. This can occur during sports training, work that requires significant effort, and so on. But this does not mean that the disease affects extremely active people. There are many reasons that lead to the development of the disease.

Launched thrombophlebitis

According to statistics, in 15% of cases, thrombophlebitis affects the veins that are located in depth.

There are some factors that trigger the development of thrombophlebitis:

changes in the properties and composition of blood, increased coagulability,
slow blood flow.
trauma to the venous wall of blood vessels.

The danger to human health arises when:

varicose veins and complications;
purulent processes on the skin;
diseases of the heart and blood vessels in acute and chronic form;
blood diseases;
period after surgery;
period after childbirth;
all kinds of leg injuries;
malignant tumors;
with prolonged presence of the catheter in the vein;
infectious diseases.

What exactly leads to thromboembolic complications?

Venous thrombosis occurs when a number of unfavorable circumstances occur, which lead to a slowdown in blood flow through the veins of the legs, an increase in blood clotting and damage (often microscopic) of the venous wall. The speed of blood flow through the veins slows down sharply when people are limited in mobility due to adherence to bed rest, a long flight or when driving in a car.

The blood clotting potential increases in response to trauma, bleeding, surgery, infection, dehydration, the development of malignant neoplasms, and uncontrolled intake of female sex hormones for contraception or replacement. The genetic predisposition of a number of people is also important - they have so-called congenital thrombophilia.

What is the catalyst for the development of thrombosis?

This "catalyst" is often a variety of trauma, surgery and, unfortunately, even childbirth.

What measures should a doctor take to minimize the risk of venous thrombosis?

First, it is important to minimize the patient's adherence to bed rest, it is advisable to activate the patient in the next few hours after operations. Secondly, reducing the duration and trauma of surgical intervention, including with the help of new technologies, are important components of preventing thrombotic complications.

In 2009, the Russian Society of Surgeons, the Association of Phlebologists of Russia and the Scientific Research Institute of Preventive Medicine developed a nationwide educational medical and social project "Safety Territory" as one of the methods of combating mortality from thromboembolism. The goal of the project is to reduce the death rate of patients from venous thromboembolic complications (VTEC).

Within the framework of the project, doctors assessed the risk of these complications using electronic scorecards in all hospital patients and prescribed effective preventive measures, if necessary, that made it possible to reduce by 10 times the level of hospital mortality from thromboembolism in hospitals participating in the project over 5 years.

As already mentioned, favorable condition for the development of thrombophlebitis is varicose veins of the legs. In this case, there is stagnation of blood in the veins, weakness of the venous walls, venous insufficiency, increased venous pressure and deformation of the venous walls. All these factors are enough for any infection to penetrate the vessel wall and cause inflammation.

Lowered immunity, blood clots caused by illness or medication, also make it easier to fix infectious agents on the vascular wall.

Thrombophlebitis can be triggered by trauma to the venous wall, a medical procedure (intravenous injection, vein catheterization, vascular surgery, etc.), an infectious disease, such as influenza, ARVI, pneumonia, tonsillitis, tuberculosis, and even caries.

Superficial venous thrombosis of the lower extremities: symptoms, treatment

Ascending thrombophlebitis is diagnosed in situations where thrombophlebitis from a part of the great saphenous vein of the lower leg moves to the region of the inguinal folds.

Ascending thrombophlebitis of the great saphenous vein can be complicated by an acute form of the disease. When deep vein inflammation occurs, there is a huge risk of a blood clot breaking off. The worst outcome is pulmonary artery inflammation.

The most common form of the disease is superficial vein thrombosis; as a rule, the vessels of the legs are affected. The reason is that the veins in this area experience the greatest stress - this is the most distant part of the bed, and the veins hardly pump blood from the bottom up. Varicose changes, if any, are more pronounced on the legs.

Thrombosis of the saphenous veins is much easier to identify than deep ones. When a blood clot forms

the vein becomes tight and painful to the touch
reddening of the skin is visually observed in the area of \u200b\u200bthe affected area,
the local temperature rises,
the limb swells slightly below the location of the thrombus.

Treatment of superficial thrombosis is usually conservative if there is no danger of the thrombosis spreading to the deep vein system.

Thrombus fixation. If it was possible to diagnose thrombosis in the acute period, there is a danger of fragmentation of the blood clot and the removal of pieces of the thrombus with the blood flow to the heart. Therefore, prescribe bed rest for a week, complete rest of the affected limb, local application of anti-inflammatory and absorbable ointments.
Fighting inflammation. Prescribe non-steroidal anti-inflammatory drugs, medications to normalize metabolic processes - troxevasin, escuzan, askorutin.
Prevention of thrombus formation. Aspirin is used as a disaggregant.

In the future, the motor regime is gradually expanded, carrying out the obligatory compression of the saphenous veins using special stockings or elastic bandages. Surgical removal of varicose veins is recommended after 2-3 months. after thrombosis.

Superficial blood clots, dangerous in terms of complications, are located in the thigh area in the great saphenous vein and in the popliteal region in the small saphenous vein. These cases are subject to surgical treatment - either a thrombus is removed, or the mouth of the saphenous vein is bandaged where it flows into the deep one.

How does thrombophlebitis manifest? Thrombophlebitis symptoms

Thrombophlebitis begins with pain in the legs. The intensity of the pain can be strong or not, but in any case, it intensifies when walking. Patients note soreness of the skin along the saphenous veins when touched.

You can see that the skin over the inflamed veins turns red. Over time, this redness is replaced by a bluish tinge, and then the skin turns brown. The temperature of the skin area above the inflamed vein is higher than in other areas.

The skin over the veins, in which blood clots appear, thickens and a painful cord can be felt along the course of the vessels. It should be noted that the top of the blood clots is most often located 15-20 cm higher than the area of \u200b\u200bvisible redness and strand.

An increase in body temperature is often observed, but after about a week or earlier, the temperature returns to normal values. Sometimes an increase in body temperature with thrombophlebitis may not be.

A slight swelling of the leg develops, on which the veins are inflamed.

The biggest problem is the spread of inflammation to deep veins, the thrombosis of which is fraught with serious complications.

What are the complications of thrombophlebitis on the legs?

What is thrombophlebitis, we have sorted out, but how is it dangerous?

Modern medical practice speaks of the danger and unpredictability of this disease, which manifests itself through:

Postthrombophlebitis syndrome, manifested by venous insufficiency, and leads to the formation of ulcers. This complication occurs in 70% of cases. This condition occurs when: prolonged swelling of the extremities due to damage to the deep veins, damage to the valves in the veins, impaired blood flow.
Detachment of a blood clot. Blood clots are poorly fixed on the walls of blood vessels, which can lead to their separation. This condition is very dangerous. The clot moves with the blood stream and can lead to blockage of the pulmonary artery (pulmonary embolism). This leads to sudden death, pneumonia, heart failure.
Blood poisoning, a very rare complication. It occurs when a secondary infection is attached. People with weakened immunity fall into the risk zone, most often these are people suffering from diabetes and oncological diseases.
The appearance of phlegmon or abscess... This complication is most often caused by improper treatment, or the use of alternative methods.

Venous thrombosis (phlebothrombosis) is a condition when blood clots fill the lumen of a vein, which interfere with blood flow. Often phlebothrombosis is accompanied by inflammation of the venous walls, then they talk about thrombophlebitis.

The favorite localization of venous thrombi is the lower extremities:

superficial network of veins, especially varicose veins;
deep veins.

According to the location of the blood clot inside the vessel, thrombosis is released

parietal - a thrombus is located at the vein wall, blocking the lumen only partially;
occlusive - blocks blood flow, occupying the entire lumen of the vessel;
floating - part of an extended thrombus is fixed to the wall of the vein, the other part fluctuates in the bloodstream;
mixed - can spread - grow both from the bottom up and in the opposite direction;
multifocal - multiple blood clots form throughout the venous system.

The danger of venous thrombosis is that 80% of its cases develop gradually and secretly. It is often diagnosed already with the development of life-threatening complications.

Thromboembolism

Complete or partial detachment of a thrombus from the venous wall and its removal by blood flow to the heart and then to the pulmonary artery. Blocking of its small branches by a thrombus leads to the death of a part of the lung, inflammation of the lung, and blockage of the main trunk often ends in the sudden death of the patient.

Blocking the venous outflow causes circulatory disorders in the area below the thrombus, the development of inflammatory and degenerative changes in the veins, skin and surrounding tissues. Trophic ulcers appear, gangrene may develop. The higher the level of thrombosis, the more serious the changes in the distal part of the limb.

Thrombosis at the level of the iliac arteries can lead to severe circulatory disorders not only in the veins, but also in the arteries - due to the growth of edema, they spasm and squeeze.

Deep vein thrombosis to the level of the iliac is the cause of white phlegmas of the extremities, and if thrombosis of superficial veins joins, blue phlegmas, which can lead to death, gangrene or amputation of the leg.

The most formidable complication of thrombophlebitis occurs when the thrombus is not firmly attached to the vascular wall and its tip floats in the lumen of the vein. In this case, they say that the top of the blood clot floats. At some point, a part of such a blood clot can break off, enter the heart with the blood flow and cause an embolism (blockage) of the pulmonary artery.

Sepsis (blood poisoning) is no less serious condition, which quite often ends in death.

If thrombophlebitis is not treated or treated inadequately, for example, with self-treatment only with folk remedies, then the inflammation can move to the surrounding tissues and take on a purulent character - an abscess or phlegmon of the leg tissues develops.

To begin with, let's figure out how varicose veins and thrombophlebitis are related. Formally, we are talking about two different ailments. In practice, deep vein thrombophlebitis of the lower extremities in many cases turns out to be a logical development of varicose veins. The deformation of the veins that accompanies it creates conditions suitable for the settling of infectious agents (their source can be any purulent process in the body). In addition, injuries of the lower extremities and increased blood clotting can lead to the development of thrombophlebitis.

The effect of an infectious agent on the vessel wall becomes the cause of its inflammation, and over time, the formation of a blood clot. Under certain conditions, it can break off and begin to gradually move along the bloodstream until it reaches the heart. The situation is fraught with blockage of the pulmonary artery, and this leads to a heart attack or even instant death.

Thrombophlebitis usually affects the superficial veins. This course of the disease is considered the most favorable, since these vessels account for only 10% of the blood flow in the legs. Thrombus formation in deep veins is much more dangerous, and if such a development of events looks real, the patient is immediately referred for surgical intervention.

Possible complications of thrombophlebitis include:

the formation of trophic ulcers, which can be a source of constant bleeding;
sepsis, that is, general blood poisoning, and gangrene;
spread of the inflammatory process to adjacent tissues.

From the above data, it becomes obvious that thrombophlebitis requires immediate treatment. In order to see a doctor in a timely manner, it is important not to ignore any of the symptoms. Among them:

aching pain in the legs;
persistent edema of the lower extremities;
the severity of the veins;
a change in skin tone to reddish or even bluish;
a slight increase in temperature that passes without any treatment.

Today, it is quite possible to defeat thrombophlebitis, provided that the fight against the disease begins in a timely manner. The therapy is complex. It is based on the patient's intake of drugs that have an anti-inflammatory and thrombolytic effect, as well as promote blood thinning.

Only in cases where the patient's life is in real danger do they resort to surgical intervention. One of the 100% indications for surgery is the presence of a so-called floating thrombus. Under other circumstances, most often conservative treatment is sufficient.

Hello Elena Olegovna!

1.Acute occlusive thrombosis of the superficial femoral vein to the mouth of the deep thigh vein - is it generally considered a large thrombus or a small one? I just looked at the picture of these veins even on the Internet, but I did not understand.

2. There is a possibility that in my case there will be no consequences after a thrombosis, given that my leg did not turn red (did not change color at all, it was a normal color), the veins did not swell, there are no varicose veins - that this thrombosis will pass without a trace ? The leg was just swollen and hurt. When I left the hospital and to this day there is no edema at all and my leg does not hurt.

3.Is there a chance of re-thrombosis if I take warfarin all the time?

5.Can I drink alcohol while taking warfarin? (I have a wedding in January)

Thanks for the answer.

Good luck to you!

Irina, Moscow, 29 years old

Hello Irina.

1. Your thrombus is dangerous because it is located high (in the femoral vein). And big or small - it doesn't matter.

2. Such a possibility is due to the fact that you are prescribed treatment on time. However, the consequences of thrombosis in the veins do not remain extremely rare.

3. There is a danger of re-thrombosis, against the background of warfarin (if you take it in the correct dose - that is, your INR is in the range from 2 to 3), the danger decreases.

4. Standard terms are valid for 3-6 months. Screening for genetic thrombophilia can help determine the timing.

5. Against the background of warfarin, alcohol intake can weaken the effect of the drug. By January, you will have finished 3 months, as I understand it.

Consult a hemostasiologist in person to determine the timing of taking warfarin and testing for thrombophilia. You can stop warfarin right away. Before canceling, you need to be tested for D-dimer. If it is not increased, you can cancel it calmly.

Good luck to you.

Respectfully yours, Elena Olegovna Belyanina.

Violation of blood circulation due to venous pathology is quite common. Studies show that about a quarter of the world's population is at risk for venous thrombosis. Some cases pass without a trace and asymptomatic, but in other situations blood clots significantly disrupt blood flow and can be dangerous complications.

Thromboembolism

Thrombophlebitis is an inflammatory process of the venous wall, leading to the formation of a blood clot. In the course of the development of the pathological process, the integrity of the venous wall is disrupted, as a result of which the lumen of the vein is blocked by a blood clot.

Thrombophlebitis is a rather dangerous disease, especially in acute stage, when there is a high probability of a thrombus rupture and the development of such dangerous complications as myocardial infarction or pulmonary embolism. Below we will talk about the danger of thrombophlebitis of the lower extremities in more detail.

Signs and treatment

Acute thrombophlebitis of the saphenous veins develops suddenly due to sharp blood clotting. The reasons can be very different - infection, injury, pregnancy, and others. Signs of acute ascending thrombophlebitis:

Varicose veins become painful and tight;
The leg swells and increases in size;
There may be sharp pains when walking;
Chills and fever appear;
General weakness persists;
Lymph nodes are enlarged.

With ascending thrombophlebitis of the saphenous vein, there may be no edema. Most often, there is heaviness when feeling the inflamed vein, the skin has a reddish tint. There is a heaviness in the lower leg. However, with the acute form of the disease and the further spread of the disease, damage occurs:

Great saphenous vein;
Common femoral vein;
Safeno-femorial anastomosis.

How to provide first aid? What to do and what not to do

If symptoms of acute thrombophlebitis appear, then the first thing to do is call a doctor. Then you should go to bed and give the sore leg an elevated position, placing a pillow under it.

In no case should you perform any mechanical manipulations over the diseased area - do not massage, do not rub in ointments and creams, even if it seems to you that they are very useful. It will not get better from such treatment, and the risk of blood clot rupture increases significantly.

It is better to wait with folk remedies and start using them only when it appears positive effect from the main treatment prescribed and monitored by a doctor.

How to recognize thrombophlebitis? Diagnostic methods

Since only half of venous thrombosis gives the classic picture of the disease with swelling and pain, patients from risk groups should be very careful about any manifestations of trouble and discomfort in the legs:

pain in the muscles of the lower leg, aggravated by feeling and movements;
increasing swelling;
heaviness in the limb, a feeling of fullness;
local or general temperature rise.

To make sure that minor symptoms do not hide a dangerous disease, you need a doctor's consultation.

The doctor will conduct an examination and prescribe an examination to reliably identify the presence of thrombosis.

Duplex scanning. Ultrasound procedure with color mapping of blood flow is most informative for detecting thrombosis. Allows you to determine the size, structure, the presence of a floating thrombus.
X-ray contrast phlebography. Examination in addition to duplex scanning if the thrombus is located in a place that is hard to reach for ultrasound - above the groin. X-ray against the background of contrasting reveals the location of the thrombus, its length, the state of the venous wall.
Tomography. Computed tomography or magnetic resonance imaging more accurately shows the localization, structure of the thrombus and the degree of blockage of blood flow.
Laboratory diagnostics. In the presence of thrombosis, fibrin degradation products - D-dimers - appear in the blood.

To make a diagnosis, doctors use the data obtained during the examination of the patient, and the results of laboratory tests and instrumental diagnostics.

The most informative are instrumental techniques, including:

Ultrasound procedure. Ultrasound allows you to find out the location of the thrombus, its size, the degree of blockage of blood flow. With the help of ultrasound, it is possible to reliably examine the condition of the venous valves.
Phlebography. The technique allows you to detect blood clots in the saphenous veins.
Radionuclide research. A radioactive substance is used injected into a vein. Radionuclide diagnostics makes it possible to detect a thrombus and assess the nature of venous lesions.
Magnetic resonance phlebography. The technique is expensive, but it allows you to accurately determine the degree of damage to veins, including deep ones.
Impedance plethysmography. With the help of this type of research, the nature of the filling of the veins with blood is determined.

Thrombophlebitis therapy is carried out by conservative or surgical methods. The choice of a specific method of treatment depends on the stage of the pathological process and the general condition of the patient.

Thrombophlebitis is treated for a long time - at least six months. The patient is prescribed medication (heparin injections). The course of treatment with heparin - 10 days or more. The patient is prescribed thrombolytic and anti-inflammatory drugs.

If thrombophlebitis is severe, bed rest is prescribed for the first week. When the acute stage of thrombophlebitis subsides, the doctor prescribes a course of therapeutic exercises for the patient.

Four types of surgery are used for thrombophlebitis:

Fogarty catheter. During surgery, a probe is inserted into the veins to remove the blood clot. The method is used at the initial stage of thrombophlebitis (up to 5 days from the moment of exacerbation of the disease).
Installation of a cava filter in the inferior vena cava. The filter is designed in such a way that it does not allow the blood clot to move through the veins.
Plication. The task of plication is to suture the vein with special metal clips.
Thrombectomy. The most common method surgical treatment thrombophlebitis. During the operation, the blood clot is removed from the vein. In this case, for the appointment of an operation, a prerequisite must be met - a thrombus arose no later than 7 days ago. If the thrombus is older, deformities have already occurred on the walls of the veins and venous valves, which will greatly reduce the effectiveness of the operation.

The main purpose of instrumental diagnostic studies in thrombophlebitis is to establish the nature and level of the location of blood clots. For this, they are used: rheovasography, ultrasound doppler, radiopaque phlebography.

Prevention of thrombosis

The main goal of thrombophlebitis prevention is the timely and adequate treatment of exacerbations in the chronic form of the disease. Sharp forms thrombophlebitis must be detected in a timely manner and treated immediately.

You should not start the treatment of varicose veins of the legs, timely identify and eliminate foci of infection in the body, for example, foci with suppuration, sinusitis, tonsillitis, caries.

If treatment with intravenous infusion is necessary, injections must be made into different veins, so that the lesions have time to heal.

Active lifestyle, proper nutrition, refusal bad habits are also important components in the prevention of thrombophlebitis.

If you suffer from varicose veins, it is recommended to sleep with raised legs. Waking up in the morning, it is necessary, without getting out of bed, to perform several kicks alternately up and down and like "scissors". Without lowering the legs, form a bandage from elastic bandages, or pull on medical jersey.

Thrombophlebitis is an insidious and dangerous disease that requires immediate treatment.

Preventive measures are as follows:

wearing special elastic underwear.
physiotherapy.
taking medications that reduce the likelihood of blood clots.
limited consumption of fried and salty foods.
exclusion of bad habits.

To avoid the appearance of thrombosis, you must initially adhere to simple rules:

To live an active lifestyle;
Drink at least 2 liters of clean water per day;
To refuse from bad habits;
Establish proper nutrition (eat more garlic and onions);
Monitor your weight;
At night, keep your legs on a dais for a better outflow of blood;
When a varicose mesh appears, lubricate the legs with heparin ointment;
When working sedentary, do exercises, warm up for at least 15 minutes.

A proven way to treat varicose veins at home in 14 days!

Preventive measures for thrombosis include compliance with the following recommendations:

Wearing compression hosiery. Special shaping underwear improves blood flow in the affected veins. The degree of compression is determined by the attending physician.
In the absence of the risk of a blood clot detachment, the patient is prescribed physiotherapy or other types of moderate physical activity (walking, swimming).
Taking medications that reduce the intensity of blood clots in the veins.
Special diet (similar to the diet for varicose veins). Salt intake should be limited, and fatty foods should be avoided. The diet should contain a sufficient amount of foods rich in salicylates (raisins, garlic, ginger, etc.).
Quitting bad habits, including smoking and drinking alcohol.

Complications of thrombophlebitis are extremely dangerous for the patient's health. It is recommended to conduct regular examinations of the condition of the veins, and if the first signs of complications are found, immediately seek medical help.

Life with thrombophlebitis

Motor activity in thrombophlebitis is of great importance, since it prevents blood stagnation and reduces the likelihood of blood clots.

If thrombophlebitis has moved to deep veins, then you will have to limit yourself in movement, since even a slight physical exertion can cause a blood clot to break off.

Nutrition for thrombophlebitis is also important. Animal fats will have to be limited and preferred vegetable oils... To strengthen the walls of blood vessels and make the blood thinner, vegetables and berries rich in vitamin C and routine should be added to the diet, for example: rose hips, sea buckthorn, chokeberry, black currant, sweet pepper, dill, parsley, Brussels sprouts.

Deep vein thrombosis of the lower extremities: symptoms, treatment

A parietal blood clot may not manifest itself in any way and may be diagnosed along the way with another examination. If a thrombus has blocked the lumen of a large vein, then the disease is characterized by

the appearance of sharp pain, heaviness and distention in the affected limb;
swelling of the limb - the skin is taut, shiny, warmer to the touch, visually the skin color is cyanotic;
when the edema becomes less intense, compensatory dilated saphenous veins appear.

If thrombosis has invaded the iliac veins, pain appears in the groin and pelvic region. In this case, the legs swell a lot, and gangrene may develop.

Treatment tactics depend on the severity of the process, the embolism of the thrombus, its localization and the tendency to spread.

Fresh thrombotic overlays with a floating part, blood clots prone to ascending spread are subject to surgical treatment. In this case, the thrombus is removed, the vessel is stitched with paper clips, or an umbrella filter is placed in a large vein.

Conservative therapy, as in the case of superficial thrombosis, involves

fixation of a blood clot - initially they create complete rest of the affected limb - for at least 2 weeks, so that the blood clot attaches to the vein wall;
dissolution of thrombotic masses, prevention of further thrombus formation - in acute thrombosis, thrombolytics, fibrinolysin with heparin, and other anticoagulants are administered, later they are not used so as not to destroy the hardened thrombus;
elimination of inflammation.

Treatment of venous thrombosis of the lower extremities is not a fleeting process. It is important to follow the treatment regimen and not quit it as soon as the pain subsided and the swelling went away. It is necessary to make sure that there are no conditions for blood stagnation in the vessels, so in the future you will have to wear compression hosiery and monitor blood clotting.

Clinical picture

Thrombophlebitis is divided into three forms:

Acute (purulent and non-purulent) - the stage lasts 2 weeks.
Subacute - develops from 2 to 8 weeks.
Chronic - goes into this stage after 2 months from the onset of the disease.

The acute stage of thrombophlebitis is characterized by an increase in subfebrile temperature. At the same time, pain occurs in the area of \u200b\u200bthe veins, especially aggravated by physical activity. Swelling begins on the affected limb. The skin along the veins becomes thickened and painful, signs of cyanosis appear.

Acute thrombophlebitis can also take a purulent form. This nature of the course of thrombophlebitis is very dangerous, since the pathological process in this case affects not only the veins, but also the nearby tissues. The result is septicopyemia.

Thrombophlebitis is classified according to the localization of the process:

skin (manifestation of pathology in the form of dermatitis, eczema or trophic ulcers);
subcutaneous tissue or in the form of phlegmons and abscesses;
blood vessels (the process leads to damage not only superficial, but also deep veins);
lymphatic system;
peripheral system (with such localization ischemic neuritis is possible).

The following factors lead to thrombophlebitis:

Traumatic damage to the venous wall.
Impaired or slowed down blood flow. Violations can be triggered by insufficient motor activity, prolonged compression of the veins of the lower extremity (for example, due to wearing a cast). Poor circulation occurs as a result of heart failure when the heart does not pump the right amount of blood. With impaired and slowed down blood flow in the lower extremities, congestion occurs.
High blood coagulability. The reason most often lies in a genetic predisposition. However, the influence of other factors, including cancer and infectious diseases, is also possible. Certain medications can thicken the blood.

In addition to direct ones, there are also indirect reasons that contribute to the development of thrombophlebitis:

age factor (people over 45 years of age are more likely to suffer from this pathology);
diseases of the cardiovascular system;
excessive body weight;
diabetes;
pregnancy (hormonal changes combined with excess weight).

The following symptoms correspond to the acute and subacute stages of thrombophlebitis:

the rapid development of symptoms without any obvious reason;
increased body temperature;
pain syndrome (acute bursting pains);
pronounced swelling of the lower limb (can reach the groin area);
feeling of heaviness in the legs;
when palpating the leg, an increased local temperature is felt;
pain syndrome increases with physical activity;
palpation causes an increase in painful sensations;
the skin becomes bluish, and if a blood clot covers the femoral or iliac vein - blackish;
cyanosis (when a blood clot moves up the lower limb).

For severe thrombophlebitis, the appearance of blisters with hemorrhagic filling is characteristic. This complication can lead to venous obstruction and gangrene.

Note! If the pelvic vein is blocked, swelling and cyanosis can spread to the healthy leg.

Chronic thrombophlebitis is characterized by a calmer course. The periods of exacerbation of the disease are replaced by remission. When the exacerbation returns, the symptoms of the disease in the chronic phase become the same as in the acute phase. During the period of remission of thrombophlebitis, symptoms may practically not manifest themselves in any way.

What is the danger of blood clots

In the story about the danger of thrombophlebitis, one should dwell on three factors that especially strongly affect the state of the venous system:

Decreased blood flow. Slow blood circulation especially adversely affects pregnancy, fractures, people suffering from cardiovascular diseases.
Increased blood viscosity. This factor leads to the formation of blood clots. Bedridden patients with cancer are at greatest risk.
Increased trauma to the veins. In pregnant women, this can lead to bleeding during childbirth and gynecological procedures.

Below we will talk about the main complications that can develop as a result of thrombophlebitis.

Bleeding

Usually, bleeding with thrombophlebitis is localized in the lower leg. The rate of blood loss may vary, but when upright position body bleeding will always be more profuse.

In case of bleeding, the patient is transferred to a horizontal position. The problem limb is placed on a dais, after which a bandage is applied. After that, you need to call the ambulance team to deliver the patient to the inpatient department of the hospital.

Sometimes bleeding in small superficial veins for a long time is practically not felt by the patient, however, subcutaneous hematomas indicate damage to the veins. As a rule, such bruising is very pronounced.

If the bleeding affects deep veins, the patient's condition inevitably worsens, since blood loss is more significant. The patient in this case needs emergency assistanceotherwise his life is in danger.

Thromboembolism

This complication is the most undesirable and most dangerous. Thromboembolism is a separation of a blood clot with further blockage of blood flow in the pulmonary artery. The result of embolism is myocardial infarction, venous insufficiency, or even death for the patient.

The size of the exfoliated blood clot has a decisive influence. If we are talking about a large blood clot, most of patients die within the first 30 minutes. As a rule, in this case, doctors simply do not have time to provide medical assistance. If the patient is at the time of the development of a pulmonary embolism in the inpatient department, his chances of survival increase significantly.

Therapeutic measures are aimed at improving blood circulation and adherence to bed rest. Blood clots must be removed from circulatory system... For this, thrombolytic treatment or surgery is used. Infusion treatments are given to thin the blood and prevent further blood clots. They decide on surgical intervention if conservative methods do not work.

Phlebosclerosis

The pathological process, during which the walls of the veins undergo changes (become thicker and denser), is called phlebosclerosis. The main danger of phlebosclerosis is that, due to the thickening of the vein wall, the lumen in the bloodstream narrows, which entails stagnation. As a result of the development of pathology, the wall can grow so much that the blood flow through the vein stops completely.

When observed externally, the veins affected by phlebosclerosis look like cord-like thickenings. Their color is whitish. However, this symptom is visible only from the outside, and changes in the veins under the skin are almost invisible.

The lymphatic system responds negatively to the development of thrombophlebitis in the lower extremities. We are talking about lymphangitis, which is an inflammatory process in the lymphatic vessels. Lymphangitis is not an independent disease, but only a consequence of the infectious process.

Lymphangitis is characterized by intoxication, which is manifested by the following symptoms:

increased body temperature;
headaches;
fever;
fast fatiguability;
general weakness.

Lymphangitis is treated with antibiotics and non-steroidal anti-inflammatory drugs. If the treatment is done on time, the prognosis is usually good.

Note! If there is a suspicion of lymphangitis, it is impossible to massage or heat the veins of the lower extremity, as such actions will complicate the course of the disease.

Elephantiasis

Pathology is a painful thickening of the skin and subcutaneous tissue. The development of the pathological process is associated with a violation of the normal outflow of lymph. Elephantiasis is accompanied by persistent edema of the lower extremities, pain syndrome is often absent.

Patients turn to doctors, first of all, because of a cosmetic defect, and not because of physical discomfort. Over time, in addition to edema, erysipelas on the skin is added to the symptoms of the disease.

In the treatment of elephantiasis (in addition to treating the underlying disease), diuretics and lymphatic drainage are used. If drug and other methods of conservative therapy do not bring results, surgical treatment is prescribed.

The peripheral nervous system means that part of the nerve endings that is outside the brain and spinal cord. Due to the peripheral system, the interconnection of the central nervous system with the organs and limbs of a person is ensured.

The peripheral nervous system is injured both as a result of mechanical influences and under the influence of intoxication. As a result, the inflammatory process and other pathological processes develop.

Ischemic neuritis

The inflammatory process in the veins - ischemic neuritis - is directly related to pathologically abnormal blood flow. Due to nutritional deficiencies, peripheral nerves cease to function fully, which is expressed in the following symptoms:

decreased reflexes;
dystrophic processes in the muscles;
reduction of skin sensitivity in the area of \u200b\u200bdevelopment of the disease.

Often, ischemic neuritis is accompanied by very severe pain.

Note! A feature of ischemic neuritis is a sharp exacerbation of the disease as a result of alcohol intake.

If the patient has not received timely treatment, general purulent complications may develop. The process is provoked by purulent fusion of a thrombus in a vein and the presence of concomitant pathogenic microflora. The name of the pathology is septicopyemia.

In the course of the pathological process, pus often metastasizes, which leads to intoxication of the whole organism. It should be understood that the spread of pus is not a self-sufficient process. The root cause of the development of the complication is an inflammatory reaction in the area through which the infection entered the body.

Septicopyemia is usually not very violent, but for a long time. This is due to the fact that, as a rule, the body is able to extinguish too intense inflammatory processes.

With septicopyemia, the lungs are affected, the cardiovascular system... Problems with the genitourinary system are also possible, due to which the body's ability to excrete urine is sharply reduced.

The septic process is associated with blood infection. The infection enters the bloodstream from tissues. Usually, sepsis develops with complications of thrombophlebitis such as peritonitis, abscess, or some other inflammatory reaction, during which pyogenic microorganisms are released. Sepsis is a very dangerous condition that, in the absence medical care can be fatal.

increased body temperature;
fever;
an increased level of leukocytes in the blood;
tachycardia;
arrhythmia;
delayed formation of urine.

If sepsis is suspected, the patient needs immediate medical attention. Treatment is carried out exclusively in a stationary setting.

According to medical practice, most blood clots can resolve on their own over time. Sometimes they simply scar, while the blood flow is practically not disturbed. With prolonged blockage of blood vessels, which leads to impaired blood circulation, irreversible disorders occur.

Valves provide normal blood flow. These are some partitions between the walls of blood vessels. If the blood rises up, then the valves open, reverse blood flow is impossible, since the valve is closed. If a vein is blocked by a thrombus, then the supply of the valves is disrupted, which affects their work.

The thrombus may dissolve after a while, but the valves will not recover.

Thrombophlebitis treatment is carried out both operatively and conservatively, depending on the cause of the inflammation and its degree. Only a doctor, after the examination, can establish which method is most effective in this case.

Removal is an extreme measure, carried out when there is a likelihood of a thrombus breaking.

What is the difference between varicose veins and thrombophlebitis?

The main causes of thrombophlebitis

Flow

Complications

Communication with the administration

GSV thrombosis

Causes of thrombosis of the great saphenous vein

Signs of the disease

Treatment

Ascending thrombophlebitis

Symptoms

Acute form of flow

Risk group

Basic principles of treatment

Basic principles of therapy

Treatment of the acute form of the disease

Preventive actions

Thrombosis bpv treatment

Factors contributing to the formation of a blood clot.

Treatment regimens for venous pathology associated with the formation of blood clots.

Thrombosis bpv treatment

Damage to the deep, superficial and perforating veins of the thigh

Distinctive symptoms and signs

Features of central and ascending thrombosis of the femoral veins

Changes during the transition to thrombophlebitis

How to diagnose the disease

Conservative and surgical therapy

Possible complications and prognosis

How pathology develops

Etiology

Disease classification

Clinical picture

Establishing diagnosis

Treatment

The most famous medicines

Physiotherapy

Operative treatment

Forecast

Ascending thrombophlebitis

Symptoms

Acute form of flow

Risk group

Basic principles of treatment

Basic principles of therapy

Preventive actions

Ascending thrombophlebitis

Symptoms

Acute form of flow

Risk group

Basic principles of treatment

Basic principles of therapy

Treatment of the acute form of the disease

Preventive actions

Thrombophlebitis of the saphenous veins

Acute form

Symptoms

Conservative therapy

Surgical intervention

Prevention

Causes of occurrence

Superficial venous thrombosis of the lower extremities: symptoms, treatment

How does thrombophlebitis manifest? Thrombophlebitis symptoms

What are the complications of thrombophlebitis on the legs?

Thromboembolism

Thromboembolism

Signs and treatment

How to provide first aid? What to do and what not to do

How to recognize thrombophlebitis? Diagnostic methods

Prevention of thrombosis

Life with thrombophlebitis

Deep vein thrombosis of the lower extremities: symptoms, treatment

Clinical picture

What is the danger of blood clots

Bleeding

Thromboembolism

Phlebosclerosis

Elephantiasis

Ischemic neuritis

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