Thrombophlebitis of the saphenous veins lower limbs or superficial thrombophlebitis is a disease in which blood clots appear in the lumen of the saphenous veins. Since the veins are located close to the skin, this phenomenon is accompanied by inflammation - redness of the skin, pain, local swelling.

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

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

More often, varicose-transformed tributaries of the great (and/or small) saphenous vein, as well as perforating veins, are thrombosed. But if untreated, thrombosis spreads to the largest (small) saphenous vein itself, and further to deep veins.

Causes of thrombophlebitis of superficial veins

The cause of any thrombosis is a combination of three factors:

• change in the configuration of the vein (for example, varicose transformation) and, as a result, “swirling” of blood in the lumen of the vessel;
• “thickening” of the 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 considered to be varicose veins. Also, the most common risk factors are:

• genetic predisposition;
• pregnancy and childbirth;
• obesity, physical inactivity;
• endocrine and oncological diseases.

Superficial thrombophlebitis: symptoms and manifestations

In the initial stages, superficial thrombophlebitis of the lower extremities may not be very noticeable in its manifestations. Mild redness of the skin, burning, minor swelling - many patients simply do not pay attention to all this. But the clinical picture changes very quickly, and the signs of thrombophlebitis of the superficial veins become noticeable and very uncomfortable:

• the appearance of “nodules” and compactions in the vein;
• edema;
• acute pain;
• local increase in temperature;
• change in skin color in the area of ​​the inflamed vein.

Treatment of superficial thrombophlebitis

To treat thrombophlebitis of the superficial veins, different techniques and their combinations are used.

More often this may be conservative treatment:

• compression therapy - wearing compression stockings, special elastic bandaging;
• taking non-steroidal anti-inflammatory and painkillers;
• locally, in the area of ​​inflammation - cold;
• according to indications - taking medications that “thin” the blood.

Emergency surgical treatment of acute thrombophlebitis of the saphenous veins is prescribed, as a rule, in cases where thrombosis does not affect the tributaries, but directly the large or small saphenous veins. Thus, with ascending thrombophlebitis of the great or small saphenous vein, the trunk of the main saphenous vein is thrombosed directly. When thrombosis of the great saphenous vein spreads to the thigh, thrombophlebitis is considered ascending. For the small saphenous vein, this is the middle and upper third of the leg.

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

If ascending thrombophlebitis has already led to the penetration of a blood clot into the deep veins - this is fraught with the occurrence pulmonary embolism– detachment of a blood clot and blockage of the pulmonary artery. This situation occurs when thrombosis spreads from the saphenous veins to the deep (“muscular”) veins.

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

Subscribe to updates

Communication with the administration

Doctor of Medical Sciences

GSV thrombosis

Thrombosis of the great saphenous vein or in abbreviation BVP thrombosis– occurs very often with varicose veins of the saphenous veins of the lower extremities. A blood clot forms in the great saphenous vein, blocking the flow of blood. Blood begins to collect in a certain area and fill the vein.

Causes of thrombosis of the great saphenous vein

Reason bvp thrombosis most often it is the expansion of veins and their deformation. The blood begins to circulate more slowly and forms clots that clog the vein. There are several factors contributing to the formation of this disease:

Age. The disease often occurs in people over 60 years of age;

Obesity. Excess weight This is a heavy physical activity 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 for a long time cannot move normally;

Operations performed 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 its tributaries. The outcome 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 resolves, destroying the valve apparatus of the vein. In some cases, a blood clot completely blocks a vein, resulting in sclerosis, or the blood 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 occurs unexpectedly. But there are also classic signs of the disease:

Sharp pain when palpating the sore spot;

Redness in the area of ​​the changed vein;

Feeling of heaviness in the affected area;

Trauma in the vein area;

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 unwell. He has slight pain and heaviness in his legs, especially when walking, sometimes a little bad feeling, which is expressed by weakness, chills and a slightly elevated temperature. But overall, 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, often this process does not have any symptoms, since the thrombosis is floating. Therefore, when diagnosing, it is better to use the instrumental method.

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

The most important thing in the treatment process is to prevent the spread of thrombosis as quickly as possible. Treatment must be very effective so that recurrence or thrombosis does not subsequently occur in other areas. Before prescribing treatment, it is necessary to take into account the location, part of the body where thrombosis of the great saphenous vein has formed. Several treatment methods can be combined if necessary.

If thrombophlebitis occurs in a mild form, you can get by with medical treatment and compresses. The affected limb must be covered with an elastic bandage or golf bandage. If the disease is in an acute phase, bandages may cause discomfort. If a blood clot in a vein grows in size, surgery is urgently needed. After surgery, you must follow your doctor's instructions. Our clinic will help you get better and completely get rid of the disease. We will do everything to make you healthy and happy again!

Subscribe to updates

Communication with the administration

Make an appointment with a specialist directly on the website. We will call you back within 2 minutes.

We will call you back within 1 minute

Moscow, Balaklavsky prospect, building 5

You can get the best advice today

only with an experienced vascular surgeon, professor

Doctor of Medical Sciences

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

Lymphopressotherapy course 10 procedures. Accepted by Phlebologist, Candidate of Medical Sciences

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

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

Varicose veins, blood clots, valve insufficiency, swelling in the legs

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

and consult a phlebologist.

Lymphopressotherapy is indicated for

swelling of the lower extremities, lymphostasis.

It is also carried out for cosmetological purposes.

Thrombosis of the great saphenous vein

Varicose veins are a fairly serious disease that cannot be ignored. Varicose veins form in the lower extremities and affect the deep saphenous veins. Gradually, blood fills the veins, which is why they become less elastic and lengthen, knots form, the valves in the vessels begin to work poorly and cannot normally push blood up to the heart.

This disease occurs for the following reasons:

High venous pressure due to sedentary lifestyle life;

Female gender, since most often this disease occurs in women. Women often wear high heels, wear uncomfortable shoes, bear children and give birth. All this contributes to the appearance of vein diseases;

Heredity. If someone in the family already has varicose veins, the disease can be inherited to a younger generation;

Heavy physical activity. Gradually, blood begins to linger in the lower extremities, and normal blood circulation is disrupted. Instead of moving up towards the heart, the blood remains in the legs and gradually accumulates in the veins.

Symptoms of varicose veins

Symptoms include:

Heaviness in the legs;

Bursting pain in the calf area;

Leg cramps;

Veins overflowing with blood become visible through the skin, they are curved and blue in color.

If you ignore and do not treat varicose veins, serious complications often begin - the formation of thrombosis in the area of ​​the great saphenous vein. Thrombosis is the formation of blood clots in veins and blood vessels. Blood clots attach to the walls of blood vessels and interfere with the flow of blood. Gradually, there are more and more blood clots, and they can completely block the lumen of the vessel. There are blood clots various shapes, there are also long ones, similar to leeches, they hold only one part to the wall of the vessel, the rest is in free movement. At any moment, such a blood clot can break off and enter the bloodstream. large veins or arteries. This is dangerous because blood clots often clog the arteries of the lungs, causing the patient to experience respiratory failure and pulmonary embolism. It happens that such a disease ends in the death of a person. Symptoms thrombosis of the great saphenous vein the following:

Pain in the legs, especially in the area of ​​the vein affected by blood clots. There is pain even when the legs are at rest, and when palpating;

Vein overflowing with blood;

You can feel blood clots in a vein;

Often the disease process begins in the upper region of the leg and gradually, and sometimes very quickly, in just a few hours, begins to spread to the area of ​​the great saphenous vein. It happens that the causes of thrombosis are blood clots that break away from the walls of blood vessels and penetrate with blood into the great saphenous vein. A sick person needs the help of a specialist, so you can’t hesitate; you should definitely contact a phlebologist - a doctor who diagnoses diseases of the veins and blood vessels. He will examine the affected limb and, after diagnosis, will be able to prescribe effective treatment. Often thrombosis of the great saphenous vein They urgently operate to remove diseased veins and blood clots. Gradually, blood circulation improves and blood can move normally through the veins.

After the operation, the patient must wear an elastic bandage, especially if he needs to walk somewhere. You always need to monitor the veins of your legs, take care of your health, do special exercises for prevention, it is advisable to raise your legs up after each busy day and lie in this position for a while, this helps blood circulate better. It is useful to go swimming and run short distances. If a person is forced to constantly be in one position at work, standing or sitting, after work you can walk instead of traveling by transport. If there are any indicators indicating problems with the veins, you need to be examined by a doctor. After all, the earlier a disease is detected, the easier it is to cure it without surgery with the help of medications. Come to our clinic! Our doctors will help you cope with thrombosis and, if necessary, perform surgery, after which your legs will be healthy again.

Treatment methods

Laser photocaugulation The use of innovative EVLT technology and instruments (radial type of laser fiber is the medicine of the future in our center today. Using a laser, very small “stars” can be removed

› Make an appointment

	January 2020					›
Mon	W	Wed	Thu	Fri	Sat	Sun
		1	2	3	4	5
6	7	8	9	10	11	12
13	14	15	16	17	18	19
20	21	22	23	24	25	26
27	28	29	30	31

‹	February 2020
Mon	W	Wed	Thu	Fri	Sat	Sun
					1	2
3	4	5	6	7	8	9
10	11	12	13	14	15	16
17	18	19	20	21	22	23
24	25	26	27	28	29

We are located:

Interesting things about phlebology

Ascending thrombophlebitis. Treatment of ascending thrombophlebitis

Our center specializes in the treatment of thrombophlebitis. Numbers:

• 16 years work experience
• 5200 patients cured
• 2392 emergency operations performed
• 2808 cured without surgery
• 100 % Pulmonary embolism was avoided

About ascending thrombophlebitis

Ascending thrombophlebitis is inflammatory disease walls of varicose veins, as a result of which a blood clot forms in the veins, closing the lumen of the vein. Ascending thrombophlebitis is most often a complication of varicose veins. Ascending thrombophlebitis is a condition of the body when thrombophlebitis of the great saphenous vein moves from the low-lying sections of the vein on the lower leg upward to the inguinal fold.

When the inflammatory process moves from the superficial vein to the deep veins, there is a threat of detachment and migration of a blood clot, which causes the development of the most dangerous, life-threatening complication - pulmonary embolism.

Symptoms of ascending thrombophlebitis

The main symptoms of ascending thrombophlebitis:

• Feeling of the lower leg being full;
• Redness of the skin along the varicose vein;
• Pain along the saphenous vein;
• The presence of a dense painful cord;
• Increased body temperature;
• Weakness and malaise.

The presence of ascending thrombophlebitis poses a serious threat to the patient’s life, therefore, at the first symptoms of this disease, you should immediately seek quality medical care from our experienced specialists, who have extensive practical experience in treating and preventing the development of complications of venous diseases.

Acute ascending thrombophlebitis

Acute ascending thrombophlebitis is a fairly common complication of varicose veins.. The acute form of ascending thrombophlebitis poses a huge threat to the life and health of the patient, since there is a risk of rapid transfer of inflammation to the deep veins of the lower extremities, the formation of a floating thrombus and the development of pulmonary embolism.

The main symptoms of the acute form of ascending thrombophlebitis:

• General inflammatory symptoms (pain, swelling, hyperemia, lymphadenitis, infiltrates of thrombosed veins, lymphangitis);
• Increased body temperature (up to 39C);
• General weakness and malaise;
• In the area of ​​the thrombosed vein, an infiltrate with clear boundaries is easily palpable.

Treatment of ascending thrombophlebitis

At the first symptoms of ascending thrombophlebitis, you should immediately contact our modern phlebology center for timely, high-quality and effective treatment.

Ignoring the issue of treating ascending thrombophlebitis is dangerous due to serious consequences for the body, sometimes even death.

Ascending thrombophlebitis is treated with:

1. Conservative treatment;
2. Surgical treatment.

Conservative treatment aimed at eliminating inflammation and the spread of vein thrombosis. The phlebologist individually selects medications, compression hosiery for the treatment of ascending thrombophlebitis. Conservative treatment can be applied only when there is no threat of inflammation spreading to the deep veins, in the presence of a local inflammatory process within the lower leg. At the slightest threat of inflammation spreading to the deep veins, acute ascending thrombophlebitis requires immediate surgical treatment.

Experienced doctors at our center for modern phlebology operate on patients with acute ascending thrombophlebitis on an emergency basis after ultrasound scanning of the veins. The main method of surgical treatment of ascending thrombophlebitis is Crossectomy.

A crossectomy is an operation in which the great saphenous vein and its main tributaries are ligated and divided where it enters the deep veins of the thigh. To perform this operation, a small incision is made at the level of the inguinal fold. After the operation, a cosmetic suture is applied, the scar from which is almost invisible. Our center for modern phlebology has a narrow specialization in the treatment of vein diseases. Taking into account our many years of experience and high skill, we confidently speak about successful results in the treatment of diseases.

Make an appointment for a consultation about ascending thrombophlebitis

Questions from users on our website about ascending thrombophlebitis

• There is a genetically determined risk of blood clots during strip operations and HRT; the diagnosis of acquired thrombophilia is questionable. Is sclerotherapy possible?

  In our city they refused me citing high degree risk. Thank you

  Doctor's answer:
  Hello! Yes, it's possible. Thrombophilia is not absolute contraindication for sclerotherapy. It all depends on the scale and nature of the manifestations for which this manipulation will be performed (there are many options for sclerotherapy). This can be assessed by a specialist who has more complete information about the goals of sclerotherapy and your medical history. Based on everything, a decision is made on the advisability of sclerotherapy.

• How dangerous is the diagnosis: subacute ascending thrombophlebitis of the GSV and tributaries on the right leg, embolic (free segment of the head 15 cm)

  Doctor's answer:
  Hello! It all depends on the nature of the blood clot and the level of thrombophlebitis (how close the upper border of the blood clot is to the saphenofemoral junction). The above criteria allow you to assess the risk of developing pulmonary embolism and make a decision on emergency surgical treatment in order to prevent this complication (we are talking about ligation of the mouth of the GSV).

• Is the appearance of thrombophlebitis common after sclerotherapy? I read on the Internet that this happens when sclerosant comes into contact with blood. Now I'm scared to go to sclerotherapy

  go. Thanks for the answer

  Doctor's answer:
  Hello. The effect of sclerotherapy is based on chemical damage to the vein wall with the drug, which leads to its inflammation (which is thrombophlebitis) and subsequently to complete resorption. The larger the diameter of the vein, the more pronounced the symptoms of inflammation (thrombophlebitis), which subsequently resolve without a trace. Currently, sclerotherapy in most cases is used to eliminate the so-called “aesthetic varicose veins,” that is, it is aimed at eliminating intradermal veins of small diameter, so specially caused inflammation of the vein wall is not fraught with complications.

• Is this ACUTE ASCENDING THROMBOPHLEBITIS? Ultrasound: RIGHT EVERYTHING IS EXCELLENT. left leg: SPS: dilated minimally when straining. Anastomosis valves

  minimal degree of deficiency. GSV: not dilated. The move is straightforward. The sensor compresses completely. Passability: passable. WITH inside in area knee joint varicose veins have a thickened wall, are compressible, and passable. CONCLUSION: Varicose vein transformation of the left side. hvn. Is this ACUTE ASCENDING THROMBOPHLEBITIS? Is surgery necessary here, or can it be treated with medications? thank you in advance.

  Doctor's answer:
  Hello! Thickened walls in the area of ​​varicose veins are indirect signs that there was previously phlebitis in this area (inflammation venous wall). Considering the presence, as you say, of varicose nodes, it is possible that ultrasound underestimates the degree of hemodynamic impairment. It is recommended to consult a phlebologist.

• HELLO, DOCTOR. Thrombophlebitis of the right saline vein thrombosis. Can you please tell me if it is possible to operate?

  Doctor's answer:
  Hello! We don't understand the essence of your question. If we are talking about the need for surgery for popliteal vein thrombosis, then no, due to anticoagulant therapy, it is noted good effect treatment. If we are talking about whether thrombosis of the popliteal vein is a contraindication for some other operation, then it depends on the volume of the planned operation, the presence or absence of flotation of the apex of the thrombus in the popliteal vein.

The condition of the blood clot is of fundamental importance, namely its fixation and the likelihood of separation. Currently, thrombophlebitis is commonly referred to as thrombosis of the superficial veins, since inflammation is absolutely clearly defined. And phlebothrombosis is venous thrombosis of the vessels of the deep system. And again, we repeat that in both cases there may be a floating thrombus without signs of inflammation. IN clinical practice Disputes and opposition between these two states also have negative consequences. The presence of thrombophlebitis of the saphenous veins should not be considered mild pathology, since the spread of a blood clot to the deep system or the parallel independent occurrence of phlebothrombosis and thrombophlebitis pose a real danger of pulmonary embolism and death. Also important is the formation of a blood clot in the deep venous system with subsequent, in fact, disability of patients. Chronic venous insufficiency and postthrombophlebitic disease require regular, long-term and expensive treatment.

Factors contributing to the formation of a blood clot.

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

Slowing down the speed of blood flow - varicose veins, prolonged static positions, external compression of blood vessels, etc.

Trauma and other damage to the vessel - operations, increased physical activity, paravasal purulent processes, systemic inflammatory processes, intravenous 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 developed thrombosis and phlebitis, three main goals can be distinguished: to stop the spread of the blood clot 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 specific 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 pointless, because the inflammation is aseptic, except in cases of purulent melting of a blood clot. The table shows 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) in the lower leg with or without signs of extension to the GSV itself. Thrombophlebitis of the GSV up to the level of the knee without signs of ascending during treatment. Thrombophlebitis of the small saphenous vein (SSV) and/or its tributaries at a distance (n/3 of the leg) from the popliteal region without signs of ascending. No symptoms of deep vein thrombosis or PE.	Maybe ambulatory treatment, Active lifestyle, Elastic bandages or knitwear, Non-steroidal anti-inflammatory drugs (NSAIDs - ketorol, ketonal, diclofenac, nimulide) initially parenterally, 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 the GSV with the spread of a physically detectable thrombus in the lower third of the thigh and above to the middle third of the thigh. Thrombophlebitis of the SVC is not higher than the middle/3rd leg. Signs of an ascending 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) initially parenterally, 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 the thrombus in the SVC at the level of the popliteal fossa.	Hospital, operation for emergency indications - Ligation and intersection, respectively, of the GSV or SSV and tributaries at the point of entry into the femoral vein. Further treatment as in the previous paragraph.
spread of thrombosis through anastomosis or perforators to the deep venous system	Installation of a cava filter or plication or clipping of the inferior vena cava, thrombectomy from the main veins or from perforators, intersection and ligation of the GSV and SSV at the mouth.
Thrombophlebitis of deep veins	Emergency hospitalization, Bed rest Bellera splint, Reopoliglyukin 400.0 + 5.0 trental, troxevasin 1 cap x 4 times, aspirin ¼ tab x 4 times, heparins, installation of a cava filter, phlebotropic drugs and NSAIDs.

Additionally, it should be noted that to clarify the location of the thrombus, it is necessary to perform an ultrasound examination of the veins. Elastic bandages for phlebothrombosis should be applied with caution after ultrasound scanning. By squeezing 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 limb. In the first case, the likelihood of a blood clot breaking off increases; in the second, the clinical picture of acute phlebothrombosis is aggravated.

Ascending thrombophlebitis is the most dangerous species pathology, which is represented by a rapid increase in thrombus size, accompanied by an inflammatory process in the saphenous vein. As a result, the venous lumen is blocked and pathological change blood flow

Most often, the pathology is provoked by a complicated type of varicose veins. Acutely ascending thrombophlebitis is diagnosed when thrombophlebitis from the area of ​​the great saphenous vein, which is located on the lower leg, moves upward, towards the inguinal folds.

What is island-ascending thrombophlebitis?

When inflammatory processes pass from a superficial to a deep vein, there is a threat of a blood clot breaking off and moving, which can cause pulmonary embolism. Thus, the blood clot moves from the low-lying sections of the great saphenous vein to the groin area and beyond.

Attention! This condition occurs due to an advanced stage of varicose veins.

Causes of the pathological condition

This pathological condition most often affects the blood vessels of the lower extremities, and about 85% of clinical cases occur against the background of varicose veins. Depending on the severity of varicose veins, the severity of thrombophlebitis is measured.

This condition can develop due to the influence of many factors, the most common of which are the following:

• blood clotting is above the physiologically correct level;
• blood flow is slower than normal;
• , and drug addiction;
• insufficiently active lifestyle;
• previous surgical interventions;
• postpartum period;
• oncological diseases;
• long-term use of hormonal contraceptives.

In addition to the above, pathology can also be provoked due to infectious diseases. Ascending thrombophlebitis is divided depending on the type of affected venous vessel - thrombosis of the deep saphenous vein and thrombosis of superficial vessels.

Acute ascending thrombophlebitis of the great saphenous vein can be treated if detected in a timely manner. The second type has a higher risk of complications, since the blood clot can move to the femoral or pulmonary artery.

Symptomatic manifestations of ascending thrombophlebitis

The main symptomatic manifestations of thrombophlebitis of the ascending type are the following negative conditions:

• soreness of the lower extremities;
• feeling of fullness in the lower leg area;
• redness of the skin along the affected venous vessel;
• pain along the saphenous vein;
• increased swelling of the lower extremities;
• dense painful cord;
• increase in general body temperature;
• general malaise and weakness.

When thrombophlebitis of the ascending type occurs, a serious threat to human life is created, and for this reason, when the first suspicion arises, you must immediately seek medical help.

Only a doctor, after diagnosis, will be able to determine the method of providing assistance.

Acute ascending thrombophlebitis

Ascending thrombophlebitis of acute type - enough common complication. This pathological condition is extremely dangerous, since there are risks of rapid spread of the inflammatory process to the deep venous vessels of the lower extremities, the occurrence of a floating thrombus and further pulmonary embolism.

The main symptomatic manifestations of the acute type of ascending thrombophlebitis are the following negative reactions of the body:

1. Symptoms that are of a general inflammatory nature, such as: hyperemia, swelling, pain, infiltrates of thrombosed venous vessels, lymphadenitis, lymphangitis.
2. An increase in general body temperature to 39̊̊, and in some cases 40̊ C.
3. General weakness and malaise characteristic of fever.
4. In the area of ​​the thrombosed venous vessel, the infiltrate is easily palpable and has clear boundaries.

If such symptoms occur, you should consult a specialist for qualified medical help. The video in this article will introduce the reader to the main causes of the manifestation of pathology.

Course of the pathological process and possible complications

At the initial stage, it concerns only small superficial venous vessels. In this case, small blood clots provoke compaction of the vascular walls of the vein and their inflammation.

The main symptomatic manifestations at this stage are swelling of the affected limb and changes in its pigmentation. With progression pathological process and its transition to the great saphenous vein, there is a possibility of blood clots moving into groin area or the passage of a blood clot into the deep femoral vein, which is an extremely dangerous phenomenon.

Thrombosis of the large subcutaneous venous vessel of the lower extremities for the most part becomes a provoking factor in the development of chronic venous insufficiency. Also, as the pathology progresses, it is possible for the pathology to transform into thrombosis of a purulent nature, which leads to the development of sepsis of the lower extremities. IN this option the patient is saved by administering an increased dose of antibiotics, which should suppress the infection.

Important! In order to prevent the blood clot from breaking off and moving further through the vessels, the patient is bandaged in the area with the inflammatory process. This is a temporary measure that requires subsequent treatment.

After the first therapeutic activities, aimed at eliminating the resulting pathological condition, the patient feels significant relief, which is expressed as follows:

• reducing the intensity of pain;
• the overall tension in the area of ​​the inflamed venous canal is reduced;
• There is a decrease in swelling of the limb.

The most effective treatment for ascending thrombosis of the venous vessels of the lower extremities is surgery aimed at removing blood clots. If there is a high probability of a blood clot breaking off, surgery is the only treatment option that can give a positive result. Thrombophlebitis great artery excludes the possibility of treatment using conservative techniques.

When superficial vessels are affected, it is possible to do without surgical intervention - the main thing is that the therapy is timely.

If ascending thrombophlebitis of the superficial veins is diagnosed, the course of treatment includes the use of compression stockings, ointments, as well as injections of certain groups of drugs:

• venotonics;
• anti-inflammatory drugs;
• anticoagulants.

Contraction bandages also have a beneficial effect and prevent the likelihood of developing ascending thrombosis. These products must be worn for a month. Similar knitwear is shown in the photo. The price of such products can vary significantly depending on the manufacturer.

After the main therapy, which is aimed at improving the person’s condition, it is extremely important point is prevention that a person performs independently - to eliminate the likelihood of recurrence of the pathology. The instructions recommend that patients fully adhere to the rules of a healthy lifestyle.

According to the advice of the treating specialist, the patient should take the following measures:

• consume the daily amount of water;
• consume sufficient amounts of vitamins;
• wear elastic knitwear.

Most patients also need to take anticoagulants regularly. In some cases, visiting steam rooms and taking baths may be contraindicated.

Diagnosis of pathology

Diagnosis of acute ascending thrombophlebitis of the great saphenous vein should reveal not only the presence of a thrombus and its location, but also determine the proximal border of the blood clot.

Diagnostic measures include the following standard actions of a doctor:

1. If a compaction is detected in the venous canal, it is necessary to perform careful palpation in the proximal direction and take not the infiltrate, but the most distant painful point as the border of the thrombus.
2. Starting on the middle third of the thigh, it is necessary to consider thrombosis as embolic dangerous, because its actual boundaries are located 10 cm or more proximally.
3. When the blood clot is located higher than the middle third of the thigh, a certain study is required to exclude the passage of the blood clot beyond the saphenofemoral anastomosis.
4. Ultrasound angioscanning, otherwise known as duplex scanning, which acts as a screening test.

According to clinical studies, in more than 60% of cases, thrombophlebitis is recurrent. At the same time, it is impossible to provide guarantees that the next occurrence of thrombophlebitis will not acquire an ascending type.

Treatment of thrombophlebitis of the ascending type

At the initial symptomatic manifestations of thrombophlebitis of the ascending form, you need to contact professional help, since ignoring the pathological process can cause life-threatening conditions. Ascending thrombophlebitis is treated with: conservative therapy and with the use of surgery

Conservative methods of treating thrombophlebitis of the ascending type are aimed primarily at stopping the inflammatory process and preventing the spread of vein thrombosis. The phlebologist selects individually medicines and compression hosiery for the treatment of thrombophlebitis of an ascending nature.

Conservative treatment methods can be used only in cases where there is no threat of the inflammatory process spreading to deep venous channels and when inflammation is localized only within the lower leg. If there is a minimal likelihood of the inflammatory process spreading to the deep venous vessels, acute thrombophlebitis of an ascending nature requires immediate surgical intervention.

Important! For patients diagnosed with acute ascending thrombophlebitis, specialists operate unscheduled, immediately after ultrasound examination of the venous vessels. The main method of surgical treatment of ascending thrombophlebitis is crossectomy.

Crossectomy is a surgical procedure that involves ligating and cutting off the large saphenous venous vessel and its main tributaries at the site where the vein enters the deep femoral veins. To perform such a surgical procedure, a small incision is made in the area of ​​the inguinal fold. After the procedure is completed, cosmetic stitches are applied to make the scar as less noticeable as possible.

Preventive measures

Acute ascending thrombophlebitis is considered dangerous pathological conditions circulatory system. In order to get rid of this disease you need a large number of time and effort. For this reason, patients who have a tendency to such a pathology need to take preventive measures to reduce the likelihood of developing island-ascending thrombophlebitis of the venous vessels of the lower extremities.

The main preventive measures for acute thrombophlebitis are the following recommendations, discussed in the table.

How to prevent the development of island-ascending thrombophlebitis
Advice	Description	Characteristic photo
Active lifestyle	The development of varicose veins and, as a consequence, thrombophlebitis is often associated with physical inactivity.
Regular training	The patient will benefit from morning exercises, fitness, and jogging. Nordic walking and swimming in the pool will bring undeniable benefits.
Correct position when resting	The lower limbs often get “tired”, so when resting it is important to provide maximum comfort for them; to do this, they should be raised slightly higher than other parts of the body.
Drinking regime	The human body needs water to maintain all necessary functions. To a healthy person It is necessary to consume at least 2 liters of clean drinking water. It is worth noting that the norms for patients with kidney problems are somewhat different.

You also need to follow the basics rational nutrition, which involve consuming more vegetables and fruits, as well as avoiding fried, smoked, overly salted and spicy foods.

In order to avoid relapse of the pathology, it is necessary to constantly wear compression stockings, as well as take anticoagulants and vitamin-mineral complexes.

When thrombosis occurs, the vein becomes blocked and blood flow becomes 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 disruption of blood circulation;
• can break off and pass with blood to other organs;
• may resolve.

The disease requires immediate treatment under 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 significantly 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 lower leg, then treatment can occur 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 create serious risks to life.

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

• Using elastic compression garments;
• To decrease painful sensations the doctor may prescribe ice compresses (apply during the day for 20 minutes);
• 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 thinning drugs: Fragmin, Phlebodia;
• The use of ointments containing heparin, which has an anti-inflammatory effect and relieves swelling: heparin ointment, ketonal 5%, lyoton gel and others;
• Physiotherapy: ultraviolet radiation, infrared radiation, electrophoresis, magnetic therapy, laser therapy, DArsonval, barotherapy.

My patients used a proven remedy that allows them to get rid of varicose veins in 2 weeks without much effort. If conservative therapy is unsuccessful, the doctor may prescribe surgery. The essence of this operation is to prevent blood from moving from deep to superficial. The veins located below the knee are ligated. Surgery is safe and is most often performed under local anesthesia.

There are several types of surgical intervention:

• Venectomy – removal of a vein;
• Removal of thrombosed vein nodes;
• Thrombectomy;
• Crossectomy – ligation of the great saphenous vein;
• Removal of the trunk of the great saphenous vein using a Babcock probe.

Causes

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

• Deep vein thrombosis;
• Heredity;
• Varicose veins;
• Tuberculosis;
• Cancerous formations;
• Change in blood, stagnation;
• Antiphospholipid syndrome;
• Obesity;
• Surgical interventions;
• Pregnancy;
• Administration of drugs intravenously;
• Sedentary work, passive lifestyle.

Main reasons venous thrombosis three, and they are called “Virchow’s triad”:

1. increased coagulability blood;
2. violation of the integrity of the walls;
3. slow blood flow in the vessels.

Contribute to the implementation of Virchow's triad:

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

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

People who overload the body with physical activity every day are at risk of injury. This may occur when sports training, work that requires significant effort, and so on. But this does not mean that the disease affects only active people. There are many reasons that lead to the development of the disease.

Advanced thrombophlebitis

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

There are some factors that provoke the development of thrombophlebitis:

• changes in the properties and composition of blood, increased clotting,
• slow blood flow.
• injury to the venous wall of blood vessels.

A 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 types of leg injuries;
• low-quality tumors;
• when the catheter is in the vein for a long time;
• infectious diseases.

What exactly leads to thromboembolic complications?

Venous thrombosis occurs when a number of unfavorable circumstances coincide, which lead to a slowdown in blood flow through the veins of the legs, increased blood clotting and damage (often microscopic) to the venous wall. The speed of blood flow through the veins slows down sharply when people’s mobility is limited due to compliance bed rest, long flights or when driving in a car.

The coagulation potential of the blood increases in response to injury, bleeding, surgery, infection, dehydration, the development of malignant neoplasms, and uncontrolled use of female sex hormones for contraception or for the purpose of replacement. The genetic predisposition of a number of people is also important - the presence of so-called congenital thrombophilias.

What is the catalyst for the development of thrombosis?

Such a “catalyst” is often various injuries, surgical operations and, unfortunately, even childbirth.

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

Firstly, it is important to reduce the patient’s compliance with bed rest to a minimum; it is advisable to activate the patient within the next few hours after surgery. Secondly, reducing the duration and morbidity of surgical intervention, including with the help of new technologies, are important components of preventing thrombotic complications.

As one of the methods to combat mortality from thromboembolism, in 2009 the Russian Society of Surgeons, the Association of Phlebologists of Russia and the Research Institute of Preventive Medicine developed a nationwide educational medical and social project “Territory of Safety”. The goal of the project is to reduce patient mortality from venous thromboembolic complications (VTEC).

As part of the project, physicians assessed the risk of these complications using electronic score sheets for all hospital patients and prescribed necessary cases effective preventive measures that made it possible to reduce by 10 times the level of in-hospital mortality from thromboembolism in hospitals that took part in the project over 5 years.

As already mentioned, a 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 of these factors are enough for any infection to penetrate the vessel wall and cause inflammation.

Reduced immunity, thickening of the blood caused by illness or medication also facilitate the establishment of infectious pathogens on the vascular wall.

Thrombophlebitis can be triggered by injury to the venous wall, a medical procedure ( intravenous injection, vein catheterization, vascular operations, etc.), infectious disease, for example, influenza, ARVI, pneumonia, tonsillitis, tuberculosis and even caries.

Superficial vein thrombosis of the lower extremities: symptoms, treatment

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

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

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 load - this is the most distant part of the riverbed, and the veins have difficulty pumping blood from bottom to top. Varicose changes, if any, are more pronounced on the legs.

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

• the vein becomes dense and painful to the touch,
• redness of the skin in the affected area is visually observed,
• local temperature rises,
• the limb swells slightly below the location of the blood clot.

Treatment of superficial thrombosis is usually conservative, unless there is a risk of thrombosis spreading to the deep vein system.

• Fixation of a blood clot. If it was possible to diagnose thrombosis in acute period, there is a danger of fragmentation of the blood clot and removal of pieces of the blood clot with the blood flow to the heart. Therefore, bed rest is prescribed for a week, complete rest of the affected limb, and local use of anti-inflammatory and absorbable ointments.
• Fighting the inflammatory process. Non-steroidal anti-inflammatory drugs and drugs to normalize metabolic processes are prescribed - troxevasin, aescusan, ascorutin.
• Prevents thrombus formation. Aspirin is used as a disaggregant.

In the future they will gradually expand motor mode, carrying out mandatory compression of the saphenous veins using special stockings or elastic bandages. Surgical removal varicose veins are recommended after 2-3 months. after thrombosis.

Superficial thrombi, which are 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 the blood clot is removed or the mouth of the saphenous vein is ligated where it flows into the deep vein.

How does thrombophlebitis manifest? Symptoms of thrombophlebitis

Thrombophlebitis begins with pain in the legs. The intensity of the pain may or may not be very strong, 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 has turned red. Over time, this redness gives way to a bluish tint, and then the skin becomes 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 vessels. It should be noted that the apex of the blood clots is most often located 15-20 cm above the area of ​​visible redness and cord.

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

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

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

What could be the complications of thrombophlebitis on the legs?

We have explained what thrombophlebitis is, but why is it dangerous?

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

• Postthrombophlebitic syndrome, manifested by venous insufficiency, and leads to the formation of ulcers. This complication occurs in 70% of cases. This condition occurs with: prolonged swelling of the extremities due to damage to the deep veins, damage to the valves in the veins, and impaired blood flow.
• Blood clot detachment. Blood clots are weakly attached to the walls of blood vessels, which can lead to their rupture. This condition very dangerous. The blood clot travels with the bloodstream and can lead to blockage of the pulmonary artery (pulmonary embolism). This leads to sudden death, pneumonia, and heart failure.
• Blood poisoning is a very rare complication. Occurs when a secondary infection occurs. People with weakened immune systems are at risk, most often these are people suffering from diabetes and cancer.
• The appearance of cellulitis or abscess. This complication most often results from incorrect treatment, or the use of traditional methods.

Venous thrombosis (phlebothrombosis) is a condition when the lumen of a vein is filled with blood clots that interfere with blood flow. Often phlebothrombosis is accompanied by inflammatory phenomena of the venous walls, then they speak of thrombophlebitis.

The favorite localization of venous thrombi is the lower extremities:

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

Thrombosis is classified according to the location of the blood clot inside the vessel.

• parietal - the thrombus is located near the wall of the vein, 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 bottom to top 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 when life-threatening complications develop.

Thromboembolism

Complete or partial detachment of a blood clot from the venous wall and its removal by the blood flow to the heart and further into the pulmonary artery. Blockage of its small branches by a thrombus leads to the death of 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 and 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 increase in edema, they spasm and are compressed.

Thrombosis of deep veins to the level of the iliac veins is the cause of white phlegmasia of the extremities, and if thrombosis of the superficial veins is added - blue phlegmasia, which can lead to death, gangrene or amputation of the leg.

The most dangerous 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 thrombus floats. At some point, part of such a blood clot may break off, travel through the bloodstream into the heart and cause an embolism (blockage) of the pulmonary artery.

Sepsis (blood poisoning) is an equally serious condition, which quite often ends in death.

If thrombophlebitis is not treated or treated inadequately, for example, when self-medicating only with folk remedies, then the inflammation can move to the surrounding tissues and become purulent - an abscess or phlegmon of the leg tissue develops.

First, let's figure out how varicose veins and thrombophlebitis are related to each other. Formally, we are talking about two various ailments. In practice, thrombophlebitis of the deep veins of the lower extremities in many cases turns out to be logical development 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 to the lower extremities and increased blood clotting can lead to the development of thrombophlebitis.

The impact of an infectious agent on the vessel wall causes 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. Thrombosis in the deep veins is much more dangerous, and if such a development of events looks real, the patient is immediately referred for surgery.

Among possible complications thrombophlebitis is called:

• education trophic ulcers which may be a source of constant bleeding;
• sepsis, that is, general blood poisoning, and gangrene;
• spread of the inflammatory process to neighboring tissues.

From the data presented, it becomes obvious that thrombophlebitis requires immediate treatment. To see a doctor promptly, it is important not to ignore any of the symptoms. Among them:

• pain aching character in the legs;
• persistent swelling of the lower extremities;
• prominence of veins;
• change in skin tone to reddish or even bluish;
• a slight increase in temperature that goes away without any treatment.

Today it is quite possible to defeat thrombophlebitis, provided that the fight against the disease begins in a timely manner. Therapy is complex. It is based on the patient taking drugs that have an anti-inflammatory and thrombolytic effect, as well as promoting 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. In other circumstances, conservative treatment is often sufficient.

Hello, Elena Olegovna!

1. Acute occlusive thrombosis of the superficial femoral vein to the mouth of the deep femoral vein - is this generally considered a large thrombus or a small one? I just looked at these veins in a picture on the Internet, but I still didn’t understand.

2. There is a possibility that in my case there will be no consequences after undergoing thrombosis, taking into account the fact that my leg did not turn red (did not change color at all, it was the usual color), the veins did not swell, there were no varicose veins - that this thrombosis will pass without a trace ? My leg was just swollen and painful. When I left the hospital and to this day there is no swelling at all and my leg doesn’t hurt.

3.Is there a chance of recurrent thrombosis if I take warfarin constantly?

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 blood clot is dangerous, since it is located high (in the femoral vein). But big or small, it doesn’t matter.

2. This possibility exists due to the fact that you were prescribed treatment on time. However, the consequences of thrombosis in the veins remain extremely rare.

3. There is a danger of repeated thrombosis; with warfarin (if you take it in the correct dose - that is, your INR is in the range from 2 to 3) the danger is reduced.

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

5. While taking warfarin, drinking alcohol may weaken the effect of the drug. By January, your 3 months will already be over, as I understand it.

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

Good luck to you too.

Sincerely, Belyanina Elena Olegovna.

Circulatory disorders due to venous pathology are quite common. Research shows that approximately a quarter of the world's population is at risk of venous thrombosis. Some cases pass without a trace and are asymptomatic, but in other situations, blood clots significantly disrupt blood flow and can lead to dangerous complications.

Thromboembolism

Thrombophlebitis is inflammatory process venous wall, leading to the formation of a blood clot. During 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 blood clot breaking off and developing such dangerous complications, such as myocardial infarction or pulmonary embolism. Below we will talk about the dangers of thrombophlebitis of the lower extremities in more detail.

Signs and treatment

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

• Varicose veins become painful and dense;
• The leg swells and increases in size;
• Sharp pain may occur when walking;
• Chills and fever appear;
• General weakness persists;
• Lymph nodes enlarge.

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

• Great saphenous vein;
• Common femoral vein;
• Sapheno-femoral anastomosis.

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

If symptoms of acute thrombophlebitis appear, the first thing to do is call a doctor. Then you should lie down in bed and elevate the sore leg by placing a pillow under it.

Under no circumstances should you perform any mechanical manipulations on the sore area - do not massage, do not rub in ointments and creams, even if you think they are very useful. This treatment will not make you feel better, and the risk of a blood clot breaking off 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 supervised 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 at risk should be very attentive to any manifestations of ill-health and discomfort in the legs:

• pain in the lower leg muscles, aggravated by palpation and movement;
• increasing swelling;
• heaviness in the limbs, feeling of fullness;
• local or general increase temperature.

To make sure that minor symptoms do not hide a dangerous disease, you need to consult a doctor.

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

1. Duplex scanning. Ultrasonography with color mapping of blood flow is most informative for identifying thrombosis. Allows you to determine the size, structure, and presence of a floating thrombus.
2. X-ray contrast venography. Research in addition to duplex scanning, if the blood clot is located in a place difficult to reach for ultrasound - above the inguinal fold. X-ray with contrast reveals the location of the thrombus, its extent, and the condition of the venous wall.
3. Tomography. Computed tomography or magnetic resonance imaging more accurately shows the location, structure of the blood clot and the degree of blockage of blood flow.
4. Laboratory diagnostics. In the presence of thrombosis, fibrin breakdown products appear in the blood - D-dimers.

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

The most informative are instrumental techniques, including:

1. Ultrasonography. Ultrasound allows you to find out the location of the blood clot, its size, and the degree of blockage of blood flow. Using ultrasound, you can reliably study the condition of the venous valves.
2. Phlebography. The technique allows you to detect blood clots in the saphenous veins.
3. Radionuclide research. A radioactive substance is used and injected into a vein. Radionuclide diagnostics makes it possible to detect a blood clot and assess the nature of damage to the veins.
4. Magnetic resonance phlebography. The technique is expensive, but allows you to most accurately determine the degree of damage to the veins, including deep ones.
5. Impedance plethysmography. Using this type of study, the nature of the filling of the veins with blood is determined.

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

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

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

There are four types of surgical intervention for thrombophlebitis:

1. Fogarty catheter. During surgery, a probe is inserted into the veins to remove the clot. The method is used on initial stage thrombophlebitis (up to 5 days from the moment of exacerbation of the disease).
2. Installation of a vena 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.
3. Plication. The task of plication is to stitch the vein with special metal staples.
4. Thrombectomy. The most common method of surgical treatment of thrombophlebitis. During the operation, the clot is removed from the vein. In order to prescribe the operation, a mandatory condition must be met - the blood clot occurred no later than 7 days ago. If the thrombus is older, deformations have already occurred on the vein walls and venous valves, which will greatly reduce the effectiveness of the operation.

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

Prevention of thrombosis

The main goal of preventing thrombophlebitis is timely and adequate treatment exacerbations in the chronic form of the disease. Acute forms of thrombophlebitis must be detected promptly and treated without delay.

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

If treatment with intravenous infusions it is necessary to make injections into different veins so that the damage has time to heal.

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

If you are suffering varicose veins, then it is recommended to sleep with your legs elevated. Waking up in the morning, without getting out of bed, you need to perform several swings of your legs alternately up and down and in a “scissors” manner. Without lowering your legs, form a bandage from elastic bandages, or pull on medical knitwear.

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.
• eliminating bad habits.

To avoid 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 elevated for better blood flow;
• When varicose veins lubricate your feet with heparin ointment;
• When working sedentarily, do exercises and warm up for at least 15 minutes.

A proven method of treating varicose veins at home in 14 days!

Preventive measures for thrombosis include compliance with the following recommendations:

1. Wearing compression stockings. Special shapewear allows you to improve blood flow in the affected veins. The degree of compression is determined by the attending physician.
2. If there is no risk of thrombus detachment, the patient is prescribed physiotherapy or other types of moderate physical activity (walking, swimming).
3. Taking medications that reduce the intensity of blood clots in the veins.
4. 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.).
5. 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 detected, immediately seek medical help.

Life with thrombophlebitis

Motor activity in thrombophlebitis has great value, as it prevents blood stagnation and reduces the likelihood of blood clots.

If thrombophlebitis has spread to the deep veins, then you will have to limit yourself in movement, since even minor physical activity can cause a blood clot to break off.

Nutrition for thrombophlebitis is also important. Animal fats will have to be limited and given preference vegetable oils. To strengthen the walls of blood vessels and make the blood more fluid, you should add to your diet vegetables and berries rich in vitamin C and rutin, for example: rose hips, sea buckthorn, chokeberries, black currants, sweet peppers, dill, parsley, Brussels sprouts.

Deep vein thrombosis of the lower extremities: symptoms, treatment

A blood clot located near the wall may not manifest itself in any way and may be diagnosed simultaneously during another examination. If a thrombus has blocked the lumen of a large vein, then the disease is characterized

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

If thrombosis has affected the iliac veins, pain appears in the groin and pelvic area. In this case, the legs become very swollen and gangrene may develop.

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

Fresh thrombotic deposits with a floating part and blood clots prone to upward spread are subject to surgical treatment. In this case, the blood clot is removed, the vessel is sutured with paper clips, or an umbrella filter is placed in a large vein.

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

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

Treatment of thrombosis of the veins of the lower extremities is not a short-lived process. It is important to follow the treatment regimen and not stop it as soon as the pain subsides and the swelling goes away. It is necessary to ensure that there are no conditions for blood stagnation in the vessels, so in the future you will have to wear compression stockings and monitor blood clotting.

Clinical picture

Thrombophlebitis is divided into three forms:

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

The acute stage of thrombophlebitis is characterized by an increase low-grade fever. At the same time, a pain syndrome occurs in the vein area, especially aggravated by physical activity. Swelling begins on the affected limb. The skin along the veins becomes thick and painful, and 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 affects not only the veins, but also 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 to superficial, but also to deep veins);
• lymphatic system;
• peripheral system (with such localization, ischemic neuritis is possible).

The following factors lead to thrombophlebitis:

1. Traumatic damage to the venous wall.
2. Impaired or slow blood flow. Violations may be caused by insufficient physical activity, prolonged compression of the veins of the lower limb (for example, due to wearing a cast). Improper circulation occurs as a result of heart failure, when the heart does not pump enough blood. With impaired and slow blood flow in the lower extremities, stagnation occurs.
3. High blood clotting. The reason most often lies in genetic predisposition. However, other factors may also influence, including cancer and infectious diseases. Some 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 often susceptible to 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:

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

Severe thrombophlebitis is characterized by the appearance of blisters with hemorrhagic filling. 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.

For chronic thrombophlebitis a calmer course is typical. Periods of exacerbation of the disease are followed by remission. When the exacerbation returns, the symptoms of the disease in the chronic phase become the same as in the acute stage. During the period of remission of thrombophlebitis, symptoms may practically not manifest themselves at all.

What is the danger of blood clots?

In the story about the dangers of thrombophlebitis, we should focus on three factors that have a particularly strong impact on the state of the venous system:

1. Poor blood flow. Slow blood circulation has a particularly adverse effect during pregnancy, fractures, and in people suffering from cardiovascular diseases.
2. Increased blood viscosity. This factor leads to the formation of blood clots. Greatest danger are exposed bedridden patients, cancer patients.
3. Increased venous trauma. 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

Typically, bleeding from thrombophlebitis is localized in the lower leg area. The intensity of blood loss may vary, but with the body in an upright position, bleeding will always be more profuse.

If there is bleeding, the patient is transferred to a horizontal position. The problematic limb is placed on an elevation, after which a bandage is applied. After this, you need to call an ambulance to take the patient to the inpatient department of the hospital.

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

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

Thromboembolism

This complication is the most undesirable and the most dangerous. Thromboembolism is the detachment of a blood clot with further blocking 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 detached 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 in an inpatient department at the time of the development of pulmonary embolism, his chances of survival increase significantly.

Therapeutic measures are aimed at improving blood circulation and maintaining bed rest. Blood clots must be removed from circulatory system. For this purpose, thrombolytic treatment or surgery. Infusion treatment carried out to thin the blood and prevent further thrombus formation. Surgical intervention is decided upon if conservative methods do not give results.

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, a narrowing of the lumen in the bloodstream occurs, which entails stagnation. As a result of the development of pathology, the wall can grow so large that blood flow through the vein stops completely.

Upon external observation, veins affected by phlebosclerosis look like rope-like thickenings. Their color is whitish. However, this symptom is noticeable only from the outside, and changes in the veins under the skin are almost invisible.

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

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

• increased body temperature;
• headache;
• fever;
• fast fatiguability;
• general weakness.

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

Note! If you suspect lymphangitis, you should not massage or heat the veins of the lower limb, as such actions will complicate the course of the disease.

Elephantiasis

The pathology is a painful thickening of the skin and subcutaneous tissue. The development of the pathological process is associated with a disruption of the normal outflow of lymph. Elephantiasis is accompanied by persistent swelling of the lower extremities; pain syndrome is often absent.

Patients turn to doctors primarily because cosmetic defect, and not due to physical discomfort. Over time, in addition to swelling, an erysipelas inflammatory process on the skin is added to the symptoms of the disease.

In the treatment of elephantiasis (except for treatment of the underlying disease), diuretics and lymphatic drainage are used. If medication and other methods of conservative therapy do not bring results, surgical treatment is prescribed.

The peripheral nervous system refers to that part of the nerve endings that is located outside the brain and spinal cord. Due to the peripheral system, the relationship between the central nervous system and human organs and limbs is ensured.

The peripheral nervous system is injured both as a result of mechanical influences and under the influence of intoxication. As a result, an 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 deficiency peripheral nerves cease full functioning, which is expressed in the following symptoms:

• decreased reflexes;
• dystrophic processes in muscles;
• reduction of skin sensitivity in the area of ​​development of the disease.

Ischemic neuritis is often 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, the development of general purulent complications is possible. The process is provoked by purulent melting of a blood clot in the vein and the presence of accompanying pathogenic microflora. The name of the pathology is septicopyemia.

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

Septicopyemia usually does not occur very violently, but over a long period of time. This is explained by the fact that, as a rule, the body is able to extinguish too intense inflammatory processes.

When septicopyemia affects the lungs, the cardiovascular system. There may also be problems with the genitourinary system, which sharply reduces the body’s ability to excrete urine.

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

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

If sepsis is suspected, the patient needs immediate medical attention. Treatment is carried out exclusively in inpatient settings.

According to medical practice, most blood clots can resolve on their own over time. Sometimes they simply scar, with little or no disruption to blood flow. With prolonged blockage of blood vessels, which leads to poor circulation, irreversible disorders occur.

Normal blood flow is ensured by valves. These are some kind of partitions between the walls of blood vessels. If the blood rises, the valves open; reverse flow of blood is impossible, since the valve is closed. If a vein is blocked by a blood clot, the supply to the valves is disrupted, which affects their function.

After some time, the clot may dissolve, but the function of the valves will not be restored.

Treatment of thrombophlebitis is carried out both surgically and conservatively, depending on the cause of inflammation and its degree. Only a doctor, after an examination, can determine which method is most effective in this case.

Removal is a last resort, carried out when there is a possibility of a blood clot breaking off.