Superficial venous thrombosis

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What is it about ?

We have two types of blood vessels: arteries, which distribute oxygen-rich blood throughout the body, and veins, which return oxygen-poor blood to the lungs for oxygen replenishment.

The veins form two interconnected systems: a superficial system just under the skin and another deeper in the muscles. Some of the superficial veins can be seen rippling under the skin.

A blood clot (thrombus) can form in a blood vessel and block the vessel. A superficial venous thrombosis therefore corresponds to a blood clot that has formed in a vein of the superficial system.

It can be a disease in itself with no apparent cause, but there are also certain factors that can cause it, such as:

  • Damage to the venous wall (for example, by needles);
  • A reduction in blood flow (for example, by varicose veins);
  • A increased tendency to form clots (for example, in case of bleeding disorders, cancer, etc.);
  • Inflammation of the venous wall (phlebitis).

How to recognize it?

If a blood clot (thrombus) blocks a vein, there is still inflammation of the wall of the vein (phlebitis).

It is in a dilation of a vein (varicose veins) that the clot forms more often. The vein is twisted and painful, and the area around the inflammation becomes red, hot, and swollen (thrombophlebitis). If it is a large vein with more extensive inflammation, you may also have a fever. The closer the clot is to the crook of the knee or groin, the more inflammation can spread to the veins of the deep system. In this case, the whole leg may swell and feel hot.

How is the diagnosis made?

Superficial venous thrombosis is a clinical diagnosis, that is, the doctor usually relies on external symptoms. If there are varicose veins and the inflamed area is less than 5 cm, then no further examinations should be done.

Sometimes the doctor will decide to have a Doppler examination. This is an ultrasound technique, specific to blood vessels. a Doppler examination is indicated in the following cases:

  • If we also suspect a deep vein thrombosis underlying;
  • If the diagnosis is not clear;
  • If the thrombosis is near the hollow of the knee or groin;
  • In case of pregnancy.

What can you do ?

To reduce swelling and pain, it is recommended to elevate the leg slightly. An elastic bandage or a stocking with varicose veins, to be applied in the morning from the foot upwards, reduces swelling. If symptoms permit, keep moving (walking). The movement reduces the risk of expansion to the deep veins.

What can your doctor do?

Treatment is based on two pillars: counteracting inflammation with a anti-inflammatory and possibly a anticoagulant. The aim is to relieve the symptoms and prevent expansion to the deep veins.

It is sometimes necessary to administer an anticoagulant by injections under the skin (subcutaneous punctures) for 6 weeks. A home nurse can do this or you can learn to do it yourself. A blood thinner is always combined with compression therapy, which involves applying bandages around the affected leg. Allow between 2 and 6 weeks for symptoms to improve. Sometimes the complaints persist for months.

Want to know more?

Source

Foreign clinical practice guide ‘Superficial venous thrombosis’ (2002), updated on 17.03.2017 and adapted to the Belgian context on 21.05.2018 – ebpracticenet

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