Phlebitis/Superficial Thrombophlebitis (SVT)
Phlebitis or superficial thrombophlebitis (SVT) is a blood clot that occurs in surface veins, limiting blood flow through the vein resulting in swelling and pain. Phlebitis means inflammation of a vein. Thrombo meaning blood clot refers to the blood clot causing the inflammation. This condition typically develops in hours to days and resolves within a few weeks. It can get better and then return. Phlebitis can often times go unnoticed and may improve without any intervention. It should not be confused with deep vein thrombosis (DVT's) a life threatening condition occurring in deeper veins.
Symptoms of Phlebitis/SVT are pain, swelling, tenderness, skin redness, warmth or firmness in the part of the body/vein affected.
Causes and Risk Factors for developing phlebitis/SVT include:
- Trauma or injury to a vein from a procedure such as having an IV, or a surgical procedure on a vein i.e. radiofrequency closure, phlebectomy or sclerotherapy.
- Hormone therapy (HT), birth control pills, and pregnancy can increase the risk for developing phlebitis/SVT.
- Smoking is a risk factor for developing phlebitis/SVT. Smoking in combination with birth control pills can substantially increase that risk (ask your healthcare provider for information on how to quit smoking).
- Obesity/being overweight.
- Inherited (primary) or acquired (secondary) hypercoagulable conditions are associated with increased risk of phlebitis and thrombophlebitis. Some, but not all, of these conditions can be identified by ordering laboratory testing and bringing known family history of these conditions to your healthcare providers attention.
- Prolonged immobility is another common risk factor; blood stored in the veins of the lower legs is pumped toward the heart by contraction of the leg muscles. If this contraction is limited due to sitting for long periods in a car or plane or after surgery, the blood in the veins can become stagnant and be at risk for clot formation.
Patients often decide to seek treatment for phlebitis when it is painful and interferes with their daily activities.
- Phlebitis/SVT is diagnosed by physical exam/history and ultrasound. Ultrasound (a sound wave study used to see the vein though the skin) is very accurate in the diagnosis of phlebitis/SVT. The ultrasound determines location and degree of phlebitis/SVT. Phlebitis/SVT in a smaller vein generally is treated with over the counter anti inflammatories, warm compresses and time as listed below. If the ultrasound findings show, the phlebitis/SVT is in a larger vein or migrating towards a larger vein, the treatment maybe with prescription anticoagulants (blood thinners). Frequent monitoring with ultrasound will be needed in either situation to monitor for changes.
- Immediate treatment goal is to reduce pain and inflammation. Warm compresses, elevation of the extremity anti-inflammatory medicines such as Ibuprofen, and compression therapy when appropriate will help alleviate pain. Long-term Treatment goal is to reduce the recurrence of phlebitis, and restore function. Surgical options such as radiofrequency closure or phlebectomy to remove or close the veins that result in phlebitis can be helpful. Your health care provider can find a solution that is right for you.