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Learn about superficial thrombophlebitis and calf vein thrombosis and what our vein clinic can do for you.

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What is superficial thrombophlebitis?

Within the system of veins, there are deep veins and superficial veins. The deep veins usually travel within the muscle compartments of the body. The deep veins within the legs carry blood directly back into the body and eventually back to the heart.

The superficial veins are veins that carry blood from the surface of the body (like the skin) back to the deep veins. These vessels are like the branches of a tree: they come in many shapes and sizes, and typically get bigger as they get closer to the ‘trunk veins,’ which are deep veins.

Thrombosis means blood has clotted within a vessel.

Phlebitis means a vessel is inflamed or irritated. This is often associated with pain, redness, and increased warmth over the vessel.

Thrombophlebitis means that both a thrombus (blood clot) and a phlebitis (vessel inflammation) are present.

What is calf vein thrombosis? 

Calf vein thrombosis is a thrombosis or blood clot that affects the deep veins within the calf muscles. When they occur, calf pain and ankle swelling are common. The risk factors for calf vein thrombosis are essentially the same as the risks factors for DVT.

Signs and symptoms

A deep vein thrombosis (DVT) may have symptoms associated with its presence, such as redness of the area, swelling, and pain. However, approximately 50 percent of the time, DVTs may be present WITHOUT any obvious symptoms. An ultrasound examination is often used to confirm or identify the diagnosis. Therefore, it is very important to understand the risk factors associated with DVT. Knowing these risk factors, and doing what you can to prevent them, is the best way to prevent a DVT from occurring.

Risk factors for DVT include:


  • Varicose veins
  • Recent surgery (particularly abdominal, chest, pelvic, or orthopedic surgeries)
  • Recent injury that may affect blood flow to the legs (like hip fracture or leg fracture)
  • Long leg (or arm) cast
  • Cancer
  • Hormone therapy (including use of birth control pills and hormone replacement medications)
  • Immobilization (i.e. casts, prolonged bed rest/hospitalization, long flights/car rides, paralysis)
  • Pregnancy or recent delivery
  • Inflammatory bowel disease
  • Inherited condition that increases blood clotting
  • Smoking
  • Extra weight/obesity

Superficial thrombophlebitis typically has symptoms, as phlebitis is a prominent feature. Redness, swelling, and pain along the course of the vein are the usual symptoms. Occasionally, a low grade fever and general aching occur along with the phlebitis symptoms. Clinical examination by your vein doctor and ultrasound examination are used to confirm the diagnosis. Up to 25 percent of the time, a DVT is associated with a superficial thrombophlebitis.

The risk factors for superficial thrombophlebitis are very similar to the risk factors for DVT. They also include:

  • Recent IV therapy including IV medications
  • IV drug abuse
  • trauma to a varicose vein

Treatment

The treatment for DVT, calf vein thrombosis, and superficial thrombophlebitis depends, at least to a certain degree, on the location of the blood clot. Some of the options for treatment of a blood clot include:


Thrombolysis – may be used for a clot high in the leg or pelvis that carries a high risk of complications associated with the blood clot. Methods of thrombolysis include medications to break up the clot and/or ‘mechanical disruption’ of the clot.

Anticoagulation – blood thinners are used when the clot is large, close to the pelvis or upper part of the leg, at high risk for getting larger, or very symptomatic and/or recurrent (not the first clot). The choice to start an anticoagulant and which one to use involves many factors that are considered by your physician.

Anti-inflammatory medication (like ibuprofen/motrin/advil) – these are not used if anticoagulation is started. They may be used for smaller clots in the lower part of the leg or for superficial thrombophlebitis. They help with the symptoms of phlebitis.


Compression stockings – these reduce swelling, may keep the clot from getting larger, and decrease the risk of post-thrombotic syndrome from developing after large clots. It is best to wear compression stockings for 2 years after a large blood clot has been diagnosed to decrease the risk of post-thrombotic syndrome.


Ice and elevation – can help with pain and swelling associated with blood clots.

Varicose veins and blood clots

Varicose veins increase the risk of both superficial thrombophlebitis and deep vein thrombosis. To decrease your risk of blood clots, you should see a vein specialist to discuss options for treatment of your vein conditions. Fortunately, the treatment of varicose veins no longer requires hospitalization, general anesthesia, or significant down-time from work or your routine. Contact our vein clinic to schedule a free screening to ensure that your healthy legs can keep you moving for years to come.