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Understanding Thrombophlebitis -- Diagnosis and Treatment

How Do I Know If I Have Thrombophlebitis?

The discomfort and appearance of a leg affected with thrombophlebitis is usually enough for a doctor to diagnose this condition. Taking your pulse and blood pressure also can help. But depending on the blood vessel involved, symptoms may or may not be obvious, and your doctor may have to order tests to determine whether this condition is causing problems.

Ultrasound uses sound waves and a computer to create images of the affected area to help your doctor determine if a clot is present and blocking the blood flow. Veins with a healthy circulation look different than a vessel with thrombophlebitis.

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Thrombolysis

Thrombolysis, also known as thrombolytic therapy, is a treatment to dissolve dangerous clots in blood vessels, improve blood flow, and prevent damage to tissues and organs. Thrombolysis may involve the injection of clot-busting drugs through an intravenous (IV) line or through a long catheter that delivers drugs directly to the site of the blockage. It also may involve the use of a long catheter with a mechanical device attached to the tip that either removes the clot or physically breaks it...

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But there are some veins in the leg that don't show up well on ultrasound, especially the deep veins close to the knee. It can be difficult or impossible to tell if you have circulation problems present in these "blind spots." Your doctor may perform an older test called a venogram, where dye is injected into the foot and is directed into the affected vessel as the blood makes its way back to the heart. The dye will show up on X-ray, giving a picture of the inside of the vein. The clots themselves don't show up, but your doctor can tell how much dye is traveling through the leg and note where blood flow stops due to the clot.

A blood test can also be done to check for a substance called D-dimer. D-dimer is formed when blood clots are broken down. A negative test significantly lowers the likelihood of a clot. A positive test may indicate a clot, but it also can indicate other causes.

What Is the Treatment for Thrombophlebitis?

Treatment for thrombophlebitis varies according to severity. When a superficial blood vessel is involved, the condition may begin to get better in a week or two. Treatment focuses on reducing swelling and pain. All you may need is to take over-the-counter aspirin or ibuprofen and apply heat to the leg for 15 to 30 minutes two to three times daily.

Some people may need to wear support hose or stockings or have their leg wrapped to apply pressure to the leg and reduce swelling. Elevating the leg can also prevent excess fluid from pooling in the affected area.

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