Thrombophlebitis is a circulatory condition caused by inflammation and blood clots in the veins. It can be superficial, affecting veins under the skin, or deep. Common causes include varicose veins, immobility, trauma, pregnancy, and cancer. Symptoms are swelling, redness, tenderness, and warmth around the affected vein. Diagnosis involves ultrasound, D-dimer blood tests, and imaging tests. Treatment focuses on reducing inflammation and preventing clots from worsening using blood thinners, anti-inflammatories, physiotherapy, and sometimes stents or surgery to remove clots.

1. THROMBOPHLEBITIS
Presented by – Abhinav Kumar ,
B.Th.O ,Final year
(A.K.U)

2. Definition:
•Thrombophlebitis is a
circulatory condition that occurs
when a blood clot, which
developed due to a venous
inflammation, inhibits the blood
flow .

3. Types :
1. Superficial thrombophlebitis: occurs in the
veins located under the skin
a) Superficial thrombophlebitis on the upper
extremity

4. b) Superficial thrombophlebitis of lower limb .

5. 2.Thrombophlebitis migrans: multiple
inflammations in different areas
•A deep vein thrombosis, which mostly
occurs without any inflammation process,
will usually be referred to as a
phlebothrombosis.

6. Causes :
•The causes of superficial thrombophlebitis are
different for the lower and upper extremities.
-For the upper extremity :most commonly the
insertion of venous catheters into peripheral
veins , the possible invasion of bacteria in the
area of the catheter, and the effect of the inserted
chemicals.

7. - For the lower extremity:
•Varicose veins
•Immobilisation (also pre- and post-surgery)
•Trauma or surgical interventions (especially including
interventions which include the removal of lymph
nodes)
•Pregnancy, and maternal and birth-related conditions

8. •Cancerous malformations
•Obesity
•History of thrombosis
•Autoimmune diseases
•Use of hormonal therapies (e.g. the
contraceptive pill or hormonal replacement
therapy)
•Smoking (also as a higher associated risk factor
to arteriosclerosis)

9. Pathogenesis:
•The pathway of the development of the disease
can be split into two stages:
1.Inflammation process in the vessel (due to a
slow in blood circulation, inflammation factors,
and possibly the exposure to risk factors).

10. 2. Secondary development of a thrombus (the
blood clods around the inflamed tissue of the
vessel, fibrous material builds up and forms a
thrombus).

11. Symptoms:
• Swelling
• Redness
• Tenderness around the vein area .
• Warm to touch of the hand

12. Diagnosis :
1. Ultrasound ( e.g. Doppler ultrasound)

13. 2. D – dimper test
A D-dimer test is a simple blood test that can help your healthcare
provider determine if you may have a blood clotting condition.
you have a high level of D-dimer in your blood .
3. MR venography and CT venography :
If the results of your ultrasound aren’t clear, your doctor will use
these imaging studies to confirm the presence of a clot. They will
inject a dye into your vein and the image will show up on an X-ray.
Possible side effects include pain and an allergic reaction to the
dye.

14. Complication :
• Although thrombophlebitis has been considered a fairly
benign disease, some research indicates that there is a
correlation of a higher prevalence of deep vein thrombosis
(phlebothrombosis) in patients with superficial
thrombophlebitis. This condition can be tested for with the
Homan’s Sign Test
• Another serious condition related complication is pulmonary
embolism .

15. Prevention :
• Patients should be advised to stretch their legs Frequently
when he / she long time drive a car .
• Walking and exercises that increase blood circulation are
effective measures to keep the blood flow steady.
• Wearing compress stockings are often used as a prevention
method for patients who are at a higher risk of developing
thrombosis.
• Routine changing and cleaning of intravenous (IV) lines help
to prevent thrombophlebitis of the upper extremity.

16. Treatment:
• Conservative treatment:
-Thrombolysis agent
- Topical treatments (e.g. with Heparin spray gel) to reduce local
symptoms .
- Anti-coagulants which are blood-thinning medications (such as
Fondaparinux/Arixtra 2.5mg)
- Anti-inflammatory medication (e.g. non-steroidal anti-
inflammatory drugs)

17. • Operative treatment
- Stenting procedures, a surgical intervention where a metal
cage is inserted into the clotted vein to reopen the blockage,
is most commonly used for deep vein thrombosis .
- Varicose vein stripping (surgical intervention) .
- Surgery to remove the entire clogged vein (in extreme cases)
.

18. • Physiotherapy treatment
Acute treatment depends on location, extent, symptoms, and
underlying medical condition, but generally include:
- Warm compression
- Elevate the limb above the heart level.
- Encouraging circulation (walking around) and limb-specific
exercises that activate the skeletal-muscle pump.