Basics of Thrombosis, Phlebitis Phlebothrombosis

1. THROMBOSIS, PHLEBITIS,
PHLEBOTHROMBOSIS
Dr. Renuka Khedekar

2. Normal Haemostasis
• Maintain blood in a fluid, clot-free state in normal vessels
• Also inducing the rapid formation of a localized
haemostatic plug at the site of injury.
• Both are influenced by components of the blood vessel
wall, platelets the clotting sequence

4. • The development of a clot is life-saving when a large
vessel ruptures or is severed.
• However, when a thrombus develops within the vascular
life-threatening
• Thrombosis is the consequence of inappropriate
the processes of normal haemostasis

5. THROMBOSIS
• Thrombosis is the formation of a solid mass (blood clot) from
the constituents of blood
• Platelets
• Fibrin
• Entrapped red cells and white cells
• Within the heart or vascular system in a living organism

8. VIRCHOW’S TRIAD
• Thrombosis is influenced by three major factors:
(1) injury to vascular endothelium
(2) alterations in normal blood flow and
(3) alterations in the blood (hypercoagulability)

9. • Thrombosis is normally categorized by where it occurs in the
body.
• Within these categories, it may be classified further.
1. Venous Thrombosis
2. Arterial Thrombosis

11. CAUSES
Venous Thrombosis
• Disease or injury to the leg veins
• Immobility for any reason
• A broken bone (fracture)
• Obesity
• Inherited disorders
• Autoimmune disorders
• Contraceptives
• Smoking
Arterial Thrombosis
• Arteriosclerosis

12. • Thrombi are significant because they cause obstruction of
arteries and veins and may give rise to emboli.
• Venous Thrombosis (Phlebothrombosis)
• Most venous thrombi occur in either the superficial or the deep
veins of the leg.
• Lower-extremity DVTs are associated with stasis and
hypercoagulable states
• Common predisposing factors include congestive heart failure,
bed rest and immobilization
• Trauma, surgery, and burns not only immobilize a patient but are
also associated with vascular injury, procoagulant release,
increased hepatic synthesis of coagulation factors.

14. Disseminated Intravascular Coagulation
• Disseminated intravascular coagulation (DIC) is the
sudden or insidious onset of widespread thrombosis
within the microcirculation
• It may be seen in disorders ranging from obstetric
complications to advanced malignancy
• The thrombi are generally microscopic in size, yet so
numerous as to often cause circulatory insufficiency,
particularly in the brain, lungs, heart, and kidneys
• The widespread microvascular thrombosis consumes
platelets and coagulation proteins (consumption
coagulopathy), and at the same time, fibrinolytic
mechanisms are activated

15. PHLEBITIS
• Phlebitis –inflammation of vein
• Thrombophlebitis – a blood clot in the vein cause the
inflammation.
• Thrombophlebitis usually occurs in leg veins, but it may
occur in arm.
• The thrombus (clot) in the vein causes pain and irritation
and may block blood flow in the veins.
• Phlebitis can occur in both the surface(superficial) or deep
veins

16. • Superficial phlebitis affects veins on the skin surface.The
condition is rarely serious and, with proper care, usually
resolves rapidly.
• Sometimes people with superficial phlebitis also get deep
vein thrombophlebitis, so a medical evaluation is
necessary.
• Deep vein thrombophlebitis affects the larger blood
vessels deep in the legs.
• Blood clots(thrombi) can form, which may break off and
travel to the lungs.
• This is a potential life-threatening condition called
pulmonary embolism

17. • Phlebitis may occur spontaneously or as a complication of a
medical procedure. Local trauma and injury to a vein also
increase the risk of forming a blood clot
• Superficial phlebitis : There is usually a slow onset of a tender
red area along the superficial veins on the skin.
• The area may feel hard,warm and tender.The skin around the
vein may be itchy and swollen
• The area begin to throb or burn
• Symptoms may be worse when the leg is lowered, especially
when first getting out in bed in the morning.
• A low-grade fever may occur

19. • Sometimes phlebitis may occur at the site where a
peripheral IV line was started. The surrounding area may
be sore and tender along the vein.
• If an infection is present, symptoms may include redness,
pain, swelling, or breakdown of the skin.

20. • Deep vein thrombophlebitis
• This can be similar in presentation to superficial phlebitis,
but some people may have no symptoms
• The classic signs and symptoms include redness, warmth,
swelling and pain in the leg
• One may have pain and swelling throughout the entire
limb
• In general, treatment may include support stockings and
wraos to reduce discomfort as well as medications

21. • Elevate the affected area to reduce swelling.
• Keep pressure off of the area to reduce pain and decrease
the risk of further damage.
• Apply moist heat to reduce inflammation and pain.
• Surgical removal, stripping, or bypass of the vein is rarely
needed but may be recommended in some situations