Phlebitis | DVT | Swollen Leg | Leg Ulcers
Phlebitis is one of the most common complications occurring in varicose veins. A clot developing in these superficial veins does not travel to the heart or much beyond a short distance within the varicosity. The first sign of phlebitis is accompanied by pain along the involved vein. The skin over the vein becomes red and is warm to the touch. Phlebitis can be safely treated on an outpatient basis with moist heat, compression stockings and painkillers. If the clotted varicosity is very painful, a small incision is made under local anesthesia and the clot is removed.
Phlebitis is one of the most common problems occurring in varicose veins. As the clot builds up inside the dilated (varicose) vein it becomes hard. The skin over the vein is red, warm, and painful. A clot in a superficial varicose vein does not travel to the heart. In most cases a short segment of the varicose vein becomes completely clotted.
Phlebitis is treated with elevation, moist heat, compression stockings and analgesics for pain. If the clotted vein is very painful, a small cut is made under local anesthesia and the clot is removed. Usually phlebitis will go away in about two to six weeks. Patients who have repeated events of phlebitis will need to have their varicose veins taken out.
If phlebitis develops in a normal superficial vein, patients should have a complete medical workup to determine the reason for this unusual event. In these cases an ultrasound is also done to look for an associated deep vein thrombosis.
Blood Clot in the Leg or Deep Vein Thrombosis [to top]
Deep Vein Thrombosis (DVT) is the development of clots in the deep veins of the leg. In the US about 600,000 patients are treated each year in hospitals with this problem. Deep vein thrombosis may arise in patients who have major surgery.
In addition, patients who have heart attacks or strokes have 20 to 50 percent risk of deep vein thrombosis. Clots in the deep leg veins is a serious complication since these clots can travel to the lungs.
Patients have swelling and discomfort of the calf when these veins are completely clotted. If the clot goes into the thigh, the entire leg becomes very swollen and painful. An ultrasound will show the doctor if there is a clot within the deep veins and how far it has moved up the leg. Patients are treated with a blood thinner given by injection. This medication does not allow the clot to move along the affected vein.
Swollen Leg of Chronic Venous Insufficiency [to top]
Chronic venous insufficiency happens years after the development of clots in the deep veins. Initially when the body destroys the clot in the deep veins the vein valves are damaged. These non-working valves allow blood to remain trapped in the deep veins of the leg. This increases the pressure inside these veins and fluid leaks out into the tissue beneath the skin. As time passes the affected leg becomes swollen and hard. The skin above the ankle becomes discolored.
The diagnosis of chronic venous insufficiency is based on the patient's history and symptoms. The deep veins need to be evaluated with an ultrasound. Prevention of deep vein thrombosis is the best treatment.
Patients at risk should have compression stockings and heparin before surgery. In patients with mild symptoms, one can use simple measures such as lifting the foot of the bed with cinder blocks. Those with more severe symptoms need to wear compression stockings prescribed by a doctor. Stockings are worn during the day slowing leg swelling while walking.
Leg Ulcers or Venous Stasis Ulcer [to top]
Ulcers form on the legs of patients with long standing chronic venous insufficiency. Brownish discoloration develops over time followed by dryness and scaliness that causes severe itching that contributes to the formation of painful ulcers.
A complete vascular exam is done to rule out blockage in the arteries of the leg. The treatment of patients with leg ulcers is surgical removal of non-viable tissue followed by the placement of a Unna boot. Also special attention is given to the care of the skin around the ulcer. These patients also require medical compression stockings. With this regimen over 90% of the leg ulcers are healed in less than six months.
The Capital Region Vein Centre uses the most advanced treatments to improve the quality of life for people suffering from vein disorders.