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Treatments and drugs
By Mayo Clinic staffIf thrombophlebitis occurs in a superficial vein, your doctor may recommend self-care steps that include applying heat to the painful area, elevating the affected leg and using an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The condition usually doesn't require hospitalization and improves within a week or two.
Your doctor may also recommend these treatments for thrombophlebitis, including deep vein thrombosis:
- Medications. If you have deep vein thrombosis, injection of a blood-thinning (anticoagulant) medication, such as heparin, will prevent clots from enlarging. After the heparin treatment, taking the anticoagulant warfarin (Coumadin) for several months continues to prevent clots from enlarging. If your doctor prescribes warfarin, follow the directions for taking the medication carefully. Warfarin is a powerful medication that can cause dangerous side effects if not taken properly.
- Support stockings. These help prevent recurrent swelling and reduce the chances of complications of deep vein thrombosis. Your doctor may recommend prescription-strength support hose.
- Filter. In some instances, especially if you can't take blood thinners, a filter may be inserted into the main vein in your abdomen (vena cava) to prevent clots that break loose in leg veins from lodging in your lungs. Typically, the filter remains implanted permanently. This procedure usually doesn't require you to stay in the hospital.
- Varicose vein stripping. Your doctor can surgically remove varicose veins that cause pain or recurrent thrombophlebitis in a procedure called varicose vein stripping. This procedure, typically done on an outpatient basis, involves removing a long vein through small incisions. Usually, you're able to resume normal activities in two weeks or less. Removing the vein won't affect circulation in your leg because veins deeper in the leg take care of the increased volumes of blood. This procedure is also commonly done for cosmetic reasons.
- Clot removal or bypass. Sometimes, surgery is necessary to remove a clot blocking a vein in your pelvis or abdomen. To treat a persistently blocked vein, your doctor may recommend surgery to bypass the vein, or a nonsurgical procedure called angioplasty to open up the vein. Once angioplasty has opened up the vein, your doctor inserts a small wire mesh tube (stent) to keep the vein open.
- Deep vein thrombosis. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Dvt/DVT_All.html. Accessed Dec. 29, 2008.
- Torpy JM, et al. Thrombophlebitis. Journal of the American Medical Association. 2008;300:1718.
- Rodriguez-Peralto JL, et al. Superficial thrombophlebitis. Seminars in Cutaneous Medicine & Surgery. 2007;26:71.
- Di Nisio M, et al. Treatment for superficial thrombophlebitis of the leg. Cochrane Database of Systematic Reviews. 2007:CD004982.
- Bauer KA, et al. Overview of the causes of venous thrombosis. http://www.uptodate.com/home/index.html. Accessed Dec. 29, 2008.
- Landaw SA, et al. Approach to the diagnosis and therapy of deep vein thrombosis. http://www.uptodate.com/home/index.html. Accessed Dec. 29, 2008.
