If thrombophlebitis occurs in a vein just under your skin, 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 significantly within a month.
Your doctor may also recommend these treatments for thrombophlebitis, including deep vein thrombosis:
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- Blood-thinning medications. If you have deep vein thrombosis, injection of a blood-thinning (anticoagulant) medication, such as low molecular weight heparin or fondaparinux (Arixtra), will prevent clots from enlarging. After the initial treatment, taking the oral 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's most serious side effect can be excessive bleeding. Rivaroxaban (Xarelto) is a newer blood-thinning option that is taken orally and may have less risk of bleeding.
- Clot-dissolving medications. This type of treatment is known as thrombolysis. These medications, such as alteplase (Activase), dissolve blood clots and are used for extensive deep vein thrombosis or in some cases of deep vein thrombosis that also include a blood clot in the lungs (pulmonary embolus).
- Compression stockings. Prescription-strength compression stockings help prevent recurrent swelling and reduce the chances of complications of deep vein thrombosis. Your doctor may recommend that you wear these for two years or more.
- 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 is removed when it's no longer needed. If you have a filter placed, ask your doctor if and when it should be removed.
- 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 involves removing a long vein through small incisions. 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 may also be done for cosmetic reasons. After vein stripping, your doctor may recommend that you wear compression stockings as well.
- Torpy JM, et al. Thrombophlebitis. Journal of the American Medical Association. 2011;305:1372.
- Deep vein thrombosis. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/dvt/printall-index.html. Accessed Oct. 3, 2013.
- Venous thromboembolism diagnosis and treatment. Bloomington, Minn.: Institute for Clinical Systems Improvement. https://www.icsi.org/guidelines__more/catalog_guidelines_and_more/catalog_guidelines/catalog_cardiovascular_guidelines/vte_treatment/. Accessed Oct. 3, 2013.
- Fernandez L, et al. Superficial thrombophlebitis of the lower extremity. http://www.uptodate.com/home. Accessed Oct. 3, 2013.
- Deep vein thrombosis (DVT). The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/cardiovascular_disorders/peripheral_venous_disorders/deep_venous_thrombosis_dvt.html. Accessed Oct. 3, 2013.
- Antithrombotic therapy and prevention of thrombosis, 9th ed. Northbrook, Ill.: American College of Chest Physicians. http://journal.publications.chestnet.org/article.aspx?articleid=1159399. Accessed Oct. 3, 2013.
- Di Nisio M, et al. Treatment for superficial thrombophlebitis of the leg. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004982.pub5/abstract. Accessed Oct. 3, 2013.
- McBane RD (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 11, 2013.
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