Thrombophlebitis of upper extremities: symptoms and treatment

Thrombophlebitis develops when veins clots, leading to inflammation. Most often this condition affects the veins in the legs, but in rare cases can occur thrombophlebitis of upper extremities. The danger of thrombophlebitis is not only to restrict blood flow, causing symptoms. It is dangerous risk of death from heart failure, strokes and pulmonary embolism.

The affected vessels may be placed close to the skin surface, causing thrombophlebitis of the superficial veins, or deep in the muscle, causing deep vein thrombosis (DVT). The disease can be caused by trauma, surgery or prolonged immobility.

What causes thrombophlebitis?

Thrombophlebitis of upper extremities has many causes and risk factors:

  • Local trauma or injury to the vein (e.g. intravenous catheters or injection).
  • Too prolonged immobility (e.g. after a stroke).
  • Central venous catheterization or pacemaker setting.
  • Pregnancy.
  • Acceptance of contraceptives or hormone replacement therapy.
  • The post-operative period.
  • The presence of oncological diseases or disorders of blood coagulation.
  • The impaired venous drainage from the upper limbs associated with, for example, removal of lymph nodes at mastectomy for breast cancer.
  • The presence of burns.

What is thrombophlebitis of the upper extremities?

Superficial thrombophlebitis of the upper extremities leads to the fact that affected area becomes red, hot, swollen and painful. This disease may be accompanied by slight fever. In the course of the inflamed vein can be felt a tight, painful bands. The acute phase of DVT may include redness and swelling of the affected arm pain and increased sensitivity. Less and later meet such clinical signs as bruising and enlargement of collateral veins on the arms and chest.

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Complications of thrombophlebitis of upper extremities

If the inflammation and thrombosis struck by the superficial veins of the hands, complications are rare. With the development of DVT of the upper extremities the risk of serious complications higher. They may include:
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  • A pulmonary embolism (PE). If part of the clot in the deep veins breaks free, it can enter the lungs, causing a life-threatening condition. Of course, a DVT of the legs this complication is more common. But the risk of pulmonary embolism in DVT hand still exists, although it is often underestimated. Recent data show that 5 – 10% of all thromboembolism of the pulmonary artery caused by migration of a clot it of the upper limbs.
  • Post-thrombotic syndrome. This condition can develop months or even years after DVT hands. Post-thrombotic syndrome can cause prolonged and severe pain, permanent swelling and feeling of heaviness in the affected arm, change its color. This disease can lead to decrease of work capacity of the patient.

How to diagnose thrombophlebitis

For diagnosis the doctor examines and inspects the hand. Superficial thrombophlebitis can be detected only by symptoms, for correct diagnosis it is possible to conduct the ultrasound examination. Deep vein thrombophlebitis is much more difficult to diagnose based only on clinical examination. Most often used for this additional instrumental methods – ultrasound, computed or magnetic resonance tomography, venography.

To confirm the presence of thrombosis may be useful blood test for D-dimer. This is the chemical that is released during the decay of blood clots. Normal levels of D-dimer indicates the unlikelihood of thrombophlebitis. However, this analysis has limitations – elevated levels of D-dimer can be detected in other diseases, including surgery, pregnancy or malignancy.

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How to treat thrombophlebitis?

Treatment of thrombophlebitis depends on the location, extent, symptoms and causes of the disease. Usually, superficial thrombophlebitis of the upper extremity can be treated by applying warm compresses, elevated position of the affected arm and taking oral anti-inflammatory drugs (Ibuprofen, Diclofenac). Useful may also be local anti-inflammatory agents such as Diclofenac gel.

If the cause of thrombophlebitis of superficial veins is endovenous catheter, it should be removed. If the inflammation is of infectious nature, then used antibacterial agents. In severe cases, infected thrombophlebitis, you may need surgical intervention. At a superficial thrombophlebitis you need with the help of ultrasound examination to exclude deep vein thrombosis. If it exists, or the risk of the development may require the intake of anticoagulant drugs, which thin the blood: Enoxaparin, Fondaparinux, Heparin, Warfarin. Occasionally, patients with severe deep vein thrombosis may need treatment with Thrombolysis.

With the ineffectiveness of conservative therapy can be applied in surgical treatment of aspiration, fragmentation of the thrombus, balloon angioplasty, stenting, thrombectomy or venous bypass grafting.Recovery after superficial thrombophlebitis may take a few weeks, and after deep – from several weeks to several months.

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