May 15, Author: Salicylates, indomethacin, and ibuprofen have been reported to be effective. In addition, salicylates, ibuprofen, and dipyridamole have been used as Clexane Thrombophlebitis agents, but their effectiveness has not been documented in this setting. Because thrombophlebitis is primarily due to inflammation and fibrin clot, antithrombotic or antiplatelet-aggregating agents would seem to have little value, Clexane Thrombophlebitis.
Anticoagulants are usually not indicated unless the process extends into the deep venous system. Additionally, in rare cases in which persistent inflammation is present in an Clexane Thrombophlebitis of superficial thrombophlebitis, a brief course of low-molecular-weight heparin LMWH can be used as an alternative to excision of the vein in order to bring the inflammation under control. This treatment alternative may be necessary for management of superficial thrombophlebitis associated with pregnancy.
Antibiotics are usually not necessary in superficial thrombophlebitis unless the process is suppurative. In persistent cases or even as early definitive therapy, excision of the inflammatory process is effective. The wounds usually heal well with primary closure; the inflammatory process, except in suppurative phlebitis, is usually nonbacterial and localized and is removed completely. Ibuprofen is the drug of choice for patients with mild to moderate pain.
It inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis. Indomethacin, which inhibits prostaglandin synthesis, is rapidly absorbed. Metabolism of the drug occurs in the liver by demethylation, Clexane Thrombophlebitis, deacetylation, and glucuronide conjugation. Naproxen Clexane Thrombophlebitis inflammatory reactions and pain by decreasing activity of cyclooxygenase, which results in decrease of prostaglandin synthesis.
Heparin is essential for patients with superficial thrombophlebitis that is progressive and for those with particular risk factors for progression or recurrence. Heparin should always be used when thrombophlebitis involves the great saphenous vein, Clexane Thrombophlebitis. Heparin is the mainstay of treatment when deep system involvement is suggested, but anticoagulation alone does not guarantee a successful outcome, Clexane Thrombophlebitis.
The disease may progress despite full and effective heparin anticoagulation. Heparin works by activating antithrombin III Clexane Thrombophlebitis slow or prevent the progression of venous thrombosis. Heparin does not dissolve existing clots.
Fractionated LMWHs have largely replaced unfractionated heparin in the treatment of superficial phlebitis. LMWHs offer several distinct advantages over unfractionated heparin, including the following:. When unfractionated Clexane Thrombophlebitis is used, an aPTT of at least 1, Clexane Thrombophlebitis. To achieve this, unfractionated heparin must be given intravenously in adequate doses. Low-dose, subcutaneous unfractionated heparin should not be used, as it is not an effective therapy for thrombophlebitis and does not Clexane Thrombophlebitis effective prophylaxis against progression of the disease.
Warfarin should not be used in the acute treatment of superficial phlebitis, because the early risk of increased thrombogenesis outweighs any convenience of oral therapy. It is widely used in pregnancy, although clinical trials are not yet available Clexane Thrombophlebitis demonstrate Clexane Thrombophlebitis it is as safe as unfractionated heparin. When enoxaparin is used, Clexane Thrombophlebitis, there is no utility in checking the aPTT the drug has a wide therapeutic window, and aPTT does not correlate with the anticoagulant effect.
It enhances the inhibition of factor Xa and thrombin by increasing antithrombin III activity. In addition, dalteparin preferentially increases the inhibition of factor Xa. The average duration of treatment is days. The initial bolus used for inflammatory or septic thrombosis is lower than that needed for spontaneous DVT and PE, Clexane Thrombophlebitis, because most patients with inflammatory or septic thrombophlebitis do not have underlying hypercoagulability.
Do not check aPTT until 6 hours after the initial bolus, as an extremely high or low value during this time should not provoke any action. These agents are not routinely useful in nonseptic superficial phlebitis. Antibiotics are indicated whenever infection is suspected to play a role and whenever phlebitis of the great saphenous vein above the knee threatens to approach the saphenofemoral junction.
Clexane Thrombophlebitis choice of antibiotics should be guided by blood culture results whenever possible, but Clexane Thrombophlebitis therapy should at a minimum provide coverage for group A streptococci and for Staphylococcus aureus.
Superficial phlebitis must not Clexane Thrombophlebitis confused with septic phlebitis, which can be life threatening, Clexane Thrombophlebitis. If septic phlebitis is suspected, the selection of antibiotics is critically important and depends upon the clinical setting.
This agent arrests bacterial growth by binding to 1 or more penicillin-binding proteins. When used for the treatment of phlebitis, ceftriaxone should be administered intravenously rather than intramuscularly. Ceftriaxone is effective in the treatment of superficial phlebitis and bacterial septicemia caused by Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, viridans group streptococci, Escherichia coli, Enterobacter cloacae, Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Morganella morganii, Serratia marcescens, Acinetobacter calcoaceticus, Bacteroides fragilis, and various Peptostreptococcus species.
Cephalexin is a first-generation cephalosporin that may be used as adjunctive therapy in superficial phlebitis if infection is possible but unlikely, and if the only likely organisms would be skin flora, including staphylococci and streptococci. An Clexane Thrombophlebitis high rate of pulmonary embolism in patients with superficial thrombophlebitis of the thigh.
The veins in thromboangiitis obliterans: With particular reference to arteriovenous anastomosis as a cure for the condition, Clexane Thrombophlebitis. Pathology, Diagnosis and Treatment. University of Nagoya Press; Best Pract Res Clin Rheumatol.
Vasculopathy related to cocaine adulterated with levamisole: A review of the literature. Oral contraceptives, hormone replacement therapy and thrombosis.
Skin necrosis and venous thrombosis from subcutaneous injection of charcoal lighter fluid naptha. Am J Emerg Med. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: Am J Med Sci.
Acute and recurrent thromboembolic disease: Carcinoma and venous thrombosis: Frequency of association of carcinoma in body or tail of pancreas with multiple venous thrombosis. Nazir SS, Khan M. Thrombosis of the dorsal vein of the penis Mondor's Disease: A case report and review of the literature. Traumatic thrombophlebitis of the superficial dorsal vein of the penis: Srp Arh Celok Lek. Treatment of superficial vein thrombosis to prevent deep vein thrombosis and pulmonary embolism: Superficial thrombophlebitis and risk for recurrent venous thromboembolism.
Protein S deficiency in repetitive superficial thrombophlebitis. Clin Appl Thromb Hemost. Superficial thrombophlebitis diagnosed by duplex scanning. Bergqvist D, Jaroszewski H, Clexane Thrombophlebitis.
Deep vein thrombosis in patients with superficial thrombophlebitis of the leg. Superficial venous thrombosis and compression ultrasound imaging. Fondaparinux reduces VTE and recurrence in superficial thrombophlebitis of the leg. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev. Fondaparinux for the treatment of superficial-vein thrombosis in the legs.
N Engl J Med. Ability of recombinant factor VIIa to reverse the anticoagulant effect Clexane Thrombophlebitis the pentasaccharide fondaparinux in healthy volunteers.
Lesser saphenous vein thrombophlebitis: Prevalence of deep vein thrombosis and pulmonary embolism in patients with superficial vein thrombosis: Lozano FS, Almazan A. Low-molecular-weight heparin versus saphenofemoral disconnection for the treatment of above-knee greater saphenous thrombophlebitis: Factors predictive of venous thrombotic complications in patients with isolated superficial vein thrombosis, Clexane Thrombophlebitis.
A randomized trial of dalteparin compared with ibuprofen for the treatment of superficial thrombophlebitis. Clinical examination of varicose veins--a Clexane Thrombophlebitis study. Ann R Clexane Thrombophlebitis Surg Engl. High versus low doses of unfractionated heparin for the treatment of superficial thrombophlebitis of the leg. A prospective, controlled, randomized study. Fusarium proliferatum superficial suppurative thrombophlebitis.
Clexane Thrombophlebitis is the best therapy for superficial thrombophlebitis?. A pilot Clexane Thrombophlebitis double-blind comparison of a low-molecular-weight heparin, a nonsteroidal anti-inflammatory agent, and placebo in the treatment of superficial vein thrombosis.
Mondor's disease as first thrombotic event in hereditary protein C deficiency and anticardiolipin antibodies. Ryan Doss, MD is a member of the following medical societies: Craig F Feied, MD is a member of the following medical societies: Jonathan A Handler, MD is a member of the following medical societies: Jeffrey Lawrence Kaufman, MD is a member of the following medical societies: Samuel M Keim, MD is a member of the following medical societies:
Superficial thrombophlebitis is a thrombosis and Clexane Thrombophlebitis of Clexane Thrombophlebitis veins which presents as Clexane Thrombophlebitis painful induration with erythemaoften in a linear or branching configuration forming cords. It is generally a benign, self-limited disorder, however, Clexane Thrombophlebitis, it can be complicated by deep vein trophischen Geschwüren exklusiven Berichten, DVT and even pulmonary embolism PE.
In addition, there is often a palpable, sometimes nodular cord, due to thrombus within the affected vein. Persistence of this cord when the extremity is raised suggests the presence of thrombus, Clexane Thrombophlebitis. Suppurative thrombophlebitis is suspected when erythema extends significantly beyond the margin of the vein and is likely to be associated with significant fever. If suspected, antibiotic treatment, surgical drainage and potentially vein excision are indicated.
Venous thromboembolism can occur with superficial vein thrombosis. Patient characteristics and predisposing factors for thrombophlebitis nearly mirror those for DVT; thrombophlebitis is a risk factor for the development of Clexane Thrombophlebitis, and vice versa.
Clinical evaluation is the primary diagnostic tool for thrombophlebitis. Patients with thrombophlebitis complain of pain along the affected area. Some report constitutional symptoms such as low grade fever and aches, Clexane Thrombophlebitis. On physical examination, the skin over the affected vein exhibits erythema, warmth, swelling, and tenderness. Later in the disease, as induration subsides, erythema gives way to a ruddy or bruised color.
Duplex ultrasound identifies the presence, location and extent of venous thrombosis, and can help identify other pathology that may be a source of the patient's complaints, Clexane Thrombophlebitis.
Ultrasound is indicated if superficial phlebitis involves or extends into the proximal one-third of the medial thigh, there is evidence for clinical extension of phlebitis, lower extremity swelling is greater than would be expected from a superficial phlebitis alone or diagnosis of superficial thrombophlebitis in question.
Treatment with compression stockings should be offered to patients with lower extremity superficial phlebitis, if not contraindicated e.
Patients may find them helpful for reducing swelling and pain once the acute inflammation subsides, Clexane Thrombophlebitis. Treatment with fondaparinux reduces the risk of subsequent venous thromboembolism. Somecases a year have been reported in the United States, but actual incidence of spontaneous thrombophlebitis is unknown.
Thrombophlebitis can develop along the arm, back, or neck veins, the leg is by far the most common site. When Clexane Thrombophlebitis occurs in the leg, the great Clexane Thrombophlebitis vein is usually involved, although other locations are possible.
Spritzanleitung für die Anwendung einer Heparin-Fertigspritze zur Selbstinjektion (Österreich)