What is a Superficial Thrombophlebitis?

A thrombophlebitis is swelling and inflammation of a vein caused by a blood clot. There are two main types of thrombophlebitits: deep venous thrombosis (affects deeper, larger veins) and superficial thrombophlebitis (affects veins near the skin surface).  This is often referred to as an STP.

The following symptoms are often associated with thrombophlebitis:

  • Inflammation (swelling) in the part of the body affected
  • Pain in the part of the body affected
  • skin redness (not always present)
  • Warmth and tenderness over the vein

The following increase your chances for thrombophlebitis:

  • Being hospitalized for a major surgery or with a major illness
  • Disorders that make you more likely to develop blood clots
  • Sitting for a long period of time (such as on a long airplane trip)
  • Varicose veins

An STP is common complication of varicose veins. But, it can also indicate an underlying problem with blood clotting.  In some cases, there may also be a concurrent blood clot in other veins, such as the deep veins (DVT) which can be serious. For this reason, a duplex ultrasound examination is used to look at the deep veins and other veins not visible to the naked eye for the presence of blood clots.

If it is localized to a small surface vein, it can usually be treated with  aspirin or other anti-inflammatory medication to reduce pain and inflammation, compression stockings, and cold/warm packs to also reduce inflammation and discomfort. The discomfort is usually improved within 6 weeks but it can take a few months to resolve.

If the superficial thrombophlebitis is extensive or if it appears to be ‘migrating’ up the leg, a blood thinner may be necessary.  You should see your doctor if you develop an STP.

stp

A thrombophlebitis is swelling and inflammation of a vein caused by a blood clot. This patient has a superficial thrombophlebitis, which is a blood clot in the superficial, surface veins. You can see redness in the inner thigh of this patient, which is caused by the inflammation and swelling from the blood clot. It can be very painful. You should see your doctor for superficial thrombophlebitis.

 

Is Darkening of the Skin A Sign of Venous Disease?

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When the skin becomes darker around the ankles, it may indicate underlying venous insufficiency. If you notice that your skin around the ankles changes color, you should see your doctor. Venous insufficiency can be diagnosed with ultrasound scanning by specialists.

Is Darkening of the Skin A Sign of Venous Disease? Yes.   Skin discoloration, also referred to as skin hyperpigmentation or venous stasis, describes the darkening of the skin as a result of venous insufficiency.    This is most frequently cause by venous reflux, an underlying condition that can be treated. When skin changes like these are present, the condition is termed chronic venous insufficiency.  Over time, the skin condition may worsen and the skin may become darker, firm to touch, scaly and itchy, and the skin may break down causing a venous leg ulcer.  It usually occurs around the ankles.  

Should I Wear Compression When I Travel to Prevent a DVT?

Should I Wear Compression When I Travel to Prevent a DVT?

travel

Using compression stockings during travel can reduce the risk of developing a flight-related deep venous thrombosis (DVT).

Yes. Compression stockings are great to use during air travel and long trips where you will be sitting for long periods of time. When you sit for long periods of time you are more at risk of blood clots and swelling. Compression stockings can reduce your risks and prevent swelling.  Ask your doctor the strength that is recommended for you.

Laser and Radiofrequency Vein Treatments

What is the difference between laser and radiofrequency procedures for varicose veins?

Both laser and radiofrequency ablation techniques are used as an alternative to surgery for the treatment of varicose veins and underlying venous insufficiency.  The concept behind both laser and radiofrequency treatments is that an energy source is used to heat the vein, causing it to collapse and seal shut. Over time, the treated veins will dissolve. This is offered as an alternative to surgical removal of the veins. The basic difference between the two, are the types of energy sources used.

Laser vein treatment, also known as laser ablation or endovenous laser ablation therapy (EVLT or EVLA) utilizes laser energy to heat the vein.

Radiofrequency vein treatment, also known as radiofrequency ablation (RFA), or the Venefit procedure (previously known as VNUS Closure) utilizes radiofrequency energy to heat the vein.

Both procedures are used to treat the small, great or anterior saphenous veins.

Either procedure involves making a tiny incision the size of a grain of rice on the skin, and a narrow catheter is inserted into the vein. The machine applies either laser or radiofrequency energy to the vein interior, an action that heats the vein and seals it closed.

Unlike traditional surgery, this new minimally invasive procedure takes about 30 minutes to perform and patients can walk out of the office afterward.

While both are effective options for vein treatment, we prefer radio-frequency ablation over laser because it has been proven to be more comfortable than laser yet equally effective. It is also our experience that there is less bruising,  pain and quicker recovery associated with radio-frequency closure of the veins.

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Laser vein treatment, also known as laser ablation or endovenous laser ablation therapy (EVLT or EVLA) utilizes laser energy to heat the vein.
Radiofrequency vein treatment, also known as radiofrequency ablation (RFA), or the Venefit procedure (previously known as VNUS Closure) utilizes radiofrequency energy to heat the vein.

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The radiofrequency catheter is inserted inside the vein. Radiofrequency energy then heats the vein causing it to collapse and seal shut. We prefer radiofrequency over laser vein treatment because we find that it is more comfortable for the patient with less bruising.

Remember, that more than one treatment type is often needed such as radiofrequency of the saphenous vein + sclerotherapy of superficial branches. Talk to your doctor to find our which is best for you or schedule a consultation at 858-550-0330.

 

What is Stasis Dermatitis?

Stasis dermatitis or venous stasis dermatitis is a change in the skin that occur when blood collects (pools) in the veins of the lower leg. ‘Stasis’ refers to pooling of the blood in the lower legs from venous insufficiency, and ‘dermatitis’ refers to the inflammation and related skin changes. Because of the inflammation, the skin around the ankles is usually itchy and discolored.

At first, the skin of the ankles and lower legs may look thin or tissue-like. You may slowly get brown stains on the skin.

The skin may become irritated or crack if you scratch it. It may also become red or swollen, crusted, or weepy.

Over time, some skin changes become permanent:

  • Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)
  • A bumpy or cobblestone appearance of the skin
  • Dark brown color
Stasis Dermatitis with Ulceration

Chronic venous insufficiency over time can lead to skin changes and eventually ulceration. This image demonstrates stasis dermatitis (also known as venous dermatitis). Stasis dermatitis refers to the skin changes including skin discoloration around the ankles, dry itchy skin that can be thin, and it may eventually break down to cause an ulceration. You need to see a doctor if these signs are present.

Skin sores (ulcers) may develop (called a venous ulcer or stasis ulcer). These most often form on the inside of the ankle.  For this reason, whenever stasis dermatitis or skin changes are noticed around the ankle, you should see your doctor or vein specialist to stop the progression of venous insufficiency and prevent the skin from forming an ulceration.

  

 

Varicose Veins vs. Spider Veins

What is the difference between varicose veins and spider veins?  Are they the same thing? Spider veins and varicose veins both refer to dysfunctional, dilated leg veins but the main difference is the size of the veins. Spider veins are small, thread-like veins at the surface of the skin. They often appear in clusters or can have a ‘starburst’ or spider-like pattern. Varicose veins, are larger veins that appear swollen, twisted cordlike veins that ‘bulge’ at the surface.

Both spider veins and varicose veins can cause pain and other symptoms like burning, aching and throbbing. Both can be treated without surgery.

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This image describes the difference between spider veins and varicose veins. Both are manifestations of unhealthy veins. Spider veins are essentially, tiny varicose veins.

What is the Femoral Vein?

The femoral vein is a large blood vessel of the leg that allows deoxygenated blood to travel to the heart and lungs to become oxygenated. It is located deep within the muscles of the thigh beginning just above the knee (at the adductor canal it is the continuation of the popliteal vein) and ends at the groin level (specifically, it ends at the inferior margin of the inguinal ligament where it becomes the external iliac vein.  It accompanies the femoral artery in the femoral sheath.  In this ultrasound image from La Jolla Vein Care, notice that the femoral vein runs along the same course as the femoral artery, which provides oxygenated blood from the heart and lungs to the rest of the body. The arteries and veins carry blood in opposite directions.  Ultrasound imaging detects the direction of blood flow and in this image it femoral vein is ‘blue’ depicting blood flow moving toward the heart and the femoral artery is ‘red’ demonstrating blood flow away from the heart.

US image, exam type "Vascular", preset "Carotid"

Ultrasound image of the femoral vein and femoral artery. Ultrasound imaging detects the direction of blood flow and in this La Jolla Vein Care image, the femoral vein is ‘blue’ depicting blood flow moving toward the heart and the femoral artery is ‘red’ demonstrating blood flow away from the heart. Notice that the femoral vein and artery are located within the muscle. For orientation purposes, the skin is located at the top of the image.

 

8 Warning Signs of Vein Disease: #4 Swollen Ankles

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Ankle swelling related to varicose veins and venous insufficiency may be subtle, leaving indentations from socks.

Swollen Ankles at Night

Thick, swollen ankles are signs that blood or other fluid is congested in the leg and / or leg veins. Over time, damaged vein walls can become even more stretched out and permeable, allowing fluid and protein to filter from the veins into surrounding leg tissue. When you lie down at night, the pressure from gravity is equalized across your leg. Usually, vein related swelling (venous edema) becomes apparent later in the day or worse throughout the day and improved with leg elevation or overnight during sleep.  Often in the morning, there may be no swelling. But, as the day progresses gravity causes poo

Pooling of blood around the ankle in incompetent veins. Venous insufficiency is one of the most common causes of ankle swelling that worsens throughout the day. Sometimes, the swelling can be subtle, leaving indentations from sock lines. Or, it may cause the skin to feel firm, shiny, or puffy by the end of the day.

If you have swelling, you should discuss it with your healthcare provider. Venous insufficiency can be diagnosed with a venous duplex sonogram, which is a non-invasive study of the leg veins.

8 Warning Signs of Vein Disease: #2 Discoloration of the Skin

 

Discoloration of the Skin

venous leg ulcers

Chronic venous insufficiency (CVI) can cause the skin to become discolored, usually around the ankles. Over time, ulcerations or skin wounds may develop.

Over time, leakage of the blood into the area surrounding the veins can cause tissue to die. The resulting pooling of blood in the tissue causes a darkening of the skin. It is at this stage that the skin is actually stained by your own blood.  This is also known as venous stasis skin changes, skin hyperpigmentation or venous stasis dermatitis because the skin is often inflamed, itchy and eczema-like.  This is most frequently caused by venous reflux, an underlying condition that can be treated. When skin changes like these are present, the condition is termed chronic venous insufficiency.  Over time, the skin condition may worsen and the skin may become darker, firm to touch, scaly and itchy, and the skin may break down causing a venous leg ulcer.

8 Warning Signs of Vein Disease: #1Tired, Heavy Legs

Tired, heavy-feeling legs

One of the first signs of vein disease- your legs feeling chronically tired and heavy. This is a clear indication that the return flow of blood from the legs to the heart is impaired. The result is oxygen depletion in your legs and pooling of blood, increasing the pressure in your legs, giving you that tired, heavy feeling.

varicose veins

Varicose veins most frequently cause the legs to become heavy, achy and tired. But, these symptoms can be present even in the absence of varicose veins. Venous insufficiency, the underlying cause for varicose veins can cause leg heaviness, tiredness and swelling even before bulging veins are visible.

Many people think it is normal to have tired, heavy legs or that it is a part of aging. It is not. If you or someone you know, suffers from these symptoms, especially legs that become tired and heavy toward the end of the day, causing you go slow down your activities to sit and elevate the legs, you should get checked out for venous insufficiency.