Deep Vein Thrombosis vs. Superficial Thrombophlebitis

Coagulation, the ability for your blood to form clots, prevents excessive bleeding when blood vessels are injured, a function necessary for survival. Most often, these gel-like clumps of proteins and platelets naturally dissolve as injuries heal.

It’s important to understand that blood clots can also form in veins that have not sustained an obvious injury. Many do not dissolve on their own. A blood clot that restricts circulation requires prompt evaluation and appropriate treatment. The location of the obstruction will determine if you have developed superficial thrombophlebitis or deep vein thrombosis.

Understanding the Significance of Thrombophlebitis

Thrombosis is the term used to identify a blood clot that blocks an artery or vein. Phlebitis is the inflammation of a vein. Knowing these terms, it’s easier to understand the nature of the disorder. Thrombophlebitis is a blood clot that causes inflammation, pain, and irritation. There are two main types of thrombophlebitis. Consider the following similarities and differences:

• Superficial Thrombophlebitis

  Superficial thrombophlebitis, more commonly known simply as phlebitis, is typically the diagnosis of a superficial vein blood clot that causes pain and inflammation just below the surface of the skin. This type of thrombosis can be caused by an injury to the affected limb or by the use of an IV (intravenous line), but the cause is not always apparent.

• Deep Vein Thrombosis

  Deep Vein Thrombosis is a potentially serious medical condition resulting from a blood clot that has formed within one of the larger veins deep within your body, typically the veins of the calf, thigh, or pelvis. The danger of deep vein thrombosis is the risk of the blood clot breaking away from its point of origin and causing a pulmonary embolism.

A pulmonary embolism is a medical emergency. It’s important to note that a person can develop a pulmonary embolism without having symptoms of deep vein thrombosis. Anyone having difficulty breathing or experiencing chest pain when breathing deeply should seek immediate medical attention.

Recognizing the Symptoms of Superficial Thrombophlebitis

You may be relieved to learn that superficial thrombi rarely make their way into the deep venous system and do not pose a significant risk of causing a pulmonary embolism.  While the condition is not particularly life-threatening, superficial thrombophlebitis can be considerably painful, and often requires medical intervention. The symptoms of superficial thrombophlebitis include:

• Sudden swelling of the affected area (commonly the leg or arm)
• Tenderness or pain in the area affected by the blood clot
• Redness or skin discoloration in the affected area
• The painful area feels increasingly warm to the touch

Since superficial thrombophlebitis affects the veins close to the surface of your skin, you may notice that the vein affected by a blood clot resembles a hard cord. The hardening of the affected vein is caused by inflammation and restricted circulation.

Identifying the Risk Factors for Superficial Thrombophlebitis

There are several known causes of superficial thrombophlebitis including vein injury, prolonged immobilization, and inherited blood clotting disorders. The following health conditions also increase your risk:

• The presence of varicose veins
• A pacemaker or central vein catheter
• Hormone replacement therapy or birth control pills
• Previous thrombophlebitis episodes
• Pregnancy or recent delivery
• A history of obesity
• A history of cancer or stroke
• Advancing age (risk increases at 60 years of age and up)

Diagnosis and Treatment of Superficial Thrombophlebitis

If your symptoms suggest superficial thrombophlebitis, your doctor may want to confirm their suspicions with a blood test (D-dimer) or ultrasound. If your thrombophlebitis is shown to be superficial, your doctor may recommend one or more of the following treatment options:

• Application of heat to the affected area
• Nonsteroidal anti-inflammatory medication (NSAIDs) for pain and inflammation
• Compression stockings to improve circulation
• Blood-thinning medication for those at risk of developing DVT

Recognizing the Symptoms of Deep Vein Thrombosis

While deep vein thrombosis (DVT) can occur anywhere in your body, DVT most commonly occurs in the veins of the leg. Like superficial thrombophlebitis, deep vein thrombosis could develop as the result of prolonged inactivity resulting from illness or injury and can be a particular risk to those living with a medical condition affecting blood clot formation.

Only half of those who develop deep vein thrombosis develop symptoms, and the signs are easily mistaken for other conditions. That’s why it’s important to contact your health care provider if you develop any of the following symptoms:

• Leg pain often described as stabbing, cramping, or soreness
• Swelling of the affected leg
• Symptoms that do not subside with rest or elevation
• The affected area feels warm to the touch
• Redness or skin discoloration

Deep vein thrombosis most often affects the veins of the calf. Heart failure, age, excess weight, family history, and hormonal therapy increases your risk of developing DVT. Regular exercise keeps blood circulating and reduces your risk.

Diagnosing  Deep Vein Thrombosis

The concern with deep vein thrombosis is the possibility of a blood clot in a larger vein breaking free and restricting circulation in the lungs (pulmonary embolism). If DVT is suspected, your doctor may order a blood test to assess the levels of the protein fibrin  D-dimer. Elevation of fibrin D-dimer is an indication that a blood clot is being degraded within your vascular system. Other possible tests may include:

• Ultrasound – an image created by sound waves to evaluate the size and location of the blockage
• Venography – An x-ray taken after a dye is injected into the veins
• MRI or CT Scan – Magnetic radiofrequency or x-ray scan used to create detailed images of internal structures

Treatment Methods for Deep Vein Thrombosis

The goals of DVT treatment are to prevent pulmonary embolism, to keep the blood clot from becoming larger, and to prevent new blood clots from forming. Anticoagulant medications are often the first line of defense and can be administered orally, injected, or given intravenously (thrombolytic therapy). Your doctor may also recommend one of the following DVT treatment methods based on your condition:

• A catheter to widen the affected blood vessels
• Surgery to remove the blood clot
• A stent to keep the affected vein open
• A vena cava filter to prevent blood clots from reaching your lungs
• Compression stockings to assist with circulation and reduce the risk of reoccurrence

Graduated compression stockings are often recommended for those with a history of deep vein thrombosis, or to reduce the leg swelling (edema) and associated symptoms of varicose veins. Compression stockings help minimize the effects of gravity and keep blood from pooling in the lower extremities. Reducing blood flow stagnation reduces the risk of blood clot formation.

Reducing Your Risk of Superficial Thrombophlebitis and Deep Vein Thrombosis

Maintaining a healthy weight and regular physical activity can help reduce your risk of developing blood clots. In addition to daily activity, it’s essential to eat wisely. A healthy diet consisting of lean protein, vegetables, fruit, and heart-healthy fats will reduce your risk of developing DVT or superficial thrombophlebitis. To further reduce your risk, consider the potential benefits of the following suggestions:

• Dietary Fiber – soluble fiber can reduce the number of fatty deposits in your vascular system and prevent constipation. Constipation can increase the amount of pressure on your veins and increase your risk of vein disease. Soluble fiber may also reduce the formation of small blood clots that increase your risk of heart attack or stroke.

• Vitamin C – Vitamin C keeps connective tissues healthy and strong by helping your body produce collagen and elastin. Studies show that vitamin C deficiencies can contribute to varicose veins and cardiovascular disease.

• Virgin Olive Oil – Olive oil is high in omega-3 fatty acids and is great for cardiovascular health. Research suggests that olive oil reduces fibrinogen concentrations and inhibits blood clot formation due to its high phenol content.

• Garlic – Studies show that garlic is a natural blood thinner that reduces coagulation, cholesterol, and fibrinolytic activity. That means fresh garlic or garlic supplements could reduce your risk of developing blood clots. If you are currently taking blood-thinning medication, consult with your healthcare provider before adding a garlic supplement to your diet.

• Grape Juice – Purple grapes contain flavonoids. Studies show that the flavonoids in purple grape juice could keep blood clots from forming. Since juice does not contain fiber, grape juice should not be used to replace any fiber-rich fruit servings in your diet.

Blood clots (thrombi) can develop in any blood vessel, with or without injury. While complications from blood clots close to the surface of the skin are rare, the formation of obstructions in the deep veins can cause life-threatening complications.

Knowing When to Contact Your Health Care Provider

After surgery, injury, or during prolonged bed rest, your risk of developing a blood clot increases. The location of the blood clot, whether it’s close to the surface of your skin or embedded within the large veins deep within your body, determine if you have developed deep vein thrombosis or superficial thrombophlebitis. A diagnosis of superficial thrombophlebitis does increase your risk of developing deep vein thrombosis in the future.

If you experience pain or swelling that is not alleviated by rest, or swelling that is accompanied by increased skin temperature, it’s important to seek the services of your health care provider. While superficial thrombophlebitis is commonly self-limiting, deep vein thrombosis can result in a life-threatening pulmonary embolism.

Medically reviewed by Dr. Susanne Woloson on 5-01-2020.