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PubMed1989

Intravenous placement device and infusion thrombophlebitis.

The incidence of thrombophlebitis in the present study was 18.3%. It was of mild grade in all the cases. The incidence of thrombophlebitis was more (24%) when short teflon canula was used as intravenous placement device. Under similar infusion conditions with stainless steel needle, scalp vein needle and long teflon canula, the incidence was 16.6%, 13.3% and 16.6% respectively. Thrombophlebitis bears a direct relationship to the duration of infusion. The incidence was negligible at the end of 8 hours, whereas 14 patients developed thrombophlebitis by the end of 24 hours (63.7%).

Adolescent↗
PubMed1979

Thrombophlebitis after intravenous use of anesthesia and sedation: its incidence and natural history.

A number of technical and clinical conditions reportedly associated with diazepam-related thrombophlebitis were investigated. Diazepam alone and in combination with fentanyl and methohexital was administered intravenously to 519 healthy, predominantly young adult patients undergoing routine oral surgery for removal of third molars. Indirect evidence is provided to show that two slightly different vasculopathies are involved: thrombophlebitis, in which pain and induration are both present but in which there is a slight delay in the time of inception of the condition; and phlebothrombosis, in which the reaction is almost immediate but pain is not significant and induration of the vein is the predominant feature. The overall incidence was 2.3% for thrombophlebitis and 9.8% for phlebothrombosis. There were four significant variables associated with phlebothrombosis: use of tobacco, use of oral contraceptives, multiple injections of diazepam, and pain during injection. The only significant variable associated with thrombophlebitis was the site of injection.

Adolescent↗
PubMedDate not supplied

Role of intravenous heparin and hydrocortisone in prevention of infusion thrombophlebitis.

In a study conducted on 110 patients intravenous heparin and cortisone were studied as regards their role in prevention of infusion thrombophlebitis. Intravenous heparin (500 I.U.) was given 6 hourly during the 24 hr period of saline infusion. Hydrocortisone (1 mg/100 ml) was added to the infusion itself. Of the 30 patients in the control group 3 patients developed thrombophlebitis (10%). In the group treated with intravenous heparin 3 out of the 40 patients (7.5%) developed thrombophlebitis. With hydrocortisone, only 1 out of 40 patients had thrombophlebitis, (2.5%). In the group in which hydrocortisone was used, the onset of phlebitis was also delayed.

Adolescent↗
PubMed1977

Infusion thrombophlebitis in a surgical department.

In hospitals where 5% glucose is the solution most often infused, the incidence of thrombophlebitis has been found to be 27-43%. In an attempt to reduce this incidence, the following principles for the administration of intravenous solutions were established in a surgical department: (1) No cannula to be placed in the same vein for continuous infusion for a period of more than 24 hours, (2) All sugar solutions to be neutralized with a phosphate buffer. (3) The thinnest possible cannulas are to be used. (4) Vein irritant solutions to be given as quickly as permissible. (5) Veins with the largest diameter to be used first. These principles were adhered to for a period of 4 months. The daily infusion period was 11-14 hours. Of 196 patients who received infusions for a total of 529 days, infusion thrombophlebitis developed in 6.1% (3-10%). 113 of these patients received (among other solutions) 1000-2000 ml 10% invertose per day. This solution was given for an average of 4 days. 9.7% (5-17%) of the patients in this group developed infusion thrombophlebitis. No patient had more than one episode of infusion thrombophlebitis.

Buffers↗
PubMed1977

Studies of the effects of estradiol, progesterone, cortisol, thrombophlebitis, and typhoid vaccine on synthesis and catabolism of antithrombin III in the dog.

Effects of estradiol, progesterone, cortisol, thrombophlebitis and typhoid vaccine on the synthesis and catabolism of antithrombin III (AT) in dogs were studied, using I-125-labeled AT (I-125-AT) as a tracer. Five dogs were used for each study. A single intramuscular injection of 20 mg estradiol caused a 20% decrease of plasma AT concentration in 6 days without appreciable changes in the plasma half-lives of I-125-AT but with a significant decrease in the fractional catabolic rate of I-125-AT(j3u). A single intramuscular injection of 250 mg progesterone did not produce any appreciable changes of plasma AT concentration, the plasma half-lives of I-125-AT or j3u. On the other hand, intravenous and intramuscular injections of a total of 750 mg cortisol caused a 17% increase of plasma AT concentration in a day after the injections without alterations of the plasma half-lives of I-125-AT or j3u. Next, thrombophlebitis was produced in dogs by a single intravenous injection of 1 ml 90% phenol into a leg vein occluded for 1 min by a gauze tourniquet and the effects of thrombophlebitis were studied. The results indicated that it did not cause appreciable changes of plasma AT concentration, the plasma half-lives of I-125-AT or j3u. However, studies of the effects of a single intravenous injection of 3 ml typhoid vaccine showed a 25% decrease of plasma AT concentration in a day after the injection with a moderate acceleration of the decline rate of plasma I-125-AT and a 14% increase in j3u values. Further studies in heparinized dogs showed similar effects with typhoid vaccine. These results indicate that estradiol causes a decreased rate of AT synthesis, that progesterone has no appreciable effects on AT metabolism, that cortisol increases the rate of AT synthesis, that localized thrombophlebitis has no appreciable effects on AT metabolism and that typhoid vaccine causes an increased j3u by unknown mechanisms which is not an accelerated coagulation process.

Animals↗
PubMed1982

[Surgical treatment of superficial thrombophlebitis].

A series of 38 cases of superficial thrombosis occurring during the period 1-12-1979 to 1-12-1981 was examined. The series included 10 cases of iatrogenic thrombophlebitis of the upper limbs, one case of Mondor's thrombophlebitis, and 27 cases of superficial thrombophlebitis of the lower limbs in subjects with essential varices of the legs. A particular predilection for women and for advanced age was noted, as well as particular frequency in the area of distribution of the Great versus and Small Saphenous Vein, and a sharp prevalence of segments below the knee as compared with the thigh. Treatment was always surgical, mainly directed to preventing any thromboembolic complications, shortening the healing times and eliminating the Varicose Disease, which is well known to constitute the basic aetiopathogenetic moment of superficial thrombophlebitis. In all cases where it was possible to follow this schedule the result was excellent, and no effects on the deep venous system or thromboembolic complications occurred. The 5 patients treated with simple ligature of the Saphenous Vein according to Cross had a recurrence of varicose disease in a period varying from 6 months to 1 years; two of them also had a relapse of the thrombophlebitic process.

Adult↗
PubMedDate not supplied

[Acute superficial thrombophlebitis--modern diagnosis and therapy].

Acute superficial thrombophlebitis of the lower extremities is one of the most common vascular diseases affecting the population. Although it is generally considered as a benign disease, it can be extended to the deep venous system and pulmonary embolism. We examined 50 patients (22 males and 28 females), mean age 52.5 years. These patients were surgically treated due to acute superficial thrombophlebitis of the lower limbs that affected great saphenous vein above the knee. The diagnosis was made by palpable subcutaneous cords in the course of great saphenous vein or its tributaries in association with tenderness, erythema and oedema. Of these 50 patients, 26 were examined by duplex ultrasonography before the operation. In 20 patients duplex scanning confirmed that the process was greater than we supposed after clinical examination (77%) and in 6 patients there were no differences (23%) (Figures 1 and 2). The operation included crossectomy, ligation and resection of the proximal part of the great saphenous vein. Intraoperative findings in 38 patients showed that the level of the phlebitic process was higher than the clinical level (76%). There was no difference in 12 patients (24%). Deep vein thrombosis and pulmonary embolism were noted in 14 patients (28%) (Tables 1 and 2). Both complications were found in two patients, and 12 had one of these complications. Generally, there were 12 patients with deep venous thrombosis and 4 patients with pulmonary embolism. Only in one patient deep venous thrombosis appeared postoperatively, while all other complications occurred before surgical intervention (Scheme 1 and Table 3). The most common risk factor was the presence of varicose veins (86%). Obesity, age over 60 years, cigarette smoking are listed in decreasing order of frequency. Patients under 60 years were more likely to have complications while older patients usually followed a benign clinical course (Tables 4 and 5). There was no intrahospital mortality. Average hospitalization was 5.7 days. It was 4 days in patients without complications. After thes urgent operation that practically removed the risk of potentially fatal consequences, the patients were dismissed from hospital. New hospitalization was recommended after two weeks when the second act of surgical treatment was performed. It included stripping of the great saphenous vein and extirpation of varicose veins in the area without acute inflammation. The findings of this study confirm the general opinion that acute superficial thrombophlebitis is a very common vascular disease with usually "benign" clinical course. In its ascending form that affects the great saphenous vein above the knee it can be associated with deep venous thrombosis and pulmonary embolism. The level of phlebitic process is usually much higher than can be palpated clinically. Duplex scanning was a highly reliable, precise, fast non-invasive diagnostic method that is necessary in examining, following and making decision for operative treatment of acute superficial thrombophlebitis. If suspected complications an urgent surgical intervention should be performed. It is short and efficient, contributing to the fast recovery of the patients and their return to normal activities.

Acute Disease↗
PubMed1997

[Crossectomy in ascending superficial thrombophlebitis of the leg veins].

Ascending thrombophlebitis of the superficial leg veins is known to propagate into the deep leg veins and to embolize. In a prospective study we followed up 44 patients with sonographically diagnosed ascending thrombophlebitis into the deep veins (V. saphena magna n = 40, V. saphena parva n = 4). In 15 of 44 cases (34%) thrombosis of the crossing veins was found intraoperatively and 6 of 44 crossings were filled with floating thrombi into the deep vein lumina (14%). Among complications of treatment (11.4%) recurrence of thrombi in the ligated superficial residual vein stump was seen in 2 of 44 cases. One of these patients suffered a symptomatic, non-fulminant pulmonary embolism. The other patient developed a femoral vein thrombosis. 1 patient had an abscess and 1 a seroma of the groin. In 11% of all cases ascending thrombophlebitis diagnosed duplex sonographically was not effective in preventing propagation of thrombi into the deep veins thromboembolism remains a complication of ascending thrombophlebitis.

Adult↗
PubMed1991

Venous duplex scanning in the diagnosis and treatment of progressive superficial thrombophlebitis.

Venous duplex scanning, employing both B-Mode imaging and Doppler waveform analysis, is a valuable noninvasive technique for the evaluation of venous disorders of the lower extremities. During the past three years, 442 venous duplex scans were performed in our laboratory, evaluating both the deep and superficial venous systems. Sixty-four scans revealed deep venous thrombosis; twenty studies revealed superficial thrombophlebitis. A subgroup of six studies revealed progressive thrombophlebitis approaching or involving the deep venous system. Three of these six studies documented progression of superficial thrombophlebitis extending into the deep venous system, producing limited deep venous thrombosis. All six patients were treated with venous excision and local venous thrombectomy. None of the patients developed deep venous thrombosis on follow-up venous duplex scans. We conclude that venous duplex scanning is a valuable noninvasive method in the detection of progressive superficial thrombophlebitis. Therefore, prompt therapy may prevent the development of deep venous thrombosis and its sequelae. Additionally, venous duplex scanning provides a method for noninvasive follow-up of the results of therapy.

Adult↗
PubMed1999

An unexpectedly high rate of pulmonary embolism in patients with superficial thrombophlebitis of the thigh.

PURPOSE: The rate of objectively proven pulmonary embolism in patients with thrombophlebitis of the greater saphenous vein was studied. METHODS: Consecutive ambulant patients with thrombophlebitis of the greater saphenous vein, involving the above-knee segment, underwent a complete venous echo color Doppler examination of the lower limbs, perfusion lung scanning, and chest radiography. A high probability of pulmonary embolism was defined as the presence of two or more large segmental defects, one large and two or more moderate perfusion defects, or four or more moderate perfusion defects, with no corresponding abnormality found by means of chest radiography. RESULTS: Of the 21 patients included in the study, findings compatible with a high probability of pulmonary embolism were detected in seven patients (33.3%; 95% CI, 14.6 to 57. 0), although clinical symptoms of pulmonary embolism were present only in one patient. No association was found between the presence of thrombosis at the saphenofemoral junction and the risk for pulmonary embolism. CONCLUSION: The rate of pulmonary embolism in patients with thrombophlebitis of the greater saphenous vein is unexpectedly high. This risk is similarly high in patients with thrombosis at the saphenofemoral junction and in patients without thrombosis at the saphenofemoral junction. Our results are consistent with those of other recent investigations and suggest that superficial thrombophlebitis of the thigh is not as benign a disease entity as previously described.

Adult↗
PubMed1994

Present status of computerized tomography and angiography in the diagnosis of cerebral thrombophlebitis cavernous sinus thrombosis excluded.

In order to evaluate the contribution of computerized tomography (CT) to the diagnosis of cerebral thrombophlebitis, a series of 28 cases was reviewed and compared with data from the literature. In an examination carried out 4 to 5 days of its constitution the thrombus may be directly visualized as a spontaneous hyperdensity. This early but very transient sign, called "cord sign", can easily be overlooked, which explains why it was found in only 5 of our 28 cases and in 2% of the largest series of the literature. The thrombus thereafter becomes hypodense and can be intensified by peripheral contrast enhancement which produces the classical "delta sign". This sign is more frequent: 13/28 in our series and 16 to 30% in published cases. It is usually found in the superior sagittal sinus and must be distinguished from anatomical variations which are common at that level. These two direct signs acquire a greater value when associated with such indirect signs as diffuse or localized cerebral oedema (12 to 52%) and venous ischaemia (22 to 59%). Venous ischaemia is characterized by its strong bleeding potential (more than 50% of the cases) and by its usually favourable course; these two elements and its site differentiate it from arterial ischaemia. Finally, venous stasis is responsible, in 5 to 19% of the cases, for intense enhancement of the tentorium cerebelli; this sign is not specific but easy to evidence and of great value when associated with a direct sign. Dilatation of cortical veins, found in 4 of our 28 cases, also seems to be an interesting sign which, to our knowledge, has not yet been mentioned in the literature. Since in 3.6 to 26% of the cerebral thrombophlebitis the CT scan is normal, a negative CT examination does not rule out this disease, and in many cases the exploration must be rapidly completed by angiography or MRI. Because it is non-invasive and very sensitive to flows, MRI has become the key examination to assert the diagnosis. Angiography is now restricted to those cases where cases where MRI cannot be performed promptly or to certain, purely cortical thrombophlebitis which might pass unnoticed at MRI. When carried out and interpreted cautiously, angiography always shows the venous thrombosis, its exact size and its suppletive network. The results of this study show that MRI alone can diagnose cerebral thrombophlebitis in most patients, that CT well done and interpreted often provides useful but seldom sufficient indices, and that angiography should be reserved for difficult cases.

Cavernous Sinus↗
PubMedDate not supplied

[The ultrasonic diagnosis of acute thrombophlebitis of the vena saphena magna].

A total of 321 patients with suspected acute thrombophlebitis were examined. There were 92 men (30%) and 229 women (70%). For control 15 patients without lower limb vein abnormalities and 19 ones with uncomplicated varicose disease were examined. Ultrasonic examinations using Ultramark-8 (Medata, Sweden) device were carried out in all the patients. Of the 313 cases (in 8 patients the diagnosis of acute thrombophlebitis was not confirmed by ultrasonic examination) ultrasonography results were erroneous in only 6 cases when assessing the proximal borderline of the great subcutaneous femoral vein thrombosis. Hence, the accuracy of duplex scanning in assessment of the proximal border of thrombosis in acute thrombophlebitis was 98.6% in our study. Ultrasonic angio-scanning in patients with superficial thrombophlebitis give reliable and valuable information about the presence, type, and extension of the pathologic process. This helps to optimally solve the therapeutic policy problems and adequately plan surgical intervention.

Acute Disease↗
PubMed2006

Superficial venous thrombophlebitis as the initial manifestation of hypereosinophilic syndrome: study of the first 3 cases.

BACKGROUND: Superficial venous thrombophlebitis (SVT), often perceived as benign, can coexist with hypercoagulable states. Predisposing risk factors for SVT are similar to those observed for deep venous thrombosis. Association of eosinophilia with SVT is a rare situation that can reveal neoplasia, malignant blood disorders, or vasculitis, but it has never been described in hypereosinophilic syndrome (HES). We herein describe the clinical and biological features, outcome, and response to therapy of 3 patients with SVT associated with eosinophilia that revealed HES. OBSERVATIONS: Superficial venous thrombophlebitis was the initial manifestation of HES in all 3 patients. The mean eosinophil count at diagnosis was 2.4 x 10(3)/muL. All patients received corticosteroids and anticoagulants as the initial treatment, with marked improvement of SVT and return of the eosinophil count to reference limits. All patients experienced relapse and remained dependent on corticosteroid therapy. Two patients received interferon alfa with dramatic regression of SVT, allowing a decrease in the dose of corticosteroids. CONCLUSIONS: We report, to our knowledge, the first 3 cases of SVT related to HES. Superficial venous thrombophlebitis was difficult to treat, with dependence on corticosteroid therapy and partial efficacy of anticoagulant and antiplatelet therapy. Interferon alfa was effective in preventing relapse of SVT related to HES. Mechanisms implied in this thrombogenesis are multiple and remain speculative.

Adult↗
PubMed1996

Aerobic and anaerobic microbiology of superficial suppurative thrombophlebitis.

OBJECTIVE: To study the aerobic and anaerobic microbiologic characteristics of superficial suppurative thrombophlebitis. DESIGN: Retrospective review of microbiologic and clinical data. SETTING: Navy Hospital in Bethesda, Md. RESULTS: Sixty-one isolates, 36 aerobic and 25 anaerobic, were isolated from samples obtained from 42 patients. Aerobic bacteria only were found in 26 (62%) patients; anaerobic only, in 11 (26%); and mixed aerobic and anaerobic bacteria, in five (12%). The predominant aerobic bacteria were Staphylococcus aureus (n = 9), Escherichia coli (n = 7), Pseudomonas aeruginosa (n = 4), and Klebsiella sp (n = 3). The most frequently recovered anaerobic bacteria were Peptostreptococcus sp (n = 8), Propionibacterium acnes (n = 6), Bacteroides fragilis group (n = 5), Prevotella intermedia (n = 3), and Fusobacterium nucleatum (n = 3). Propionibacterium acnes and Peptostreptococcus sp were associated with cannula-related superficial suppurative thrombophlebitis; B fragilis and Enterobacteriaceae, with abdominal surgery or pathology; and S aureus and P aeruginosa and Citrobacter sp, with burns. CONCLUSION: These data illustrate the importance of anaerobic bacteria in superficial suppurative thrombophlebitis.

Adult↗
PubMed1975

Iliofemoral thrombophlebitis associated with central nervous system pathology.

It is very uncommon for acute thrombophlebitis to develop in children without an identifiable predisposing cause. During a ten year period at a children's hospital, central nervous system disease was observed in four of eight children with iliofemoral thrombophlebitis. This association suggests that a thorough neurologic evaluation should be carried out in any child with acute thrombophlebitis.

Acute Disease↗
PubMed2005

[A rare aetiology of the post-partum fever: ovarian vein thrombophlebitis].

OBJECTIVES: To clarify the contribution of the doppler and the CT in the balance aetiology of a fever of the post-partum and to connect it with a thrombophlebitis of ovarian vein. PATIENTS AND METHODS: Five patients presented there post-partum a fever with pointed abdominal painful syndrome. A doppler and a CT were performed. RESULTS: Doppler showed a hypoechoic tubular structure located forward and laterally with regard to the psoas with a flat spectre in pulsed Doppler in every case. CT confirmed the diagnosis of a thrombophlebitis of the right ovarian vein in three cases and left in two cases. Evolution after anticoagulation and an antibiotic therapy was favourable with regression of clinical signs and doppler evaluation. CONCLUSION: In front of any fever of the post-partum, it is necessary to evoke a thrombophlebitis of the vein ovarian, although it is about a rare aetiology. In spite of the superiority of the CT-scan and RP imaging for such a diagnosis, doppler is a simple and reproducible diagnostic tool for the monitoring which must be practised in first intention.

Abdominal Pain↗
PubMed2006

Intravenous heparin in combination with antibiotics for the treatment of deep vein septic thrombophlebitis: a systematic review.

Antibiotics, heparin, and several surgical interventions have been used in various combinations for the treatment of septic thrombophlebitis, but the optimal management remains unclear. There are limited data from comparative trials studying this issue. Specifically, only one randomized controlled trial was conducted, while the rest of the evidence comes from case series and case reports. The results of this systematic review of septic thrombophlebitis suggest that the use of heparin in combination with antibiotics is associated with low mortality in patients with this serious type of infection. In addition, adverse effects related to heparin were limited in the reported literature. Although data from comparative trials are required to draw definitive conclusions, the available evidence suggests that the administration of heparin should be considered early in the management of patients with septic thrombophlebitis.

Anti-Bacterial Agents↗
PubMed1982

The association of septic thrombophlebitis with subperiosteal abscesses in children.

An association of septic thrombophlebitis with acute osteomyelitis in four children is described. Each patient presented with physical findings consistent with thrombophlebitis. Venography, done in two, demonstrated significant acute thrombophlebitis, and another had an infected venous cutdown. A subperiosteal abscess was the predominant bony involvement found in all three patients who underwent surgical drainage. The initial radiographs were normal in each case. Bone scans showed diffuse increase in activity in the extremity, consistent with hyperemia, but no focal areas of increased uptake to suggest osteomyelitis. Computerized tomography, done in two patients, failed to reveal any bony abnormality, although subperiosteal abscesses were drained within 48 hours of each study. The existence of reverse collateral venous flow through the bone, associated with a rise in intramedullary pressure, may be responsible for these findings.

Abscess↗