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PubMed1982

Catheter-associated septic thrombophlebitis.

The clinical presentation and results of management of septic thrombophlebitis in 35 patients over a seven-year period are reviewed. There were 25 men and ten women; 20 patients were over age 50. At diagnosis, fever was present in 33 patients (94%), and 33 (94%) had local signs of inflammation. Pus was expressed from the infusion site in 25 patients (71%). All patients had plastic catheters, with 95% present longer than 48 hours. Klebsiella-Enterobacter was the dominant organism both at the infusion site and in the blood. All patients had surgical excision of the infected vein, followed in 60% by rapid lysis of fever. Other infections were responsible for persistent fever after total excision. Septic thrombophlebitis is best prevented by strict asepsis in catheter placement and rotation of infusion sites every 48 hours. Total excision of the infected vein remains the treatment of choice.

Adolescent↗
PubMed1983

Pelvic lipomatosis with ureteral encasement and recurrent thrombophlebitis.

Multiple complications occurred in a patient with severe pelvic lipomatosis and recurrent superficial thrombophlebitis. Distal ureteral and rectal encasement by lipomatous infiltration caused obstructive uropathy and rectal deformity without substantial compromise of renal or gastrointestinal function. Clinical evidence suggests an association between pelvic lipomatosis and recurrent superficial thrombophlebitis.

Humans↗
PubMed1992

Topical nonsteroidal anti-inflammatory gel for the prevention of peripheral vein thrombophlebitis. A double-blind, randomised, placebo-controlled trial in normal subjects.

A double-blind, randomised, placebo-controlled study was undertaken to determine whether topical application of a nonsteroidal anti-inflammatory gel to skin overlying peripheral vein cannula sites has a role in reducing the incidence or delaying the onset of peripheral vein thrombophlebitis. Fifty normal subjects had intravenous cannulae placed in right and left arms. Subjects were randomised to receive twice daily application of either active nonsteroidal anti-inflammatory gel or placebo gel to each cannula site. Cannula sites were observed and signs and symptoms of inflammation recorded up to 108 h. If any site had signs extending beyond 2 cm then the cannula was removed. Cannula sites that had 'active' gel applied had half the incidence of marked signs at 108 h (44% vs 22%, p less than 0.05). These results suggest that local application of topical nonsteroidal anti-inflammatory gel to cannula sites may have a significant role to play in the prevention of peripheral vein thrombophlebitis.

Administration, Topical↗
PubMed1981

Local discomfort and thrombophlebitis following intravenous injection of diazepam. A comparison between a glycoferol-water solution and a lipid emulsion.

Diazepam is frequently used for pre- and peroperative sedation. However, at i.v. injection local pain and thrombophlebitis are not uncommon, probably due to tissue irritancy of the various organic solvents necessary to keep diazepam in aqueous solution. In this study the incidence of local adverse effects following i.v. injection of Diazemuls, a new lipid emulsion formulation, was compared with that of Apozepam, a glycoferol-water solution. We found that the latter preparation caused local pain and thrombophlebitis as often as reported with propyleneglycol-phenylcarbinol-ethanol preparations (Stesolid, Valium) and in a statistically higher incidence that the lipid emulsion form, which therefore seems more suitable for intravenous use.

Adult↗
PubMed1977

Idiopathic recurrent superficial thrombophlebitis: treatment with fibrinolytic enhancement.

Sixteen patients with idiopathic recurrent superficial thrombophlebitis were shown to have a defect of blood and tissue fibrinolytic activity. After six months' treatment with stanozolol their mean dilute blood clot lysis time and plasma fibrinogen fell significantly and the mean fibrin plate lysis area increased. Attacks of thrombophlebitis stopped completely in 13 patients, though five patients later suffered recurrences and phenformin had to be added to their treatment. Fibrinolytic enhancement with stanozolol seems to be effective in this previously intractable condition, and regular blood studies will indicate which patients also need phenformin.

Adult↗
PubMed1995

Ultrasonographic evaluation of the jugular vein of cows with catheter-related thrombophlebitis.

Thirty cows with an indwelling jugular catheter developed thrombophlebitis 72 hours after the insertion of the catheter. The animals with palpable changes of the jugular vein, were examined ultrasonographically to reveal the severity and extent of the thrombosis. Sixteen cows had mild to moderate thrombotic changes at the site of insertion or at the tip of the catheter, and in the other 14 cows the jugular vein was completely thrombosed, from 7 to 20 cm. Catheter-related damage to the intima, chemical damage by irritating medications and reduced host resistance attributable to the underlying illness were thought to be possible causes of the thrombophlebitis.

Animals↗
PubMed1996

Prophylaxis of intravenous catheter-related thrombophlebitis in cattle.

Two methods of preventing intravenous catheter-related thrombophlebitis of the jugular vein, using clinical and ultrasonographic criteria, were compared. The first method consisted of minimising bacteriological contamination by the preparation of the skin as if for surgery. The second method involved the daily subcutaneous administration of low doses of heparin to decrease procoagulant activity. The results showed that the preparation of the skin before the placement of an indwelling catheter in the jugular vein and adequate daily maintenance of the catheter were of great importance in the prevention of thrombophlebitis induced by bacteriological contamination. The use of heparin should be limited to cases that require long-term catheterisation or are predisposed to thrombosis or other clotting abnormalities.

Animals↗
PubMed1975

Popliteal cysts: presentation as thrombophlebitis.

Synovial-lined cysts in the popliteal space associated with rheumatoid arthritis or meniscal tears may compress the popliteal vein and produce signs and symptoms suggestive of thrombophlebitis. Because of a presumptive diagnosis of thrombophlebitis, venography may be performed initially and demonstrate compression of the popliteal vein by an extrinsic mass. The correct diagnosis of a popliteal cyst can easily be made with B-mode ultrasonography, and, if desired, confirmed by arthrography. Four cases are presented which emphasize these features.

Adult↗
PubMed1981

Detection of deep venous thrombophlebitis by gallium 67 scintigraphy.

Deep venous thrombophlebitis may escape clinical detection. Three cases are reported in which whole-body gallium 67 scintigraphy was used to detect unsuspected deep venous thrombophlebitis related to indwelling catheters in three children who were being evaluated for fevers of unknown origin. Two of these children had septicemia from Candida organisms secondary to these venous lines. Gallium 67 scintigraphy may be useful in the detection of complications of indwelling venous catheters.

Candidiasis↗
PubMed1981

Efficacy of noninvasive modalities of diagnosis of thrombophlebitis.

In a blind prospective study of 158 limbs, Doppler ultrasound, pneumoplethysmography, and radionuclide venography (RNV) using 99mTc-MAA were compared to phlebography as methods of detecting thrombophlebitis. All three noninvasive modalities were very insensitive to isolated thrombus below the knee. In patients with extension of thrombus above the knee and isolated thrombus in the deep veins of the upper limb, Doppler ultrasound had a sensitivity of 81% and RNV had a sensitivity of 77%. All of the noninvasive modalities were found to be dependent on venous occlusion. Overall, pneumoplethysmography had a sensitivity of 28% and specificity of 96%, compared with 56% and 91%, respectively, for Doppler ultrasound and 51% and 84% for RNV. Based on these findings, phlebography would still seem to be the modality of choice in the diagnosis of thrombophlebitis.

Double-Blind Method↗
PubMedDate not supplied

Cerebral thrombophlebitis in three patients with probable multiple sclerosis. Role of lumbar puncture or intravenous corticosteroid treatment.

We report 3 cases of young patients, 2 women and 1 man, who presented a cerebral venous thrombosis following intravenous treatment with high doses of corticosteroids. All of them presented a probable multiple sclerosis according to clinical, biological (CSF) and MRI criteria and were treated for the first time by a bolus of 1,000 mg of methylprednisolone OD during 5 days. All the usual causes of cerebral venous thrombosis were systematically excluded in all of them. The role of corticosteroid treatment in cerebral thrombophlebitis is discussed. All of them underwent a lumbar puncture a few days before corticosteroid treatment and the relationship between lumbar puncture and cerebral thrombophlebitis is also discussed. Cerebral venous thrombosis associated with corticosteroid treatment has rarely been reported. The relationship between corticosteroids and venous thrombosis has already been suggested but has never been clearly understood.

Adult↗
PubMed2001

Glycosaminoglycans of normal veins and their alterations in varicose veins and varicose veins complicated by thrombophlebitis.

The aim of the study was to examine the content and molecular differentiation of glycosaminoglycans (GAGs) in the wall of varicose veins. The studied material consisted of normal, varicose veins and varicose veins complicated by thrombophlebitis collected during operations on 26 patients. In the wall of varicose veins the mean GAGs' content as well as the content of sulphated GAGs, except heparan sulphate was increased, whereas the amount of hyaluronic acid was decreased. Furthermore, the increased quantitative ratio between sulphated and nonsulphated GAGs was demonstrated. The results indicate an evident extracellular matrix remodelling in the wall of varicose veins particularly those complicated by thrombophlebitis, that is characterised by alterations in the content and molecular differentiation of GAGs.

Adult↗
PubMed1986

Defibrotide therapy for thrombophlebitis--controlled clinical trial.

Deep venous thrombosis is a common disease with significant danger of both acute and chronic complications. Widely accepted therapies are based on anticoagulant (heparin and/or anticoagulant agents) or early fibrinolytic therapy. All these therapies frequently have severe side effects. Defibrotide is a new drug with antithrombotic and profibrinolytic activities but without anticoagulant activity and major side effects. To evaluate the efficacy of this drug against acute thrombophlebitis, we treated a group of 10 patients with 200 mg defibrotide intravenously three times a day for 15 days. Fibrinolysis parameters were monitored every other day. The indices of venous function by strain-gauge plethysmography and venous occlusion were evaluated every 7 days. The drug induced a significant improvement in plethysmographic indices and a significant profibrinolytic activity. Defibrotide-treated patients showed a fast disappearance of clinical and instrumental signs of thrombophlebitis. No side effects were reported during the study.

Aged↗
PubMedDate not supplied

Superficial thrombophlebitis and low-molecular-weight heparins.

The current status of superficial thrombophlebitis, including incidence, diagnosis, and management, are reviewed. Treatment options are assessed in the light of data from the main studies reported in the literature. These include compression, ambulation, and nonsteroidal antiinflammatory agents and surgical management with high saphenous ligation (with or without saphenous vein stripping) with or without anticoagulants, ranging from aspirin, unfractionated heparin, warfarin, and low-molecular-weight heparin (LMWH). The advantage of the surgical approach is that by ligation with or without stripping of the superficial veins the underlying pathesis (i.e., varicose veins) is also eradicated. In the presence of deep venous thrombosis (DVT), surgery could be combined with anticoagulants. The extensive current literature for DVT treatment shows that the LMWHs are at least as effective and safe as the unfractionated heparins. On this basis, one could reasonably recommend LMWH for the treatment of superficial thrombophlebitis with involvement of the deep veins. Pentasaccharide, a drug that has been recently explored for the prophylaxis and treatment of DVT could be another option. However, there are as yet no data for recommended dosages or duration of treatment for the latter two options.

Anticoagulants↗
PubMed1976

Thrombophlebitis and cancer. A review.

Thrombophlebitis has been associated with virtually all cancers, especially gastrointestinal, urogenital, and lung neoplasms. Although occurring infrequently in cancer patients, thrombophlebitis may appear before the cancer has become symptomatic and may lead to an earlier diagnosis of cancer. The phlebitic syndrome associated with cancer, although not unique, is distinctive. It is often recurrent and migratory, often involves unusual locations, and is often resistant to anticoagulation therapy. Pulmonary emboli are frequent complications. The pathogenesis of phlebitis in cancer patients is not well understood. Evidence suggests that many cancer patients are hypercoagulable, with abnormalities in platelets, coagulation factors, and the fibrinolytic system. These changes may results from the elaboration of thromboplastin-like substances from the cancer tissue.

Blood Coagulation↗
PubMed1980

Thrombophlebitis: diagnostic techniques.

A review of the extensive literature on the diagnosis of deep vein thrombophlebitis (DVT) is presented. DVT affects approximately 10% of all patients with superficial thrombophlebitis. Many authors have shown that the clinical finding of DVT are unreliable. Although pulmonary emboli are relatively frequent in all patients with calf DVT, these emboli are generally not associated with clincial events. Venography is the "gold standard" of diagnostic tests, but it is too cumbersome to be practical as a screening procedure. Radioisotope-labeled fibrinogen is reasonable accurate in diagnosing calf DVT, but much less so in proximal lesions. The results of Doppler ultrasound and impedance plethysmography (IPG) agree with those of venography in 90% of the cases of proximal DVT.

Fibrinogen↗
PubMed1999

Superficial thrombophlebitis of the legs: a randomized, controlled, follow-up study.

The aim of the present study was to evaluate the effects of different treatment plans (compression only, early surgery, low-dose subcutaneous heparin [LDSH], low-molecular-weight heparin [LMWH], and oral anticoagulant [OC] treatment) in the management of superficial thrombophlebitis (STP), by considering efficacy and costs in a 6-month, randomized, follow-up trial. Patients with STP, with large varicose veins without any suspected/documented systemic disorder, were included. Criteria for inclusion were as follows: presence of varicose veins; venous incompetence (by duplex); a tender, indurated cord along a superficial vein; and redness and heat in the affected area. All patients were ambulatory. Exclusion criteria were obesity, cardiovascular or neoplastic diseases, bone/joint disease, problems requiring immobilization, and age > 70 years. Patients with superficial thrombophlebitis without varicose veins and patients under treatment with drugs at referral were also excluded. Color duplex (CD) was used to detect concomitant deep vein thrombosis (DVT) and to evaluate the extension or reduction of STP at 3 and 6 months. Venography was not used. Of 562 patients included, 3.5% had had a recent DVT in the same limb affected by SVT and 2.1% in the contralateral limb. In six patients DVT was present in both limbs. These patients were treated with anticoagulants and excluded from the follow-up. After 3 and 6 months the incidence of STP extension was higher in the elastic compression and in the saphenous ligation groups (p < 0.05). There was no significant difference in DVT incidence at 3 months among the treatment groups. Stripping of the affected veins was associated with the lowest incidence of thrombus extension. The cost for compression alone was the lowest and the cost including LMWH was the highest. The average cost was 1,383 US$. However the highest social cost (lost working days, inactivity) was observed in subjects treated only with stockings.

Absenteeism↗
PubMed1982

Saline flush: a simple method of reducing diazepam-induced thrombophlebitis.

Five hundred outpatients undergoing endoscopy were admitted into a controlled trial comparing the incidence of thrombophlebitis following intravenous diazepam administered in the way, with the effects of either a saline flush following the diazepam or diluting the drug with the patient's own blood before injection ('barbotage'). The results were assessed using a questionnaire completed by patients two weeks after endoscopy; 80% replied. A saline flush reduced the incidence of side effects, particularly pain (P less than 0.05). 'Barbotage' gave the highest incidence of side effects. Saline flush is therefore recommended as a means of reducing the thrombophlebitis which may follow intravenous diazepam.

Clinical Trials as Topic↗