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At least 19 recordsLinked to original sources
PubMed1982

[The radiofibrinogen test and the fibrinsplit product test in the diagnosis of deep veinous thrombophlebitis during radiotherapy. A contribution to the evaluation for silent acute thrombophlebitis (author's transl)].

The radiofibrinogen test is especially useful for the diagnosis of deep veinous thrombophlebitis in the legs in patients undergoing radiotherapy for gyanecological cancer. In 62 patients, 6 deep veinous thrombophlebitis were observed during 124 radium insertions in conjunction with preventive administration of anti-coagulants. The most important test for the early coagulation physiologic diagnosis of deep leg thrombophlebitis is the test for fibrinogen and fibrinsplit products. A suitable procedure is the Latex-agglutination test which is technically uncomplicated. If deep leg vein thrombophlebitis is found by the radiofibrinogen test, the fibrinsplit products always show at least a fourfold increase.

Aged↗
PubMed2001

Factors influencing the occurrence of thrombophlebitis after post-surgical long-term intravenous catheterization of colic horses: a study of 38 cases.

Thrombophlebitis is a well-known complication of the use of long-term in-dwelling catheters. In humans, catheter material has been shown to strongly influence the occurrence of thrombophlebitis. In the horse, the influence of catheter material has been studied in healthy experimental animals, but information on the relative importance of this factor is lacking. To investigate which factors have most impact on the frequency of jugular vein thrombosis in post-surgical colic horses, a clinical study was performed on 38 animals. Horses were randomly divided into two groups. In one group a polytetrafluoroethylene catheter was used, in the other a polyurethane catheter. Both groups were clinically monitored and screened for signs of thrombophlebitis. Seven out of 38 horses developed thrombophlebitis. The type of catheter material used had no influence on thrombophlebitis development. Dwell time was significantly longer in horses that developed thrombophlebitis compared with those that did not. There was no relationship between the occurrence of thrombophlebitis and underlying disease or surgical treatment, suggesting that the general state of debilitation these horses experienced was the most important determinant for the development of thrombophlebiris. This was further stressed by the fact that seven horses developed thrombophlebitis of the contralateral vein that had been used for the induction of anaesthesia (this incidence is much higher than in horses anaesthetized for elective surgery). It is concluded that the state of debilitation is the most important determining factor for the occurrence of thrombophlebitis after the use of long-term in-dwelling intravenous catheters. This makes a substantial reduction of the incidence of thrombophlebitis difficult, but some progress can be made by consequently restricting dwell time.

Animals↗
PubMed2001

[The course of pregnancy, delivery and puerperium in women with varices and thrombophlebitis of lower extremities, after application of low molecular weight heparins].

OBJECTIVES: Estimation of the long term prophylactic or therapeutic application of low molecular weight heparin (LMWH) on the platelets count, and incidence bleedings during pregnancy, delivery and puerperium in the women with varices of lower extremities and past thrombophlebitis of lower extremities. MATERIAL AND METHODS: 5212 pregnant, women in labour and in puerperium divided into 4 groups.; 142 women with varices and thrombophlebitis of lower extremities (group I); 10 with past thrombophlebitis of lower extremities (group II); 15 with thrombophlebitis in current pregnancy; 5045 without vascular complications (group IV--control). In group I during pregnancy compression therapy was applied (stockings) and low molecular weight heparins (LMWH) in course of puerperium. In group II during the 1st trimester of pregnancy and in labour the same heparin doses were administered, while the doses were increased in the 2nd and 3rd trimester. In group III, when thrombophlebitis was stated non-steroid anti-inflammatory drugs and LMWH were administered. In all cases treated with heparin both number of platelets and incidents of bleedings from genitourinary tract were observed. Presence of embolic complications was also noted. RESULTS: No cases of decrease platelets number or bleedings from genitourinary tract were observed in group I-III during administering of LMWH. In women in group II where prophylactic with LMWH was applied no incidences of recurrent thrombophlebitis during pregnancy and puerperium were observed. In group I-III all newborns were born in good condition and no complications were observed. Average blood loss during both labour and cesarean section, among women in group I-III was not significantly different comparing with control group. No incidences of pulmonary artery embolism or decrease number of platelets were observed. CONCLUSIONS: 1. The long term prophylactic or therapeutical administration of LMWH in the women with varices of lower extremities or thrombophlebitis has no influence on the platelets count and incidence of bleedings from genitourinary tract during pregnancy or increase of blood loss during labour and puerperium. 2. In the women with past thrombophlebitis of the lower extremities after application of LMWH during pregnancy there were no recurrence observed.

Adult↗
PubMedDate not supplied

Septic pelvic thrombophlebitis or refractory postpartum fever of undetermined etiology.

The objective of this study was to review and characterize the presentation, diagnostic dilemmas, management, and prognosis of postpartum septic pelvic thrombophlebitis. Medical records of postpartum women with the diagnosis of septic pelvic thrombophlebitis were reviewed for the 8-year period 1986-1994. Cases of documented ovarian vein thrombosis or those with other pelvic pathology on imaging study were excluded. Thirty-one women, four following vaginal delivery and 27 following cesarean delivery, with a final diagnosis of septic pelvic thrombophlebitis were identified. All patients demonstrated refractory febrile morbidity (mean 5.5 +/- 1.9 days prior to instituting heparin therapy) despite multiagent antimicrobial therapy with ampicillin, gentamicin, and clindamycin. Imaging studies (CT and/or ultrasound) were performed in 20 women and revealed no pelvic pathology. The patients required an average of 4.7 +/- 2.1 days (median 5, range 1-9 days) of heparin therapy before defervescence. Heparin levels were therapeutic at a mean of less than 24 h (range 6-24 h). The average dose of heparin required was 16.0 +/- 3.0 U/kg/h. Nine women had 13 subsequent pregnancies without recurrent thromboembolic complications. Currently available imaging studies cannot diagnose the entity we now define as septic pelvic thrombophlebitis (once cases of ovarian vein thrombosis are excluded). Our findings do not support the time-honored rule that septic pelvic thrombophlebitis responds within 24-48 h to therapeutic anticoagulation with heparin. Therefore, criteria other than imaging studies or immediate defervescence following heparin therapy are necessary for diagnosis of septic pelvic thrombophlebitis. A more appropriate terminology for septic pelvic thrombophlebitis should be refractory postpartum fever of undetermined etiology.

Adolescent↗
PubMed1974

Thrombophlebitis and thromboembolism: results of a prospective study.

Thrombophlebitis leading to pulmonary embolism has been stated to cause as many as 9% of hospital deaths. Its diagnosis, sites of common occurrence, treatment and immediate sequelae have long been controversial subjects. A prospective study of thrombophlebitis was set up to evaluate these problems. One hundred and sixty-six patients diagnosed clinically as having thrombophlebitis or pulnmonary embolus were studied with the ultrasonic flow detector (doppler). To assess the stated accuracy of this instrument, venograms were done when possible. The doppler proved in this series to be 93% accurate as compared to venography which is comparable to other series. Pulmonary scans and angiograms were obtained from patients suspected of having pulmonary emboli. Results were as follows: 1) Of 113 patients suspected of having thrombophlebitis clinically, only 26 (23%) of the cases were confirmed by doppler; 2) Of 53 patients suspected of having pulmonary embolus clinically, only 18 (34%) had confirmation by scan, angiogram or doppler; 3) Of 39 patients in this series who had thrombophlebitis, 11 (23%) were not suspected of having lower extremity venous disease until pulmonary embolus occurred, 4) Calf vein thrombosis without additional proximal occlusion was present in only 10% of cases; and 5) Thirty per cent of doppler or venographically proven cases of thrombophlebitis occurred after orthopedic injuries or operations. It was concluded that physical examination alone was grossly inaccurate in determining the recurrence of lower extremity thrombosis. In fact physical examination alone appeared to select out for treatment large numbers of patients without venous disease while a significant number of patients with thrombophlebitis remained clinically asymptomatic until pulmonary embolism occurred. Most deep venous disease was found in the larger veins above the knee, explaining the paucity of diagnostic symptoms in these individuals. The ultrasonic flow detector was found to be an extremely accurate, simple and rapid bedside test that could be applied daily to the high risk groups. The appearance of thrombosis could then be treated with heparin with excellent prospects of preventing occurrence of pulmonary embolus.

Angiography↗
PubMedDate not supplied

High osmolality feedings do not increase the incidence of thrombophlebitis during peripheral i.v. nutrition.

BACKGROUND: Peripheral i.v. nutrition has been advocated for patients who require short-term i.v. nutrition support to avoid the complications and expense of central venous catheterization. Feeding formulas for peripheral administration have usually been modified by increasing the proportion of lipid, because increasing osmolality is reported to cause thrombophlebitis. The aim of this study was to determine whether standard feeding formulas can be given via the peripheral route and also to establish whether increasing osmolality does increase the incidence of thrombophlebitis under these conditions. METHODS: Thirty-six patients requiring parenteral nutrition were randomized to receive either a "high" (1700 mOsmol/L) or "standard" (1200 mOsmol/L) osmolality feeding containing 2000 kcal and 12 g nitrogen via a peripheral line. RESULTS: Twenty patients (mean age 55.6 years, range 16 to 78) received standard osmolality feedings using 20 peripheral feeding lines for a mean duration of 6.8 days (range 2 to 16) with 10 line failures (8 thrombophlebitis, 2 occlusion). Nineteen patients (mean age 56.1 years, range 27 to 83) received high osmolality feedings via 20 lines for a mean of 6.3 days (range 0 to 18) with five line failures (4 thrombophlebitis, 1 occlusion), one failed insertion, one line removed at the patient's request, and four lines that fell out. Forty lines were inserted overall of which 19 (47.5%) were removed electively, 12 (30%) developed thrombophlebitis, 3 (7.5%) occluded, 4 (10%) fell out, 1 (2.5%) was a failed insertion, and 1 (2.5%) was removed for nonmedical reasons. CONCLUSIONS: Increasing osmolality of total parenteral nutrition did not increase episodes of thrombophlebitis in this trial and did not affect the success rate of the lines. We conclude that standard total parenteral nutrition formulas of higher osmolality than previously thought can be safely given via the peripheral route for short-term feeding and do not increase the risk of thrombophlebitis.

Adolescent↗
PubMed1988

Are anaerobic bacteria involved in peripheral vein catheter associated thrombophlebitis?

While thrombophlebitis is a common complication of intravenous therapy, infection has been shown to be a cause of this problem in only a minority of cases. However, the methodology employed in the past would not have detected the anaerobes as a cause of this problem. As anaerobes are associated with thrombophlebitis in situations such as septic pelvic thrombophlebitis, we undertook a study to see if they might also be involved in thrombophlebitis associated with peripheral vein catheters. We prospectively studied 26 episodes of peripheral intravenous catheter associated thrombophlebitis. These catheters were all cultured under aerobic conditions by the semiquantitative technique on blood agar plates. In addition, they were promptly processed and cultured under optimal anaerobic conditions. In none of the episodes of thrombophlebitis were the catheters positive on semiquantitative culture. In addition, we did not show the presence of anaerobes on any of these catheters. We conclude that there is no evidence that anaerobes are associated with peripheral vein thrombophlebitis.

Bacteria, Anaerobic↗
PubMed1981

The surgical treatment of superficial thrombophlebitis.

Of 3,941 patients who underwent varicose vein surgery from 1968 through 1978, 163 had superficial thrombophlebitis, a common complication of varicose veins. Superficial thrombophlebitis was more frequently found in the older age groups. The incidence of occurrence (three women to one man) was identical to that of the overall group operated on for varicose veins. Twenty-two percent of the patients had thrombophlebitis that extended into the saphenous vein at or near the saphenofemoral juncture. Superficial thrombophlebitis was more frequently located in the varicosities below the knee instead of above the knee. The prolonged duration of superficial thrombophlebitis and the recurrent attacks suggest that thrombophlebitis can be chronic, recurrent, or subacute and may remain a threat as long as the varicosities are present. Review of these 163 patients, 161 of whom have been followed up from 1 to 12 years (average 5 years), who were consecutively treated by surgical excision of the thrombosed segments, with excision or stripping of the remaining varicosities, underscores the clinical impression that the surgical removal of the thrombosed vein segments and the associated varicosities shortens the convalescence and mitigates against later recurrence. This form of treatment was accomplished without death or significant morbidity, except for two patients who had clinical suspect nonfatal minor pulmonary emboli during the postoperative hospital period. Prophylactic anticoagulants were used in most patients. Surgical removal of the varicosities with excision of the thrombosed veins is currently our preferred treatment for superficial thrombophlebitis in otherwise healthy patients.

Adult↗
PubMed1997

Superficial thrombophlebitis and deep vein thrombosis. A controversial association.

BACKGROUND: Superficial thrombophlebitis is a common and benign disease. However, an association with deep vein thrombosis, a more severe condition that requires anticoagulant treatment, has been reported repeatedly with frequencies ranging from 12% to 44%. METHODS: All consecutive records of patients with lower limb superficial thrombophlebitis were retrieved from the laboratory database over a 6-year period (1989-1994), and association with deep vein thrombosis was sought. Also, to detect late events, consultations were registered over a 3-month period after the initial examination. Patients with the association of superficial thrombophlebitis and deep vein thrombosis were also compared with a randomly selected sample of subjects with superficial thrombophlebitis only. RESULTS: Objectively confirmed deep vein thrombosis was detected in 31 patients (5.6%; 95% confidence interval, 3.8%-7.9%). Additional late thromboembolic events were detected in 1.7% of the patients during the 3-month follow-up period. Previous immobilization was more common among patients with deep vein thrombosis associated with superficial phlebitis (11/31, 36%) than among a randomly selected subset of patients with superficial thrombophlebitis only (13/93, 14%), the difference being statistically significant (P < .02). CONCLUSIONS: When large populations of patients with superficial thrombophlebitis are studied, the association with deep vein thrombosis appears rather small. Thus, systematic screening for deep vein thrombosis may not be warranted in the presence of superficial thrombophlebitis unless additional risk factors (eg, immobilization) are present.

Adult↗
PubMed1999

Puerperal septic pelvic thrombophlebitis: incidence and response to heparin therapy.

OBJECTIVE: Before the availability of modern imaging studies the diagnosis of septic pelvic thrombophlebitis causing prolonged puerperal fever was difficult to confirm without surgical exploration. With the use of computed tomography infection-related pelvic phlebitis can now be confirmed, and this study was designed to determine its incidence after delivery. We also designed a randomized clinical trial to evaluate the efficacy of heparin added to antimicrobial therapy for treatment of women with septic phlebitis. STUDY DESIGN: We studied women who had pelvic infection and fever that persisted after 5 days despite adequate antimicrobial therapy with clindamycin, gentamicin, and ampicillin. After giving consent study participants underwent abdominopelvic computed tomographic imaging. Women with pelvic thrombophlebitis were randomly assigned to 1 of 2 management schemes that included continuation of antimicrobial therapy, either alone or with the addition of heparin, until the temperature was </=37.5 degrees C for 48 hours. RESULTS: During the 3-year study period 44,922 women were delivered at Parkland Hospital; among these 8535 (19%) were delivered by the cesarean route. There were 69 women who met criteria for prolonged infection, and 15 (22%) of these were found to have septic pelvic thrombophlebitis. Four had infection after vaginal delivery and 11 had been delivered by the cesarean route. Of 14 women randomly assigned to therapy, 8 were assigned to receive continued antimicrobial therapy without the addition of heparin and the other 6 were assigned to receive heparin therapy in addition to the antimicrobial agents. According to an intent-to-treat analysis there was no significant difference between the responses of women with pelvic infection who were and were not given heparin therapy. Specifically, women not given heparin were febrile for 140 +/- 39 hours compared with 134 +/- 65 hours for women who received heparin (P =.83). Duration of hospitalization was also similar between the 2 groups at 10.6 +/- 1.9 days for those with thrombosis who were given antimicrobial agents alone and 11.3 +/- 1.2 days for women who also received heparin (P >.5). The 54 women with persistent fever but without computed tomographic evidence of septic pelvic thrombophlebitis were hospitalized for a mean of 12.0 +/- 4.1 days, compared with 10.9 +/- 2.9 days for women in whom thrombosis was diagnosed (P =.14). These women were followed up for >/=3 months post partum and none showed evidence of reinfection, embolic episodes, or postphlebitic syndrome. CONCLUSIONS: The overall incidence of septic pelvic thrombophlebitis was 1:3000 deliveries. The incidence was about 1:9000 after vaginal delivery and 1:800 after cesarean section. Women given heparin in addition to antimicrobial therapy for septic thrombophlebitis did not have better outcomes than did those for whom antimicrobial therapy alone was continued. These results also do not support the common empiric practice of heparin treatment for women with persistent postpartum infection.

Adult↗