Treatment

What is the treatment?

• For thrombophlebitis

  Self–care steps are recommended – leg elevation. Compression stockings and non-steriodal anti-inflammatory drugs. There is no hospitalization needed and the condition normally improves in 3-4 weeks.

• For DVT the following measures are done

• Blood thinning drugs

  Heparin of Low Molecular Weight Heparin (LMWH) are given. They prevent clot from enlarging. This is followed by oral anticoagulants like warfarin or Acetrome or Xoralto for several months to years. They are stopped only when colour Doppler study shows the vein clear of DVT.

• Clot dissolving medication

  This is thrombolysis (Urokinase, streptokinase or altepace. They dissolve the clot and are used for extensive DVT or when there is a high probability of developing clots in the lung – pulmonary embolism (PE).

• Graded Compression Stockings

  These prevent swelling and reduce the chances of DVT. These stockings may need to be worn for 2 years or more.

• IVC Filter

  If there is failed medical treatment or the anticoagulation is contraindicated due to other medical conditions then an IVC filter is inserted. This is done under local anesthesia via the vein in the groin and the filter is placed in the main vein (IVC) just below the level of the kidneys. This prevents clots from the legs reaching the lungs.

• Varicose veins surgery

  This is recommended to prevent the above complications as the incidence of the above complications rises with varicose veins. Varicose veins surgery is done by pin-hole technique using Radio-Frequency Ablation along with sclerotherapy. Once the superficial veins are ablated the blood returns via the deep venous system.

How can I prevent DVT?

Sitting for long in flight or car journey causes

• • swelling of the ankles and calves increasing the risk of thrombophlebitis in the leg veins.

To prevent this the following measures are taken:

• • Take a walk. If in flight walk hourly in the isle and if in car stop and walk around the car.
  • If walking is not possible then move your legs regularly by flexing your ankles or pressing down on the floor with your toes.

If the flight or drive is over 4 hours then:

• • Avoid wearing tight clothing
  • Drink a lot of non-alcoholic fluid to prevent dehydration.
  • Stretch your calves by walking at least once an hour.

If you are at risk of developing DVT ask your doctor for his advice:

• Compression stockings
• Blood thinning injections before the journey.

Content Reviewed by – Dr. Jaisom Chopra