11.17.15 Dr. Garth Rosenberg Blood Clots and Flying

Varicose Veins and Blood Clots - How to Avoid the Risks

I just attended the annual American College of Phlebology annual meeting, and one very important sessions dealt with the issue of superficial blood clots in the leg (phlebitis). These superficial clots typically occur in raised varicose veins in the leg, though the clots can also occur in previously normal leg veins.

Phlebitis causes a firm, tender, sometimes red knot or 'cord' along or just under the skin. Previously flowing blood in these veins suddenly clotted, causing the pain, but often there other associated leg clots that are not immediately visible. There is even an association with deep vein blood clots (DVT), and untreated, these can cause serious harm.

Because of this association between superficial and deep vein clots, patients should undergo a venous duplex evaluation to identify any associated disease. This will help guide therapy.

Small segments of phlebitis are often easily managed with conventional anti-inflammatories like Motrin or ibuprofen. More widespread areas, or those located close to deep veins, may be better managed with anticoagulant medications.

We also know that same patients with phlebitis have genetic reasons for clotting, and we may order specialized blood tests to identify patients who are at high risk for repeated clotting events.

There is a strong association between varicose veins and phlebitis, and the enlarged surface veins are susceptible to clot formation. Patients with varicose veins should have evaluation with ultrasound and treatment to minimize phlebitis risk. The ultrasound commonly shows saphenous vein reflux, and the Closure Procedure is the ideal procedure that will treat the cause of the varicosities. This office based procedure allows immediate return to normal activity and is usually considered medically necessary (NOT cosmetic) by your medical, insurance carrier.

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