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Peripheral Venous Disease

Peripheral venous disease is the blockage of a vein by a blood clot. It can happen anywhere in the body but is most common in the arms and legs. It is caused by injury, infection, a long bed rest or illness, recent major surgery, pregnancy, or being overweight.

If the clot is located in the veins deep within the body, it is called deep venous thrombosis. Clots in the veins near the skin are called superficial venous thrombophlebitis.

Risk Factors

Factors that place you at risk of venous thrombosis include:

  • Surgery
  • Trauma (wounds or injuries)
  • Pregnancy
  • Obesity (being overweight)
  • Changes in blood clotting
  • Being unable to walk for a long time
  • History of peripheral venous disease or blood clot in the legs or lungs
  • Use of birth control pills
  • Cancer
  • Smoking

Why Treat Peripheral Venous Disease?

In deep venous thrombosis, a small clot may break off and travel to the lungs. This type of clot is known as a pulmonary embolism, and it can be a life-threatening condition. It is very important to recognize and treat deep venous thrombosis early to avoid a blood clot in the lung.

Symptoms

The symptoms of peripheral venous disease are not always clear. Usually the pain indicates where the clot is located

  • A hard area over a vein that feels like a cord or rope.
  • Tenderness or pain over a vein or in the calf of your leg.
  • A warm or feverish area over a vein. A streak or area of redness over a vein.
  • Swelling of the arm or leg.

Postphlebitis syndrome is a recurrence of superficial or deep venous thrombosis in which the valves in the veins become damaged, causing blood to collect in the veins. The result is swelling, skin discoloration and leg ulcers.

Diagnostic Tests

In addition to a physical examination, the following tests may be needed to determine if the vein is blocked by a clot. If you are scheduled for testing, please bring any X-rays or other scans you already have with you.

Doppler Ultrasound Imaging

Ultrasound is performed in the Peripheral Vascular Laboratory. This test is noninvasive (no needles are used) and painless. A warm, water-soluble lotion is spread on your legs, and a small probe (hand-held instrument) is moved over your legs to show the flow of blood through the veins. From this, the doctor can tell if there are any blockages. As the probe moves, you will be able to hear the blood flowing through your veins. Photos are taken during this test, which takes about one hour. No special preparation is needed.

Venography

Venography is performed in the Radiology department. Venograms are X-rays obtained by first injecting a contrast medium (dye) through a small catheter inserted into a blood vessel in your arm or leg. The dye travels through your blood vessels, highlighting them on the X-ray. The venogram shows the location of any narrowing or blockage in the veins. Venography takes about two hours and requires no special preparations.

Nuclear Venography

Nuclear venography is performed in the Nuclear Medicine Department. A radionuclear venogram is an X-ray obtained by injecting a radioisotope solution through a small catheter inserted into a blood vessel in your arm or leg. The radionuclear venogram shows the location of any narrowing or blockage in the veins. This test takes about two hours. Afterward, you will need to lie on your back for two hours.

VQ Scan

VQ scans are performed in the Nuclear Medicine Department. This test is usually used to detect blood clots in the lungs. A solution containing an isotope is injected through a small catheter that has been inserted into a blood vessel in your arm or leg. A camera takes pictures of your lungs, and these pictures show any blood clots. During this time you will lie flat on a table for approximately one hour and will be required to do several breathing exercises.

Treatment

Superficial venous thrombosis, especially superficial thrombophlebitis usually improves by itself although this may take several weeks or months. Deep venous thrombosis requires medical treatment. Your doctor will recommend one of the following treatments. Your doctor will recommend one of the following treatments.

Superficial Thrombophlebitis

  • Raise the affected arm or leg with a pillow until the swelling goes away
  • Wear support stockings if so advised by your doctor
  • Take anti-inflammatory medicine as recommended by your physician

Deep Venous Thrombosis

  • Rest in bed
  • Raise the affected arm or leg with a pillow until the swelling goes away
  • Take pain medication as prescribed by your doctor
  • Take blood-thinning drugs
  • Monitor blood clotting times during this treatment

Follow-Up

Follow these guidelines while you are recovering from peripheral venous disease:

  • Avoid sitting with your legs crossed
  • Wear support stockings if recommended by your doctor
  • Exercise regularly
  • Don’t sit or stand for a long time
  • Don’t place pillows under your knees
  • Protect your legs to avoid injury
  • Don’t wear tight clothing such as an elastic abdominal support or elastic bands around your legs

If you have pain, redness, or swelling at the site of the clot, or if you notice an ulcer (sore) on your arms or legs, call your doctor immediately.