Venous Thrombosis

Venous insufficiency and blood clots (venous thrombosis) are closely related. In some cases a person develops a blood clot in a deep vein due to some other risk factor (e.g., surgery, trauma/broken bones, cancer, or a genetic predisposition to forming clots). These clots can damage the valves in the veins and lead to chronic venous problems.

On the other hand, a person may develop the venous insufficiency first. In these cases, the valves in their veins fail for some other reason. When the valves in veins are damaged, there is more blood pooling in the vein under higher pressure. This high pressure leads to inflammation in the vein. That, combined with more sluggish flow of blood and a damaged valve surface are the ideal conditions to form a blood clot.

The clots associated with venous disease may be superficial or deep. Deep vein thromboses (DVTs) are the most dangerous, having the ability to break off and travel to the lungs (pulmonary embolism, PE). If the clot that travels is large enough, it can be fatal. Patients who are diagnosed with a DVT or PE are put on blood thinner medications and sometimes require urgent procedures to remove the clot.

Superficial Thrombophlebitis (STP) is a clot that develops in a superficial (above the muscle layer) of the body. They cause the vein to become suddenly hard and painful. Often there is redness of the overlying skin. Up to a third of cases of STP are associated with an underlying DVT, so an evaluation by a vein specialist and an ultrasound should be considered. In most cases, blood thinners are not needed to treat STP. They symptoms generally resolve within a few weeks. Compression, ice packs or warm compresses and anti-inflammatory pain medications can help relieve the symptoms.