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Vascular Surgery

Vasoconstriction & thrombophlebitis

09/24/2004

Question:

I have a vascular condition in which the superficial veins of the extremities constrict markedly when the temperature falls below 75 degrees and any minor trauma (blood draw, IV etc.) can initiate thrombophlebitis which does not resolve and gradually extends through all the interconnecting vessels. An episode can last for months and is accompanied by severe burning pain of the involved limb and only stops after the blood vessels are obliterated. I was once anticoagulated (when the condition affected my entire arm) and that immediately resolved the problem but doctors have offered me no treatment other than aspirin, ibuprufin, and antiinflammatory drugs since the blood vessels were not deep veins. But these medications had no effect. Coagulation and immunological blood tests have come back negative and it appears that poor blood flow through the constricted vessels is a major factor. Is there any recommendation other than moving to a warm climate since the problem has also occurred in an air conditioned environment.

Answer:

Have you tried using compression stockings (knee high 20-30 mmHg)? You are describing superficial thrombophlebitis which is an infection and clotting of superficial veins. No anticoagulation is necessary unless the deeper veins become involved with clot. If you have normal pulses in your feet, I would suggest using compression stockings.

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Response by:

Amy B Reed, MD Amy B Reed, MD
No longer associated