Treatment Of Acute Thrombophlebitis Research Articles

Efficacy and tolerance of systemic enzyme therapy in the treatment of acute thrombophlebitis–a randomised double-blind controlled trial

Objective: Investigation of efficacy and safety of systemic enzyme treatment (SET)-the oral administration of proteolytic enzymes (trypsin, bromelain) plus antioxidants (rutoside)-in acute thrombophlebitis. Subjects and Methods: In this double-blind study, 100 patients with acute thrombophlebitis were randomised 1:1, and treated with either SET or placebo for 14 days. Analgesic drugs were allowed; compression treatment was not allowed. Primary endpoint was reduction in resting pain within 7 days. Further endpoints were reduction in pain and thrombophlebitis symptoms on days 4, 7 and 14 as well as safety. Results: Within 7 days of treatment, resting pain was reduced significantly better with SET than placebo (64% vs. 29%, p <0.0001), meeting the primary endpoint. In the course of treatment, most symptoms improved in both the SET and the placebo group. However, reduction in resting pain and pain under pressure occurred faster and was significantly greater in the SET group compared to placebo on days 4, 7 and 14. The leading symptoms of acute thrombophlebitis (redness of the skin, hyperthermia, phlebitis cords, feeling of heaviness and tenseness) were all relieved significantly better with SET. The risk profile of SET was favourable, with only mild to moderate adverse events (AEs) and fewer AEs detected in the SET than the placebo group, where the majority of AEs were attributed to analgesic drugs. Use of SET may thus avoid analgesic-associated AEs. Conclusion: SET is shown to be a safe and effective option to treat acute thrombophlebitis in the absence of compression treatment.

DEXTRAN THERAPY IN THROMBOPHLEBITIS.

The value of dextran has increased far beyond that of a volume expander. Low-molecularweight fractions (average molecular weight [mol wt] 40,000) have the ability to disrupt red cell agglutination and in some states to improve blood flow 1 ; this has proved useful in ischemic and low flow situations. 2 Clinical Dextran (average mol wt 75,000) has been found useful in preventing experimental arterial and venous thrombosis. 3,4 These properties suggest that dextran would be useful in the treatment of acute thrombophlebitis. Sodium heparin is presently accepted by clinicians as the optimum therapy for nonembolic thrombophlebitis. However, there are multiple problems associated with its administration, and proof that its administration causes more than symptomatic relief is lacking. To be properly used, heparin should be given intravenously, frequently, and with careful laboratory control. This is expensive and laborious, and still does not eliminate the danger of secondary hemorrhage. One aim of anticoagulation

Surgical treatment of the postphlebitic syndrome

We find that treatment of acute thrombophlebitis has changed radically in the last decade. It is hoped that more adequate therapy based on better understanding of these pathophysiologic changes will reduce the number of patients suffering from a postphlebitic syndrome. Present day treatment of the postphlebitic syndrome, once it has become chronic and disabling, is encouraging both to the patient and to the physician.