Collapsed veins are a common injury that results from repeated use of
intravenous injection
Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutri ...
s. They are particularly common where injecting conditions are less than ideal, such as in the context of
drug abuse
Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, ...
.
Causes
Permanent vein collapse occurs as a consequence of:
* Repeated injections, especially with blunt needles.
* Poor injection technique.
* Injection of substances which irritate the veins; in particular, injection of liquid
methadone
Methadone, sold under the brand names Dolophine and Methadose among others, is a synthetic opioid agonist used for chronic pain and also for opioid dependence. It is used to treat chronic pain, and it is also used to treat addiction to heroin ...
intended for oral use.
Smaller veins may collapse as a consequence of too much suction being used when pulling back against the plunger of the
syringe
A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...
to check that the needle is in the vein. This will pull the sides of the vein together and, especially if they are inflamed, they may stick together causing the vein to block. Removing the needle too quickly after injecting can have a similar effect.
Mechanism
Vein
Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated b ...
s may become temporarily blocked if the internal lining of the vein swells in response to repeated injury or irritation. This may be caused by the
needle, the
substance
Substance may refer to:
* Matter, anything that has mass and takes up space
Chemistry
* Chemical substance, a material with a definite chemical composition
* Drug substance
** Substance abuse, drug-related healthcare and social policy diagnosis ...
injected, or donating plasma.
Individual endothelial cells may change the structure of their
cytoskeleton
The cytoskeleton is a complex, dynamic network of interlinking protein filaments present in the cytoplasm of all cells, including those of bacteria and archaea. In eukaryotes, it extends from the cell nucleus to the cell membrane and is compos ...
when a vein collapses to better deal with the increased
shear stress
Shear stress, often denoted by (Greek: tau), is the component of stress coplanar with a material cross section. It arises from the shear force, the component of force vector parallel to the material cross section. ''Normal stress'', on the ot ...
.
Prognosis
Once endothelial swelling subsides,
circulation will often become re-established. Collapsed veins may never recover. Many smaller veins are created by the body to circulate the blood, but they are not adequate for injections or IVs.
See also
*
Phlebitis
Phlebitis (or Venitis) is inflammation of a vein, usually in the legs. It most commonly occurs in superficial veins. Phlebitis often occurs in conjunction with thrombosis and is then called thrombophlebitis or superficial thrombophlebitis. Unlike ...
References
Vascular diseases
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