DEEP VEIN THROMBOSIS OF THE LEGS CAUSES AND TREATMENT

 

Normally, the appearance of blood clots is an important mechanism of the body's response to vascular damage. At the site of a vein or artery injury, blood clots to form a clot that blocks blood flow and stops blood loss. The giandliverconsultants provide the best gastrointestinal consultants in USA. However, due to a number of diseases, the mechanism of thrombosis can be started without bleeding. Then blood clots can come off and block the lumen of large vessels. 

WHAT IS THE DIFFERENCE BETWEEN THROMBOSIS AND THROMBOPHLEBITIS?

Thrombi can occur due to impaired blood clotting, damage to the walls of blood vessels or due to inflammation in the walls of the vein. In such cases, the disease is called thrombophlebitis, it is more characteristic of superficial veins. Varicose veins, affecting primarily the subcutaneous veins, leads to stretching and inflammation of the venous walls, against which thrombosis begins.

Deep vein thrombosis is a more serious condition than thrombophlebitis. It affects the veins located deep in the tissues, most often the veins of the lower leg or thigh. Deep vein thrombosis of the legs is more dangerous, as blood clots are significant. Because of this, they are able to block the lumen of large arteries, including the pulmonary.

CAUSES OF THROMBOSIS

·         Deep vein thrombosis (DVT) can develop due to a variety of factors, including:

·         age - patients older than 60 years are more at risk of venous thrombus formation;

·         cancers - first of all, malignant tumors of the intestine and pancreas;

·         smoking, including passive;

·         pathologies for which there is increased blood clotting;

·         taking certain hormonal drugs (estrogen, oral contraceptives);

·         insufficient motor activity;

·         limb injuries;

·         overweight;

·         pregnancy and childbirth;

·         postponed surgery.

SYMPTOMS OF DEEP VEIN THROMBOSIS

Signs of deep vein thrombosis are nonspecific - they can not be unequivocally stated that the disease is provoked by the formation of a blood clot. Most often patients complain of:

·         soreness along the veins;

·         mild dull pain in the extremities;

·         swelling of the whole leg - the circumference of the patient's leg may be greater than the healthy, 3 centimeters or more;

redness of the skin

The intensity and frequency of these symptoms can vary from person to person.

Unpleasant sensations in the calf muscles when flexing the ankle joint when the knee is unbent can also be disturbing. In some cases, due to deep vein thrombosis, the body temperature rises to subfebrile (37 ° - 37.9 ° C).

WHAT ARE THE POSSIBLE COMPLICATIONS OF THROMBOSIS?

Deep vein thrombosis of the lower extremities is dangerous because the blood clots can come off and move through the circulatory system, carrying the risk of blockage of any of the vessels. Pulmonary artery occlusion is called pulmonary embolism (PE). In the absence of adequate treatment for deep vein thrombosis of the legs, approximately 3 patients out of 100 die from pulmonary embolism.

Chronic venous insufficiency and postphlebitic syndrome can be dangerous consequences of ignored DVT. Occasionally, the disease can even lead to venous gangrene of the extremities. Thrombus infection is also a rare but possible complication.

Deep vein thrombosis can also recur. The giandliverconsultants provide the best liver consultants in USA. This probability is high in patients whose risk factors are constant, for example, in malignant tumors. In patients whose risk factors are temporary (temporary limitation of motor activity, trauma, surgery), the risk of recurrence of DVT is low.

DIAGNOSIS OF VENOUS THROMBOSIS

Although the doctor is able to predict the likelihood of deep vein thrombosis based on the results of the patient's examination, the basis for the diagnosis of deep vein thrombosis, as well as other phlebological diseases, is ultrasound of the veins. It may be called Doppler or duplex vascular scanning.

With the help of ultrasound, the doctor visualizes the vein and assesses the nature of blood flow through it. In cases of such common pathologies as thrombosis of the femoral or popliteal vein, the sensitivity of ultrasound of the veins is more than 90%. With thrombosis of the tibial or iliac vein, the sensitivity of the method is slightly lower.

Among the methods of laboratory diagnosis are often used blood tests for D-dimer, the product of the breakdown of fibrin protein - the basis of blood clots. Its presence in the blood is evidence that a blood clot has recently been present in the bloodstream.

X-ray diagnostic method - phlebography can also be used. To do this, a contrast agent is injected into the circulatory system. It is used, as a rule, in those cases when ultrasound of veins could not locate a thrombus. Limited use of the method is associated with its invasiveness, accompanied by radiation exposure and the risk of allergic reactions to contrast. Ultrasound is non-invasive, safe and comfortable for the patient.

TREATMENT OF VENOUS THROMBOSIS

Drug treatment is the appointment of anticoagulants that prevent blood clots. The disadvantage of coagulants is the increased risk of bleeding. To eliminate already formed blood clots, thrombolytic drugs are prescribed, which dissolve blood clots, but the risk of bleeding is also high.

The duration of treatment for some patients may be insignificant - from three to six months. Some have to take medication for life.

One of the options for surgical treatment is a coffee filter, which is installed in the inferior vena cava and intercepts blood clots. The filter can be permanent or temporary, which is removed a few months later.

PREVENTION OF DEEP VEIN THROMBOSIS

Prevention of blood clots is needed primarily by patients bedridden due to major surgery or serious illness. Prevention is prescribed after the doctor assesses the risk of deep vein thrombosis and the general condition of the patient.

The development of thrombosis can be prevented by shortening the period of immobility of the patient. In addition, anticoagulants may be prescribed. Some patients are shown intermittent pneumatic compression, in which the legs are periodically compressed by special gaiters connected to the pump.

Also, patients, if possible, are advised to adjust their lifestyle in the direction of increased mobility and weight loss (for example, through diet).

PATIENT PROGNOSIS

The prognosis is favorable provided that the disease is detected in time, and adequate therapy is started immediately.