Thrombosis | Johns Hopkins Medicine

What is thrombosis?

Thrombosis occurs when blood clots block your blood vessels. There are 2 main types of thrombosis:

• Venous thrombosis is when the blood clot blocks a vein. Veins carry blood from the body back into the heart.
• Arterial thrombosis is when the blood clot blocks an artery. Arteries carry oxygen-rich blood away from the heart to the body.

What causes thrombosis?

Venous thrombosismay be caused by:

• Disease or injury to the leg veins
• Not being able to move around (immobility) for any reason
• A broken bone (fracture)
• Certain medicines
• Obesity
• Inherited disorders, or a greater likelihood of having a certain disorder based on your genes
• Autoimmune disorders that make it more likely your blood will clot
• Medicines that increase your risk of clotting (such as certain birth control medicines)

Arterial thrombosismay be caused by a hardening of the arteries, called arteriosclerosis. This happens when fatty or calcium deposits cause artery walls to thicken. This can lead to a buildup of fatty material (called plaque) in the artery walls. This plaque can suddenly burst (rupture), followed by a blood clot.

Arterial thrombosis can occur in the arteries that supply blood to the heart muscle (coronary arteries). This can lead to a heart attack. When arterial thrombosis occurs in a blood vessel in the brain, it can lead to a stroke.

What are the risk factors for thrombosis?

Many of the risk factors for venous and arterial thrombosis are the same.

Risk factors for venous thrombosis may include:

• A family history of a blood clot in a vein deep in the body, called a deep vein thrombosis (DVT)
• A history of DVT
• Hormone therapy or birth control pills
• Pregnancy
• Injury to a vein, such as from surgery, a broken bone, or other trauma
• Lack of movement, such as after surgery or on a long trip
• Inherited blood clotting disorders
• A central venous catheter
• Older age
• Smoking
• Being overweight or obese
• Some health conditions, such as cancer, heart disease, lung disease, or Crohn’s disease

Risk factors for arterial thrombosis may include:

• Smoking
• Diabetes
• High blood pressure
• High cholesterol
• Lack of activity and obesity
• Poor diet
• Family history of arterial thrombosis 
• Lack of movement, such as after surgery or on a long trip
• Older age

What are the symptoms of thrombosis?

Each person’s symptoms may vary. Symptoms may include:

• Pain in one leg (usually the calf or inner thigh)
• Swelling in the leg or arm
• Chest pain
• Numbness or weakness on one side of the body
• Sudden change in your mental state

The symptoms of thrombosis may look like other blood disorders or health problems. Always see your healthcare provider for a diagnosis.

How is thrombosis diagnosed?

Your healthcare provider will take your medical history and give you a physical exam. Other tests may include:

• Ultrasound. This test uses sound waves to check the blood flow in your arteries and veins.
• Blood tests. These may include tests to see how well your blood can clot.
• Venography. For this test, a dye is injected into your veins. Then X-rays are taken to show blood flow and look for clots. The dye makes your veins easier to see on the X-rays.
• MRI, MRA or CT.  The imaging procedure that is used will depend on the type of blood clot you have and where it is located.

How is thrombosis treated?

Your healthcare provider will create a treatment plan for you based on:

• Your age, overall health, and medical history
• How sick you are
• How well you handle certain medicines, treatments, or therapies
• If your condition is expected to get worse
• What you would like to do

Treatment may include:

• Blood-thinning medicines (anticoagulants)
• Thin tubes (catheters) to widen the affected vessels
• A wire mesh tube (stent) that holds a blood vessel open and stops it from closing
• Medicines to interfere with or dissolve blood clots

Your healthcare provider may advise other treatments.

What are the complications of thrombosis?

Thrombosis can block the blood flow in both veins and arteries. Complications depend on where the thrombosis is located. The most serious problems include stroke, heart attack, and serious breathing problems.

Can thrombosis be prevented?

You can reduce your risk of thrombosis by:

• Being active
• Getting back to activity as soon as possible after surgery
• Exercising your legs during long trips
• Quitting smoking
• Losing weight
• Managing other health problems such as diabetes, high blood pressure, and high cholesterol

Key points

• Thrombosis occurs when blood clots block veins or arteries.
• Symptoms include pain and swelling in one leg, chest pain, or numbness on one side of the body.
• Complications of thrombosis can be life-threatening, such as a stroke or heart attack.
• Treatment includes medicines that thin the blood or prevent clots, and using stents or catheters to open blocked vessels.
• Prevention includes being active, quitting smoking, losing weight, and managing other health conditions.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Leg pain can signal deadly blood clot

Far too many Americans are dying of dangerous blood clots that can masquerade as simple leg pain, says a major new government effort to get both patients and their doctors to recognize the emergency in time.

“It’s a silent killer. It’s hard to diagnose,” said acting Surgeon General Dr. Steven Galson, who announced the new campaign Monday. “I don’t think most people understand that this is a serious medical problem or what can be done to prevent it.”

At issue are clots with cumbersome names: A deep vein thrombosis, or DVT, forms in large veins, usually a leg or the groin. It can quickly kill if it moves up to the lungs, where it goes by the name pulmonary embolism, or PE.

These clots make headlines every few years when seemingly healthy people collapse after long airplane flights or being in similarly cramped quarters. Vice President Cheney suffered one after a long trip last year. NBC correspondent David Bloom died of one in 2003 after spending days inside a tank while covering the invasion of Iraq.

Risk rises with age

But that provides a skewed vision of the problem. While there aren’t good statistics, the new surgeon general’s campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots — and at least 100,000 of them die.

There are a host of risk factors and triggers: Recent surgery or a broken bone; a fall or car crash; pregnancy or taking birth control pills or menopause hormones; being immobile for long periods. The risk rises with age, especially over 65, and among people who smoke or are obese.

And some people have genetic conditions that cause no other symptoms but increase their risk, making it vital to tell your doctor if a relative has ever suffered a blood clot.

People with those factors should have “a very low threshold” for calling a doctor or even going to the emergency room if they have symptoms of a clot, said Galson, who issued a “call to action” for better education of both consumers and doctors, plus more research.

Symptoms include swelling; pain, especially in the calf; or a warm spot or red or discolored skin on the leg; shortness of breath or pain when breathing deeply.

But here’s the rub: Doctors are ill-informed, too. For example, studies suggest a third of patients who need protective blood thinners when they enter the hospital for major surgery don’t get them. And patients can even be turned away despite telltale symptoms, like happened to Le Keisha Ruffin just weeks after the birth of her daughter, Caitlyn.

Ruffin made repeated visits to doctors and emergency rooms for growing pain in her leg and groin in December 2003 and January 2004, but was told it must be her healing Caesarean section scar.

Finally one night, Ruffin’s husband ran her a really hot bath for pain relief — only to have her climb out minutes later with her leg swollen three to four times its normal size, and then pass out.

“I like to call that my miracle bath,” Ruffin said, because the sudden swelling proved the tip-off for doctors.

Pieces of a giant clot in her right leg had broken off and floated to her lung. The ER doctor “said if I hadn’t made it in when I did, I may not have lived through the rest of the night,” recalled Ruffin, now 32, who spent a month in the hospital and required extensive physical therapy to walk normally again.

National spotlight

These clots “tend to fall through the cracks” because they cross so many areas of medicine, said Dr. Samuel Goldhaber, chairman of the Venous Disease Coalition and a cardiologist at Boston’s Brigham & Women’s Hospital.

With the surgeon general’s campaign, “DVT after all these years will finally get the national spotlight like cigarette smoking did in the mid-60s,” he said.

In addition to Galson’s report:

• The Agency for Healthcare Research and Quality is issuing a 12-page booklet to help consumers tell if they’re at risk for DVTs and what to do — and a 60-page DVT treatment-and-prevention guide for doctors and hospitals.
• As a prevention incentive, starting Oct. 1 Medicare will withhold payment from hospitals when patients develop the clots after knee-or hip-replacement surgery.

DVT or Blood Clots – Savannah Vascular Institute

DEEP VEIN THROMBOSIS: WHAT YOU SHOULD KNOW ABOUT BLOOD CLOTS

WHAT IS A DVT AND WHY IS IT DANGEROUS?

Deep Vein Thrombosis (DVT) refers to blood clots that form in the deep veins of your body, most commonly in your legs. The deep veins are the ones that you cannot see on your body surface. When a blood clot (termed thrombus within the body) forms suddenly in a deep vein and stops the flow of blood towards the heart, the vein becomes bigger and can no longer effectively drain the affected leg of venous blood. The clot in the deep vein in essence causes a roadblock and causes the venous traffic to back up and find alternate routes (usually through the superficial veins) to get back to the heart. If large enough, the obstruction and lack of proper venous emptying of the leg thus causes symptoms such as pain, tenderness, and swelling.

Venous Thromboembolism (VTE) refers to the fact that blood clots in the deep veins formed in one part of the body are prone to break off and travel to the heart and lungs causing potentially lethal results. When the blood clot travels to the lungs, it is called a pulmonary embolus (PE). Thus DVT and PE are different manifestations of VTE. Normally, the right side of the heart (right ventricle) pumps blood via the pulmonary arteries to the lungs. The lungs in turn oxygenate the blood and return it to the left side of the heart (left ventricle), the main pumping chamber that ejects the blood throughout your body. If you are unlucky enough to sustain a massive PE, a so called “saddle embolus”, the blood clot lodges in the main pulmonary artery. When this happens the right side of the heart essentially tries to pump against a door that has been “slammed shut” and cannot either eject blood or refill. The lungs in turn do not get new blood to oxygenate and send back to the left side of the heart. This leads to cardiopulmonary collapse and sudden death. Symptoms of a pulmonary embolus, when present, include sudden shortness of breath and chest pain, or shock. The beguiling problem lies in the fact that most DVT’s do not cause symptoms. However, when they do, the first presentation can be sudden death from a large pulmonary embolus.
Pic: massive PE on its way.

SCOPE OF THE PROBLEM:

Deep venous thrombosis is the most common preventable cause of hospital death. It occurs in of medical and surgical patients. However, it is more common in medical than in surgical patients and in fact approximately 75% of all hospital deaths from PE occur in non-surgical patients. Of over 10 million medical and surgical patients at risk for DVT/VTE per year at U.S. hospitals, approximately 1 million will be diagnosed with DVT/PE. In 2002 alone, there were an estimated 296,000 deaths from PE. Of these, fully one-third were sudden and fatal. Others have estimated that death occurs in approximately 6% of those with DVT and 12% of those with PE within one month of diagnosis. Equally ominous, is the fact that the majority of symptomatic VTE occur after hospital discharge. We commonly associate the period of highest risk with being in the hospital and this is likely the case. Once home however, there exists a period of time that one is still at risk of DVT /PE while one is on the way to recovery. Thus in some patients, prophylaxis for DVT/PE is maintained for a period of time even after hospital discharge.

WHAT ARE THE CAUSES OF DVT?

There are many known risk factors for DVT. Some are inherited and cannot be changed while others are acquired and may be transient or permanent. The most common risk factors in hospitalized patients include those with a prior history of DVT/PE, cancer, the elderly, trauma patients, and those who are immobile or who have had recent surgery. Indwelling intravenous lines are now also gaining more attention as iatrogenic causes of DVT and PE. With respect to age, it is estimated that one’s risk of DVT/PE around age 40 is 1 per 10,000 persons annually while at 80 years old it is 5-6 per 1000 annually. This equates to a 50-fold higher risk from age 40 to age 80. Other risk factors include inherited blood clotting disorders, obesity, smoking, congestive heart failure, severe respiratory disease, hormone replacement (estrogen), pregnancy and the post-partum period. As stated before, varicose veins are also associated with an increased risk of DVT/PE.

Deep venous thrombosis, however, is not just is a problem for hospitalized patients. Clearly, the untimely death of CNN news correspondent David Bloom from a PE in 2003 highlighted this fact. Vice-President Dick Cheney and former Vice-President Dan Quayle also developed DVT’s thought to be related to travel. Risk factors such as prolonged immobilization and travel play a large part in those who develop DVT/PE outside a hospital setting. It is thought that the duration of travel plays the most important part. In one study, travel of more than 4 hours doubled the risk of DVT/PE. More importantly, this period of increased risk persisted for weeks after the journey. In others, a DVT or PE may present without any known risk factors (termed idiopathic) and studies must be undertaken to determine the root cause.

HOW DO I KNOW IF I HAVE A DVT OR PE?

Many DVT’s and PE’s are asymptomatic. If one is known to have the risk factors mentioned and develops asymmetrical arm or leg swelling, an ultrasound of the affected extremity can diagnose whether or not a DVT is present. There is also a blood test that can help establish the absence of a DVT to an accurate degree if one is not a hospitalized patient. A pulmonary embolus can be detected by a CAT scan with the help of intravenous dye. About one-third of people who have a DVT will also have a PE. Clearly, the more dangerous situation is a first presentation as a PE rather than a DVT. However, because both DVT and PE can be asymptomatic, a high index of suspicion must be present to detect them.

Catheter-Directed Thrombolytic Therapy

WHAT IS THE TREATMENT FOR DVT/PE?

Whether for DVT or PE, the treatment is the same: anticoagulation (blood thinners). It is the duration of treatment that differs. Generally, blood thinners such as heparin and LMWH (low molecular weight heparin, for example Lovenox), help to keep the clot from becoming larger while over time your body breaks down the blood clot. The blood thinners are started as intravenous infusions or shots under the skin and then one is transitioned to oral blood thinners, the most common being coumadin. If for any reason a patient who has or is at risk for DVT cannot be placed on blood thinners, then something called an IVC (inferior vena cava) filter can be placed. This is an umbrella like device that is placed into the inferior vena cava and is positioned between the clot in ones legs and the lungs. The idea is that if any large clot breaks off from the legs and is travelling towards the lungs, is would be trapped by the filter. (see pic). Some people develop an extensive blood clot that could potentially lead to a loss of an extremity. This is termed an iliofemoral deep venous thrombosis with phlegmasia. In this instance, true “clot busting” medications are used in concert with a minimally invasive technique called catheter-directed thrombolysis (CDT). The clot busting medicines called lytic agents are placed directly into the clot with catheters that then act to immediately break down the clot. (DVT 2) Note the distinction made between blood thinners versus lytic or clot busting drugs. If abnormal lesions are seen within the vein at the time, catheter based techniques such as angioplasty and stenting may also be used. The trade-off with lytic therapy is that serious bleeding can be a side-effect in a minority of cases. This is the reason that most DVT’s are treated with anticoagulant drugs (blood thinners) and not clot busting drugs. The treatment for PE is the same unless a patient is in a state of shock. In this instance, systemic lytic therapy is advocated or under extreme circumstances, emergency surgery (a pulmonary embolectomy) may be performed to remove the clot. Thus vascular specialists have at their disposal a variety of minimally invasive techniques that that are used in conjunction with clot busting medications to treat this condition.

IF I HAVE A DVT HOW LONG DO I NEED TO BE ON BLOOD THINNERS?

The answer is: it depends. For someone who has what is called a transient reversible risk factor, for example, a traveler who develops a DVT with no others risk factors, current guidelines recommend LMWH for a minimum of 5 days together with oral blood thinners for a period of three months. At the other extreme are persons with known active cancers who develop DVT/PE. As long as their cancers are active, they would remain on anticoagulant therapy indefinitely. Lastly, if someone is at risk of DVT but has not yet developed a DVT, a reduced dose of anticoagulant medicine, usually one shot per day of Lovenox, is given. This has been shown to substantially decrease the risk of getting a DVT. Hospitalized patients are usually placed on this regimen prophylactically unless there exist reasons to the contrary.

Another potential long-term consequence of DVT that needs to be mentioned is Post-Thrombotic Syndrome (PTS). As mentioned earlier when a blood clot develops in a vein, over time the body dissolves this clot. Sometimes the process can damage the valves of the vein or the vein itself. Blood then flows backwards in the veins towards the feet again and causes pain, engorgement, and swelling. This is known as venous reflux. If the reflux goes on for some time, the venous pressure in the legs increases and when sufficient damage has been done, the skin starts to become discolored and can break down. In extreme cases, reflux and venous hypertension cause venous ulcers which can be a significant cause of disability and pain. These are all manifestations of the post-thrombotic syndrome which occur in 20-50% of patients within 1-2 years of a DVT. To decrease the incidence of PTS, the wearing of graduated compression stockings is recommended for a period of at least two years.

TAKE HOME MESSAGE

DVT and PE are dangerous manifestations of venous disease and remain the most preventable cause of hospital deaths. They also occur outside the confines of a hospital and may not cause symptoms until too late. Awareness of their risk factors and symptoms is paramount if diagnosis and treatment are to be rendered in a timely manner. Effective treatment is available and vascular specialists have the requisite expertise and tools to provide comprehensive care in the management of this disease entity.

A Patient’s Guide to Recovery After Deep Vein Thrombosis or Pulmonary Embolism

When a blood clot forms in the deep veins of the body, it is called deep vein thrombosis (DVT). DVT occurs most commonly in the leg; however, it can occur anywhere in the body, such as the veins in the arm, abdomen, pelvis, and around the brain. A complication of DVT in legs and arms is pulmonary embolism (PE). A PE occurs when a blood clot breaks off from a DVT and travels through the blood stream, traversing the right atrium and right ventricle, and lodging in the lung.

How Long Will I Need Treatment With an Anticoagulant?

The primary treatment for DVT and PE is anticoagulation with blood thinners. These medications increase the time it takes for blood to clot. They prevent new clots from forming and existing clots from growing larger. Anticoagulants do not dissolve a clot. The body naturally dissolves a clot over time, sometimes completely, sometimes only partially.

The duration of time you will need to take an anticoagulant depends on a number of factors your doctor will review with you, such as the following:

• The location of the clot (whether your clot was in the calf only or further up in the leg in the thigh or pelvis)

• Why the clot formed (what risk factors contributed to your clot)

• An assessment of your risk for developing future clots if your anticoagulant is stopped (what risk factors you have which may cause another clot to develop)

• How well you have tolerated the anticoagulant and what your risk for bleeding is if you stay on an anticoagulant.

• Your personal preference and how anticoagulant treatment has impacted your lifestyle.

In general, if the risk of another clot is low, then short-term treatment for 3 months is often sufficient (Figure). This is long enough for the present clot to heal. However, if the risk for developing another clot is high, then treatment for >3 months may be appropriate. This typically means long-term (also referred to as extended) treatment, which can last several years and, in some cases, life-long.

Figure. Length of anticoagulation.

Which Anticoagulant Will I Receive?

Several anticoagulant choices are available to treat DVT and PE. They may be given as an oral tablet or as injection under the skin. Choice of anticoagulant depends on a number of individualized factors, and your doctor will decide with you which one of these medicines is best for you.

The oral anticoagulant warfarin was the mainstay of treatment for nearly 50 years. In recent years, new oral anticoagulants have emerged that also offer effective treatment for DVT and PE (Table).

Table. Comparison of Oral Anticoagulants

	Warfarin (Coumadin, Jantoven)	Apixaban (Eliquis)Dabigatran (Pradaxa)Rivaroxaban (Xarelto) Edoxaban (Savaysa)
Monitoring	Frequent testing (INR) required to determine blood thinning effect	No monitoring to determine blood thinning effect
Dosage	Variable dosing for each patient, with frequent dosing changes sometimes required. Dosing dependent on coagulation test to keep blood thinning affect within desired therapeutic range	Same dose for each patient.
Food interactions	Vitamin K containing foods (such as salads and green vegetables) influence warfarin’s blood thinning effect. Patients on warfarin must carefully monitor what they eat to maintain a consistent vitamin K intake.	No food interactions.
Drug interactions	Many common drugs influence the blood thinning effect of warfarin, such as antibiotics, thus requiring more frequent blood monitoring tests.	Fewer drug interactions.
Time to fully active	Warfarin takes ≥5 days after starting to reach its full blood thinning effect. Therefore, patients who start warfarin need to be treated with an additional blood thinner (typically injections underneath the skin) during those first 5 or more days.	Full blood thinning effect is achieved within 2–3 h. Therefore, there is no need for the initial injections with an additional blood thinner.
Time to being out of system	After being stopped, warfarin takes 5–7 days to clear the body.	Takes 24 to 48 h to clear after being stopped.
Reversal in cases of excessive bleeding	There are proven reversal methods in case of excessive bleeding on warfarin.	There is no antidote or reversal strategy that is guaranteed to work if major bleeding occurs.
Cost	Depends on insurance, but generally lower-cost.	Depends on insurance, but generally more expensive.
Effectiveness in preventing recurrent clots	Same	Same
Safety	Same risk of major bleeding, but higher risk of bleeds into the head	Same risk of major bleeding, but lower risk of bleeds into the head

When Will My Clot and Pain Go Away?

As the body naturally absorbs a clot over the course of several weeks to months, the symptoms which accompanied the blood clot gradually improve and often eventually disappear. Symptoms typically improve within a few days of starting the anticoagulant. Most patients with DVT or PE recover completely within several weeks to months without significant complications or long-term adverse effects.

However, long-term problems can occur, with symptoms ranging from very mild to more severe. Around half of patients with DVT will have some degree of chronic discomfort, and ≈15% will experience moderate to severe chronic swelling and pain known as post-thrombotic syndrome. Post-thrombotic syndrome is partly attributable to damage done when the clot formed and partly to the chronic obstruction from left-over clot (scar tissue).

Graduated compression stockings may make your leg feel better. Graduated compression stockings are made of special elastic and are very tight at the ankle and are less tight as the stocking moves up the leg. This graduated tightness helps the leg muscles squeeze fluid up the leg, which prevents or decreases leg swelling and pain. A prescription from your doctor is needed to get stockings with the recommended tightness (30–40 mm Hg pressure). Stockings should be individually fitted.

Around 2% to 4% of patients with PE will have chronic damage to the lungs known as pulmonary hypertension (chronic thromboembolic pulmonary hypertension), which is characterized by shortness of breath and decreased exercise ability. Pulmonary hypertension can lead to heart failure if untreated. An evaluation for pulmonary hypertension may be done if you had a large PE or if after several months following a PE you have not gotten back to your preclot level of feeling well.

How Soon Can I Be Physically Active?

Many patients worry that being physically active might cause a DVT to break off and become a PE. The risk of clot breaking off and forming a PE is mostly present in the first few days, up to ≈4 weeks, while the clot is still fresh, fragile, and not scarred. However, patients who carry out normal daily activities after a clot are no more likely to develop PE than those who don’t walk around. Thus, being physically active after a clot is generally fine and is typically encouraged.

After a diagnosis of DVT or PE, use common sense and listen to your body. Physically, do only what is comfortable. You will not speed up recovery by pushing yourself aggressively through symptoms of pain and swelling. But you also will not make things worse by being active. You should discuss with your physician whether physical activity is appropriate for you, how much activity is recommended, and how soon you can begin.

Is It Normal to Feel Anxious or Depressed After a Clot?

A diagnosis of DVT or PE brings many things to cope with, both physically and mentally. Immediately after a diagnosis, you may be dealing with physical pain, trying to understand why the clot happened, and adjusting to the lifestyle impact of taking an anticoagulant. It is normal to feel shock, anxiety, and fear after the diagnosis of a blood clot.

Temporary feelings of anxiety or depressed mood can occur in the first few weeks, but the fear of a future clot recurrence can produce ongoing anxiety. Ask your doctor about support groups that may be available. Tell your doctor if your feelings do not improve or are accompanied by a withdrawal from activities or increased negative thoughts and tearfulness, because these may indicate a more severe depression requiring treatment.

What Kind of Doctor Do I Need?

Not everybody with DVT or PE needs the same type of doctor. If you take warfarin, the ideal combination may be to have (1) a health care professional (most likely a pharmacist or a nurse) in a formal anticoagulation clinic (to manage your blood thinning medication) and (2) a physician with special expertise in blood clots (thrombosis). If you take 1 of the newer oral anticoagulants, you may not need to be followed in an anticoagulation clinic. Discuss with your doctor where you should be referred for anticoagulation management.

Multiple types of physicians may have a special expertise and interest in DVT, PE, anticoagulation, and clotting disorders, including hematologists, cardiologists, pulmonologists, vascular surgeons, vascular medicine specialists, and general internists. Many primary care physicians also follow patients with DVT or PE. Specialized Thrombosis Clinics may also go by the name of Heart and Vascular Clinic or something similar. Patients and their primary care physicians should decide together what specialty care is needed.

Where to Get More Information

Resources for patients diagnosed with DVT or PE can be found online at the following:

www.ClotConnect.org a resource provided by the University of North Carolina at Chapel Hill

www.NATFonline.org a resource provided by the North American Thrombosis Forum

www.StopTheClot.org a resource provided by the National Blood Clot Alliance

Disclosures

Dr Moll has been a consultant for Daiichi-Sankyo, Janssen, and Boehringer Ingelheim. B. Waldron reports no conflicts.

Deep Vein Thrombosis—The Blood Clot That Can Kill

According to the National Blood Clot Alliance, 274 people will die every day from the consequences of a blood clot. Neither age nor gender offer protection:  you can develop a clot just as easily at 25 years of age as 85 years of age. Most are the result of a traumatic injury, a surgical complication or due to taking hormone replacement therapy. Some birth control medications also present an increased risk of blood clots in susceptible patients.

A thrombosis is a blood clot that blocks the normal flow of blood through an artery or vein. A deep vein thrombosis (DVT) occurs in the deeper veins-for example in the lower leg or calf. However, thromboses can occur anywhere in the body including the upper limbs (arms). The latter are much less frequent:  10% of all DVTs are found in the upper limb and usually result from the use of catheters; surgery or trauma to the neck or shoulder.

Even sitting for long periods of time at work or at home in front of the computer can cause a DVT. Long plane flights, particularly if you have taken a sedative or sleeping pill and don’t move during the flight, pose a real risk for deep vein thrombosis. You should be certain to get up out of a seat, either in front of your computer or on an airplane, at least every two hours. If you must work at home, consider placing your printer across the room from your computer so that you have to get up to retrieve printed material.   Doctor Legato has deliberately chosen not to keep her printer nearby for that very reason.

The risks from DVTs vary and can include tissue necrosis (tissue death), swelling and pain. The most important risk occurs when part of the clot breaks off and travels to the lung or brain. The resulting damage is always significant and may lead to sudden death.

Symptoms of a DVT in the leg include swelling and cramping pain or soreness in the calf muscles.  The skin over the area can become reddened or warm to the touch because of the underlying inflammation.

DVTs can also occur without warning and without noticeable symptoms. Sometimes they resolve on their own. However, if you develop signs or symptoms of deep vein thrombosis, contact your doctor, who will order an ultrasound examination of the area and prescribe blood thinners.  If you think you might have a problem, do not delay; see your physician at once or go to an emergency room for examination.

The warning signs and symptoms of a pulmonary embolism (or clot to the lung) include:

• Shortness of breath that is sudden and unaccountable
• Chest pain or discomfort that visibly worsens when you inhale deeply or when you cough
• Feeling lightheaded and/or dizzy, or fainting
• Fast heartbeat or rapid pulse
• Coughing up blood

Finally, there are some preventative measures if you feel you are at risk. Doctor Legato advises patients who are immobile or who travel frequently to try and exercise on a regular basis and avoid sitting still for long periods of time. It’s also important to avoid crossing your legs, which can block blood flow. She suggests that “If you’re traveling by car, stop every 45 minutes to an hour and walk around. If you’re on a plane, stand, stretch and walk up and down the aisle. If you can’t do that, exercise your lower legs by raising and lowering your heels while keeping your toes on the floor, then raising your toes while your heels are on the floor. You can also rotate your feet in a circular motion. All of these movements can keep your blood circulating.”

DVTs are more common than we realize but don’t have to be deadly, if we pay attention to our bodies and take preventative measures whenever possible.

Strategic Communications Professional/Content Strategist/Marketing Communications Consultant

Damage to the vessels of the legs

Damage to the vessels of the legs (lower extremities)

These are the femoral, tibial arteries. Diseases such as chronic ischemia (oxygen and trophic starvation) of the lower extremities are associated with them.

Ischemia often develops gradually. At the beginning, pains appear in the calf muscles when walking a certain distance, over time, the intervals of painless walking are shortened, the patient is forced to stop and wait out the pain, then he continues to move (therefore this condition is called “ intermittent claudication “).

Legs, especially feet, begin to freeze, become cold, suffering intensifies in the autumn-winter period.

In advanced stages of the disease, pain appears at rest – the legs hurt constantly, even when sitting and lying down, deprived of sleep, ulcers and necrosis (black skin) appear on the fingers, feet, legs.

The end of the disease – ischemic gangrene of the limb , resulting in the death of the patient in case of refusal to amputate.With the timely start of treatment, the limb, as a rule, can be saved.

Diseases of the veins of the lower extremities – primarily varicose veins and deep vein phlebothrombosis.

Varicose veins are a very insidious disease – there are several reasons for this:

– firstly, this pathology is usually classified as not difficult and not urgent,

– secondly, people suffer from varicose veins of the lower extremities from a young age and tend to view this problem more as a cosmetic defect.

Unfortunately, this is far from the case. Varicose expansion, with its complications, leads to one of the most severe health conditions – pulmonary embolism (PE) – with a massive nature, the process leads to sudden or rapid death of the patient, regardless of age. Trophic ulcers are also a frequent consequence of varicose veins and require much more effort in treatment than early, uncomplicated forms. Phlebothrombosis is not always associated with varicose veins, it is a consequence of many pathological processes in the human body and always requires a complex diagnostic search.A direct complication of phlebothrombosis is also pulmonary embolism .

90,000 Thrombus – causes, signs, prevention.

Thrombus – causes, symptoms, prevention.

Blood is not just a liquid that moves through blood vessels. It is a very complex organ in the human body. She is susceptible to many diseases and the appearance of various formations. A thrombus is a blood clot in the lumen of a vessel or heart cavity.Attached to the wall of the vessel, it not only interferes with blood flow, leading to ischemia (decreased blood supply) in the area of ​​appearance. Breaking off and moving with the bloodstream, a blood clot can cause a sudden blockage of a vessel located at a considerable distance from the site of formation.

There are the following types of blood clots:

– Blood clots in the arteries. Formed from fatty and cholesterol tissues, over time an atherosclerotic plaque forms around them: a neoplasm grows and thickens on the artery wall against the background of cholesterol.

-Venous vessels are susceptible to phlebothrombosis. This is the formation of a clot at the site of injury or damage within the vessel.

The main causes of blood clots include the following:

– slow blood circulation in the circulatory system;

– excessively increased blood clotting;

– stagnant blood due to prolonged immobility of a person;

– complication after surgery;

– high cholesterol level;

– overweight, diabetes, sedentary lifestyle;

– smoking.

Blood clots vary in size and location. Main types :

– A blood clot that forms on the wall of a vessel and does not block the blood flow is called parietal.

-A formation that completely blocked the vessel and the blood flow stopped is called occlusive.

– A thrombus, which is a blood clot and is easily detached from the vessel wall, is called a floating thrombus. This clot is most commonly found in the lungs.

– A blood clot that moves through the circulatory system is called a vagus. This formation is also called an embolus.

A blood clot can be recognized if it interferes with the blood supply, symptoms of thrombosis appear :

1. Deep vein thrombosis of the lower leg: distension, pain, it becomes stronger when palpating in the area of ​​the affected vessel, swelling, redness or bluish color of the skin, an increase in its temperature, pronounced venous network, congested veins.
2. Pulmonary artery thrombosis: sudden onset of shortness of breath, blue skin with a gray tint, drop in pressure, chest pain, heart rhythm disturbance, swelling of the neck veins, fainting, cough, wheezing, pinkish sputum, fever, pain in the right hypochondrium …
3. Thrombosis of the coronary arteries of the heart: pain behind the sternum, radiating to the back, neck, occurs during stress physical exertion, accompanied by shortness of breath, palpitations.
4. Thrombosis of the arterial network of the legs: chilliness, numbness of the feet, burning sensation, pain when walking, which stops when stopping, the skin becomes pale, and then the fingers turn blue.
5. Cerebral artery thrombosis: dizziness, unsteadiness, various visual impairments, blurred speech, decreased muscle strength and sensitivity in the arm and leg, loss of memory.

Signs of ruptured vessel clogging :

-If this occurs in the vessels of the brain, then a stroke occurs. Signs of a stroke: speech impairment, paralysis of the face (usually the left or right half), dizziness, paralysis of various parts of the body.

-If a blood clot clogs the jugular vein passing in the neck, then dizziness, severe headache, and visual impairment are possible.

– When a mass clogs a coronary artery, a heart attack occurs. This is expressed by a sharp pain in the region of the heart. The pain can be constricting, pressing. Sometimes it gives to the neck or arm, sometimes to the stomach or lower jaw.

– Necrosis, peritonitis, severe pain in the intestines are signs of mesenteric thrombosis.

-If a blood clot clogs the vessels of the upper or lower extremities, then the result is pain, discoloration of the extremity, its temperature.Since a person is not able to endure pain in a bloodless limb for a long time, it rarely comes to gangrene. Otherwise, limb amputation is necessary.

– Discoloration of the skin, shortness of breath, palpitations are signs of oxygen starvation caused by pulmonary thromboembolism. It is a consequence of a blockage of the pulmonary artery by a thrombus. If you do not provide timely assistance to a person, he will die.

If a blood clot comes off, you should act immediately.You should put the person to bed, then call an ambulance. When you call, list all the symptoms, this will help the operator to send a specialist of the desired profile to the site.

Prevention of thrombosis includes :

– active lifestyle;

– rejection of bad habits;

– proper nutrition;
– weight control;

-timely appeal to specialists.

A blood clot is a very dangerous phenomenon, because, growing inside a vessel, it gradually blocks the flow of blood, and therefore oxygen and other substances to the internal organs of a person, including the brain, which can lead to death.

90,000 Thrombosis and thrombophlebitis of the veins of the lower extremities: treatment and diagnosis in Odessa

Vein thrombosis and thrombophlebitis: what is the danger?

The main symptoms of thrombophlebitis are pain, induration and redness of the veins. When it comes to thrombophlebitis of the lower extremities, it is difficult for a person to walk, there is heaviness and fatigue in the legs. Thrombophlebitis of the upper extremities, in addition to induration, pain and reddening of the veins, can be manifested by an increase in lymph nodes.In acute thrombophlebitis, body temperature also rises slightly.

Deep vein thrombosis is a more serious condition that requires immediate treatment. In 30% of patients, it proceeds secretly and is accompanied by only mild pain, slight edema.

If you are worried about the signs that indicate the presence of these diseases, treatment can be obtained at the Odrex Medical House, whose specialists will help you improve your quality of life as quickly as possible, thanks to their extensive experience and the use of advanced technologies.

Diagnostics

Diagnosis of thrombosis and thrombophlebitis begins with a duplex scan. It is desirable that the study be conducted by the same doctor , ultrasound diagnostics , who works in a team with vascular surgeons, as is the case in our clinic.

Superficial vein thrombophlebitis, as well as deep vein thrombosis, at the diagnostic stage requires a mandatory blood test and lung examination. When referring to the patient, the state of blood flow in the pulmonary artery system should be established, into which particles of a thrombus from the veins or larger areas of a thrombus can get.

The next stage of the examination is an ultrasound of the heart, a cardiogram and, if necessary, an examination by a cardiologist. These diagnostic measures make it possible to identify those patients in whom thrombosis of the pulmonary vessels has occurred.

Treatment of thrombophlebitis and thrombosis in Odessa

Treatment of diseases begins from the first minutes of a patient’s stay in the hospital. When the diagnosis is established, the patient is immediately injected with blood thinners in order to stop the growth of a blood clot.

The need for surgical treatment is discussed after the acquisition of duplex scan data. In some cases, the operation is performed immediately, and in others, only after the inflammation has been relieved. Often, surgery is not needed at all (for example, for deep vein thrombosis).

Surgical treatment of thrombophlebitis

If a patient is diagnosed with thrombophlebitis and an operation is required, the Odrex clinic (Odessa) has all the conditions for this. The operation in such cases consists in the removal of thrombosed veins and those areas that are not yet thrombosed, but may become so in the near future.Often, ordinary punctures and laser exposure, as in uncomplicated varicose veins, are no longer possible. Therefore, as a rule, several small incisions are made.

Deep vein thrombosis of the legs is not a reason for urgent surgery, except in some cases, such as blue or white phlegmas. (The extreme degree of impaired venous outflow). In other cases, it is possible to carry out an operation to eliminate the floating part of the thrombus. Flotation is free movement in a vein at the apex of a blood clot, which is especially dangerous, as it can break off and enter the lungs. If such a condition is determined by ultrasound, it affects the exercise regimen, hospitalization or outpatient treatment, and the duration of therapy.

There is a technique intermediate between conservative and surgical treatment – fibrinolysis. It involves the intravenous administration of special drugs that dissolve blood clots and allow the lumen of the vein to be quickly emptied. The drugs are administered systemically or locally – in the area where the thrombus is located. In the course of such therapy, the risk of separation is possible, therefore, a temporary cava filter is installed if necessary.Blood clots older than a week can no longer be dissolved with these drugs.

Along with the main stage of treatment, which may consist in conservative therapy, surgery or fibrinolysis, the doctor prescribes a number of drugs for the patient: venotonics, anticoagulants designed to thin the blood, anti-inflammatory drugs. Medical knitwear is also used, which protects the patient from new episodes of venous inflammation and creates conditions for recovery.

It should be noted that all of the listed methods of treating thrombosis and thrombophlebitis are successfully used at the Odrex Medical House (Odessa).In combination with high-quality pre-treatment diagnostics and subsequent therapy, they allow the patient to protect himself from the negative consequences of these diseases.

Recovery

In the event of an operation, patients remain in the hospital for 2-3 days, as they need to be monitored. But if the patient is stable, young, follows all the recommendations, he can be discharged on the first day. They try to activate patients as early as possible. Movement, walking after surgery are useful and are used as a therapeutic factor.However, a person can return to hard physical labor no earlier than in a month.

Question – Answer

What is the danger of deep vein thrombosis of the lower extremities?

Thrombosis of the upper and lower extremities is characterized by approximately the same symptoms. The patient suddenly develops swelling, pain that makes him stop or restrict movement, lead or heaviness of the affected area of ​​the body, discoloration of the skin. Deep veins, unlike superficial ones, have a direct connection with the central blood flow.If a blood clot forms in the deep vein system, it can break off, enter the central veins, and clog the pulmonary arteries. As a result, there is a sharp deterioration in the condition or even death.

Is it possible to independently determine thrombophlebitis of the saphenous veins?

There is a simple method that anyone with varicose veins can use. You need to lie down, raise your leg up and hold it for a minute in this position. Clot-free veins become empty and not only disappear, but in some cases form pits in the skin.But the place where there is a blood clot or inflammation of the vein will remain hard, dense and convex. This is already a reason to see a doctor.

How long should be treated for venous thrombosis?

Treatment for deep vein thrombosis is long-term and depends on the drugs chosen. Sometimes it is necessary to keep in touch with the doctor every week or two. In other cases, these may be rare meetings, but regular ultrasound control and long-term use of drugs and knitwear are required.

Can relapse occur after surgery and how can it be prevented?

The risk of recurrent deep vein thrombosis in a patient never goes away. If in your life you have already encountered this problem once, you need to undergo a thorough examination and consultation of a vascular surgeon once a year. To reduce the risk of relapse, it is recommended, in particular, to drink as much purified water as possible with a normal content of minerals and other beneficial substances.This prevents the blood from clotting.

How to treat local treatment for thrombosis and thrombophlebitis?

Many people mistakenly believe that this is the main type of treatment. Ointments, compresses, gels have a positive effect, but mostly psychological. These methods are complementary and should never be mistaken for the only treatment option.

90,000 symptoms and first signs, how it is life-threatening

Acute disturbance of blood flow in the lower extremities is often found in smoking patients with diabetes mellitus as a severe and dangerous complication.

As a result, without qualified medical care, gangrene becomes, with the need for amputation.

To avoid such an unenviable fate, you need to know well what thrombosis is, how dangerous it is and who to contact in case of a problem.

Pathological processes associated with occlusion (blockage) of the vessels of the lower extremities are formed as a result of a combination of factors. You need to evaluate them in the system, after conducting a thorough diagnosis.

Blood clots in the veins of the legs and arteries manifest themselves in different ways, which makes a universal approach to the recognition of pathology impossible.

It will not be possible to identify the disease on our own. If symptoms are found, it is recommended that you go to a general surgeon or call an ambulance.

The examination is urgent. The clock goes on. In case of untimely exposure, there is a high risk of tissue necrosis. A traumatic operation, fraught with disability, will be required.

On average, there is from an hour to two. Emergency therapy. Usually radical in a conservative system. Predictions vary on a case-by-case basis.

Mechanism of formation of blood clots in the legs

Three factors are at the heart of the formation of the process.

• The first reason for the formation of a blood clot is a violation of the normal rheological properties (fluidity) of the blood. It becomes thick, viscous, therefore it moves much more slowly, it is necessary to overcome significant resistance, blood pressure rises. The likelihood of the formation of clots is very high for this very sign alone.
• The second reason is blood stagnation. As a result, the question is different. Perhaps we are talking about varicose veins, prolonged stay in the same position, immobilization with forced bed rest, prolonged standing (especially at risk for manual workers, including teachers, cooks).

• The third point is mechanical damage to a vessel. Not necessarily as a result of injury. We can talk, including about carrying out any diagnostic measure, vasculitis (inflammation of the wall of an artery or vein).

It is not always a question of a system. Isolated development is possible as a result of individual factors.

All reasons are subject to evaluation at once. Identification of a specific condition is carried out as part of a thorough diagnosis.

The movement is based on the points indicated. Further, the process develops according to the same typical scheme.

A clot of protein and blood cells is forming. It comes in various sizes and structures.

• Venous clots almost never move. They stand still, since the pressure in these vessels is lower and there are valves that partially retard them.
• Arterial – they move and can block the channel with the development of a rapid death.There are no valves here, and the pressure is higher.

Then everything depends on the case. Occlusion of a different degree is possible, in different localization. With the minimum size of the clot, the symptoms are scarce, there is time for first aid, transportation to the hospital and treatment.

Such chances do not always come up. More often it happens the other way around. Rapid blockage and tissue necrosis. Disability or death from severe complications.

It is necessary to act quickly if there is a desire to maintain social, professional activity and biological existence.

Symptoms of venous blockage

Manifestations are lesion-specific. There are two main types:

• The first is blockage of superficial vessels or thrombophlebitis.
• Another form is accompanied by a violation of the deep vessels, this type is much more dangerous, because it often provokes gangrene and lethal complications.

Signs of superficial vascular thrombosis

The clinical picture develops relatively quickly. Full deployment takes from a couple of minutes to an hour.

Signs of thrombosis are typical and specific enough to detect the problem even with the naked eye:

• Redness of the skin above the surface of the vein involved in the violation, looks like a bruise.
• Local temperature rise. Hyperemia and a change in the thermometer reading are typical for an inflammatory process or vessel blockage.
• Severe soreness. It is found by feeling, palpation of the site.
• The intensity is significant, subsides while maintaining the same body position.
• By its nature, the syndrome is baling, pressing, pulsating in time with the beating of the heart.
• There is a bloating feeling that is typical of a vascular problem.
• Seal. It is found again on palpation, physical examination.
• Impaired motor activity of the limb. A person cannot walk, which is associated with severe pain syndrome.

Symptoms develop rapidly, gradual spontaneous regression is possible, but this is not an indicator of improvement.Rather addictive.

The probability of complications is about 40%, the optimal time to start treatment is 2-3 hours. Then irreversible changes in tissues begin.

Symptoms of deep vein thrombosis

The clinic is pronounced, it develops as quickly as in the case of external vascular lesions.

An indicative list of signs is as follows:

• Heaviness in the limb. Feels as if lead has been poured into the leg.
• Decrease in physical activity almost to zero.
• Puffiness. The dimensions are increased by one and a half times. Depending on the severity, there may be more. This is the result of a violation of venous outflow, stagnation of blood and lymph.
• Feeling cold. On palpation and subjective.
• Cyanosis of the skin. If redness is typical for thrombosis of external structures, then the opposite is true.

If the femoral region is affected, the clinical picture is more varied:

• Severe pain in the affected leg.
• Symptoms of a blood clot in the leg are accompanied by discoloration: first, the skin turns pale, a marble tint appears. Then it turns purple, dark.
• Severe swelling of the leg.
• Formation of blisters, blisters filled with serous exudate.

The result in both cases is gangrene. Dying off of the tissues of the limb.

Without surgery, the process is rarely self-limited, it spreads further, which leads to massive necrosis, sepsis, shock and relatively quick death.

Typical features of venous lesions – localization of blood clots in an isolated environment.

They relatively rarely break away from the place of their own formation and move along the bed of the vessel. This is almost impossible. Therefore, generalized manifestations do not occur.

Signs of arterial blockage

The variability of this condition is much higher.

Despite the fact that blood clots of a similar origin are somewhat less common, they tend to migrate through the body, move independently of the primary place of formation.Therefore, manifestations from the side of the legs are relatively rare.

If we talk only about them, the clinical picture will be as follows:

• Expressed severe pain at the site of the lesion. The intensity increases with pressure, palpation. The first signs of a blood clot in the leg are always associated with painful sensations of a shooting, pressing character.
• A typical moment is the pallor of the dermal layer. Chilliness. When touched, a lower body temperature is noted at the local level.
• Violation of sensitivity. As the progression progresses, this symptom is also found. First to a minimum, then more and more.
• Fall of motor, functional activity of the leg from the side of involvement. Accompanied by a complete inability to lean, walk. In this case, the pain syndrome persists throughout the entire course of the emergency.
• Edema. The leg looks puffy, greatly increased in size.

Necrosis crowns the picture.Dying off of tissues.

In all the cases described, the time for first aid, transportation of the patient to the surgical hospital and carrying out medical measures is barely enough. On average, we are talking about an hour or three maximum. For all.

Signs of general intoxication appear later, after irreversible structural changes in the tissues of the leg.

This is an increase in overall body temperature, weakness, drowsiness, nausea, vomiting, chills, headache, inability to navigate normally in space.Probably the development of blood poisoning – sepsis.

Rehabilitation measures in this case are carried out in intensive care. The chances of a favorable outcome are vaguely small.

Diagnostics

Examination of patients is carried out urgently, in a hospital. There is no time for long reflections. The minimum program (required) includes a group of activities.

• Visual assessment of the affected limb.
• Palpation. Plays the greatest role in the early diagnosis of the pathological process.Depending on the physical data, the patient’s reactions, one can talk about one or another alleged state.
• Brief oral questioning of the patient on the subject of complaints, their nature. The symptoms are almost always the same. But some nuances, such as localization, the moment the unpleasant sensation begins, can indirectly indicate the essence of the deviation.
• Doppler ultrasonography of the vessels of the lower extremities. In doubtful cases, especially with suspected deep vein thrombosis, it is impossible to detect the disorder by palpation alone.

Accurate tooling data is required. It is them that Doppler ultrasound provides. She explores the state in dynamics: speed, intensity of blood flow.

• An MRI or angiography is urgently performed (the first technique does not require special preparation, therefore, it is preferred if possible). Visualization of tissues is required.

And if Doppler ultrasound is an ultrasound and the main indicators relate to the functional component: the speed and quality of blood flow, then tomography shows anatomical features in statics.Information of this kind is evaluated in the system.

Usually this is where the emergency treatment ends and begins. At the end of the initial measures, you can find out in more detail the origin of the pathological process.

The first assumptions relate to varicose veins (if there is a lesion of the veins, including deep veins) and atherosclerosis.

It is not difficult to identify a blood clot in the leg, it is much more difficult to understand the treatment tactics and to do it as quickly as possible.

• In the first case, the pathological process, blockage of blood vessels by clots has the character of a late complication.
• In the second named situation, smokers, people who abuse animal fats, are at risk, especially in the presence of metabolic disorders.

Therefore, laboratory parameters are mandatory studied: the concentration of low and high density lipoproteins, the level of hormones of the thyroid gland, adrenal glands, pituitary gland.

It is imperative to exclude diabetes mellitus, because if you miss this dangerous endocrine disease, there will be no point in therapy.

Treatment depending on the type of thrombosis

Methods of recovery depend on the nature of the pathological process.

Deep vein involvement requires initial surgery if there is no other way to help. But first they try to fix the problem in a conservative way.

What drugs are prescribed:

• Thrombolytics to dissolve the clot. Urokinase, Streptokinase. They have a pronounced effect. But they create a lot of “side effects”.
• Antiplatelet agents.Heparin and its derivatives or analogs. As part of urgent assistance. They are categorically not suitable for long-term use.
• Means that restore blood circulation. Reopoliglyukin and others.
• Parenteral administration of solutions to restore blood flow. Intravenously.

Next, everything depends on the results. In the absence, mechanical removal of blood clots is performed by surgery, open or endovascular thrombectomy is practiced.

In some cases, it is practiced to install a cava filter, which will stop clots, but this technique is rare.

Damage to external veins or thrombophlebitis requires approximately the same measures. Only the dosages of the drugs differ.

In general, this condition has slightly better prognosis and less likelihood of complications.

Among the drugs:

• Non-steroidal anti-inflammatory drugs. Ketorolac, Nimesulide, Nise.
• Heparin-based products.
• Phlebotonics. Detralex, Venarus, Troxerutin and analogues. Used to restore normal venous-lymphatic drainage.
• It is possible to wear compression hosiery. The operation is also a last resort.

As for the lesion of the arteries of the legs, the main technique is considered to be just surgical correction. In most cases, this is the only one that makes sense.

All other methods are assigned later as auxiliary ones. For example, the use of the same Heparin and its analogs.

In all cases, without exception, the pathological process requires additional treatment of the primary condition that causes thrombosis.Be it atherosclerosis, diabetes and other problems.

Without addressing the root cause, it makes no sense to do anything. This is a short term measure. The same thing will happen very soon.

If possible, you need to normalize the state. Give up smoking, alcohol, adhere to acceptable physical activity.

Attention:

Contrary to beliefs, thrombosis does not imply prolonged bed rest, rather the opposite. As soon as the patient feels the ability to move, this should be done.

Blood flow and metabolic processes are restored, which has a positive effect on rehabilitation.

Removal of a blood clot from a vein in a leg or artery requires some recovery period. The total duration is 2-3 weeks.

Forecast

Depends on the start of therapy. Most patients can expect positive results.

The survival rate is 95%, the chances of maintaining full working capacity and total cure in the early stages of therapy, if recovery begins less than 2 hours from the start of the condition, are also determined at the level of 90-98%.

As the disorder progresses, the likelihood of a good outcome is much lower and decreases in proportion to the hours of inactivity.

Arterial lesions almost always have the worst prospects, because they can penetrate the pulmonary, coronary arteries and provoke sudden death.

A thrombus looks like a blood clot of different sizes, based on its shape and diameter, we can talk about a varying degree of risk. But in this case, there is a huge amount of randomness.

More accurate perspectives can be described by the attending physician.

Potential consequences

Among the probable complications, the following are the most common:

• Stroke. As a result of the separation of a blood clot and blockage of blood vessels in the brain.
• Heart attack. If the coronary arteries are involved. The essence of both pathological processes is tissue death. Nervous and muscular, respectively. The outcome is fatal in many cases.
• Gangrene. Massive cell death of the limb.It is especially common in the blockage of the veins of the legs.
• Pulmonary embolism. It is almost instantly fatal without the possibility of recovery.
• Sepsis, shock in case of untimely assistance not a background of necrosis of the extremities.

The result is disability or death. Depending on the developed consequences.

In conclusion

Thrombi in the leg are formed as a result of the influence of one or another external disease or condition.The problem is not taken out of nowhere, it is almost impossible.

Formation factors require correction in the first place, along with the symptoms of the pathological process.

At the initial signs, it is recommended to go to the hospital, call an ambulance. The prognosis and the likelihood of preserving life and its quality depend on the speed at which treatment begins.

90,000 Discounts and promotions in the medical center “K Medicine”

In 90% of cases, patients with covid have residual lung changes.Fibrosis is most common when scar tissue appears in the lungs and oxygen saturation of the blood is impaired. With covid infection, the kidneys, liver, gastrointestinal tract, and heart can also be affected.

Common consequences

Lung damage:

• dyspnea on exertion
• cough
• increased body temperature within 37.0 ° – 37.5 ° for a long time

Increased thrombus formation:

life-threatening condition, as a result of the formation of blood clots, stroke, myocardial infarction or thromboembolism can develop.

Heart disease:

rhythm disturbances, inflammation of the myocardium, manifested by heaviness in the region of the heart, interruptions in the work of the heart.

Kidney disease:

impairment of excretory function, development of renal failure.

Disorder of the nervous system:

headache, blurred vision, distraction, memory loss, decreased concentration, sleep disturbance, fear, depression.

Disorder of the gastrointestinal tract:

abdominal pain, heaviness in the right hypochondrium, nausea, indigestion.

Muscle weakness and pain

Male infertility

Consultation with a pulmonologist

• Investigation of the function of external respiration (FVD)
• Laboratory diagnostics
• Pulse Oximetry

Covid-19 rehabilitation program

The program can be adjusted and supplemented by the attending physician, taking into account the patient’s condition and the characteristics of the transferred disease.

Individual selection of medicines

Respiratory gymnastics

Allows to improve lung ventilation and blood oxygenation. Exercise regularly increases lung capacity.

ILBI (intravenous laser irradiation of blood)

Improvement of the body through the action of light energy on the blood directly in the vessels themselves. The procedure is carried out using the apparatus – ALT “Matrix-ILBI”.The session lasts 15-20 minutes. It helps to improve the properties of blood, increase immunity, reduce swelling, supply organs with oxygen, and restore metabolism.

Inhalation

Treatment based on inhalation of vapors of necessary drugs through a nebulizer into the respiratory tract. The local effect of using the inhaler occurs instantly.

Therapeutic massage

Normalizes the respiratory system. Massaging movements increase the intensity of blood supply and bronchial patency.

Reflexology

Therapeutic method of influencing certain acupuncture points of the body using special needles. It activates and restores the internal natural forces of the human body.

Comprehensive rehabilitation will allow you to fully recover

• Reduce inflammation as soon as possible;
• Improve lung ventilation;
• Normalize oxygen supply to the body;
• Eliminate bronchial obstruction;
• Prevent the formation of fibrous tissue as the main cause of respiratory failure after pneumonia.

Rehabilitation is necessary for absolutely all patients who have had coronavirus infection, pneumonia and acute respiratory viral infections in order to restore and maintain the quality of life!

Program lead

Unilateral nasal polypotomy

In 90% of cases, patients with covid have residual changes in the lungs. Fibrosis is most common when scar tissue appears in the lungs and oxygen saturation of the blood is impaired. With covid infection, the kidneys, liver, gastrointestinal tract, and heart can also be affected.

Common consequences

Lung damage:

• dyspnea on exertion
• cough
• increased body temperature within 37.0 ° – 37.5 ° for a long time

Increased thrombus formation:

life-threatening condition, as a result of the formation of blood clots, stroke, myocardial infarction or thromboembolism can develop.

Heart disease:

rhythm disturbances, inflammation of the myocardium, manifested by heaviness in the region of the heart, interruptions in the work of the heart.

Kidney disease:

impairment of excretory function, development of renal failure.

Disorder of the nervous system:

headache, blurred vision, distraction, memory loss, decreased concentration, sleep disturbance, fear, depression.

Disorder of the gastrointestinal tract:

abdominal pain, heaviness in the right hypochondrium, nausea, indigestion.

Muscle weakness and pain

Male infertility

Consultation with a pulmonologist

• Investigation of the function of external respiration (FVD)
• Laboratory diagnostics
• Pulse Oximetry

Covid-19 rehabilitation program

The program can be adjusted and supplemented by the attending physician, taking into account the patient’s condition and the characteristics of the transferred disease.

Individual selection of medicines

Respiratory gymnastics

Allows to improve lung ventilation and blood oxygenation. Exercise regularly increases lung capacity.

ILBI (intravenous laser irradiation of blood)

Improvement of the body through the action of light energy on the blood directly in the vessels themselves. The procedure is carried out using the apparatus – ALT “Matrix-ILBI”.The session lasts 15-20 minutes. It helps to improve the properties of blood, increase immunity, reduce swelling, supply organs with oxygen, and restore metabolism.

Inhalation

Treatment based on inhalation of vapors of necessary drugs through a nebulizer into the respiratory tract. The local effect of using the inhaler occurs instantly.

Therapeutic massage

Normalizes the respiratory system. Massaging movements increase the intensity of blood supply and bronchial patency.

Reflexology

Therapeutic method of influencing certain acupuncture points of the body using special needles. It activates and restores the internal natural forces of the human body.

Comprehensive rehabilitation will allow you to fully recover

• Reduce inflammation as soon as possible;
• Improve lung ventilation;
• Normalize oxygen supply to the body;
• Eliminate bronchial obstruction;
• Prevent the formation of fibrous tissue as the main cause of respiratory failure after pneumonia.

Rehabilitation is necessary for absolutely all patients who have had coronavirus infection, pneumonia and acute respiratory viral infections in order to restore and maintain the quality of life!

Program lead

.