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Causes for blood clots in legs. Understanding Deep Vein Thrombosis (DVT): Causes, Symptoms, and Prevention of Blood Clots in Legs

by alexxlab

What are the main causes of blood clots in legs. How can you recognize the symptoms of Deep Vein Thrombosis. What are the most effective methods for preventing DVT. How is Deep Vein Thrombosis diagnosed and treated. Who is at higher risk for developing blood clots in the legs. What lifestyle changes can help reduce the risk of DVT. How does Deep Vein Thrombosis differ from other types of blood clots.

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What is Deep Vein Thrombosis (DVT) and How Does It Occur?

Deep Vein Thrombosis (DVT) is a serious medical condition characterized by the formation of blood clots in the deep veins, typically in the legs. These clots can potentially break free and travel to other parts of the body, causing life-threatening complications. Understanding the nature of DVT is crucial for early detection and prevention.

DVT occurs when blood coagulates and forms a clot within a deep vein, most commonly in the lower legs or thighs. This process can be triggered by various factors, including prolonged immobility, certain medical conditions, and genetic predispositions. The clot can partially or completely block blood flow, leading to swelling, pain, and other symptoms.

The Difference Between DVT and Superficial Thrombophlebitis

It’s important to distinguish DVT from superficial thrombophlebitis, which affects veins closer to the skin’s surface. While superficial thrombophlebitis can be uncomfortable, it generally poses less risk than DVT. DVT involves deeper veins and has a higher potential for serious complications, such as pulmonary embolism.

Recognizing the Symptoms of Deep Vein Thrombosis

Identifying the symptoms of DVT is crucial for timely intervention. While some cases may be asymptomatic, many individuals experience noticeable signs that should prompt immediate medical attention.

  • Swelling in the affected leg, often in the calf
  • Pain or tenderness, which may worsen when standing or walking
  • Warmth in the area of the clot
  • Redness or discoloration of the skin
  • Visible surface veins

Are these symptoms always indicative of DVT? Not necessarily. Similar symptoms can occur with other conditions, such as muscle strains or cellulitis. However, if you experience these signs, especially if you have risk factors for DVT, it’s essential to seek medical evaluation promptly.

Risk Factors Contributing to Blood Clots in Legs

Understanding the risk factors for DVT can help individuals take proactive measures to prevent its occurrence. Some risk factors are within our control, while others are not.

Modifiable Risk Factors

  • Obesity
  • Smoking
  • Prolonged immobility (e.g., long-distance travel, bed rest)
  • Dehydration
  • Use of oral contraceptives or hormone replacement therapy

Non-modifiable Risk Factors

  • Age (risk increases with age, especially after 60)
  • Family history of blood clots
  • Certain genetic conditions affecting blood clotting
  • Previous history of DVT or pulmonary embolism

Can certain medical conditions increase the risk of DVT? Yes, several medical conditions can elevate the risk of developing blood clots in the legs:

  • Cancer and its treatments
  • Heart failure
  • Inflammatory bowel disease
  • Recent surgery, especially orthopedic procedures
  • Pregnancy and the postpartum period

Diagnosing Deep Vein Thrombosis: Methods and Procedures

Accurate diagnosis of DVT is crucial for appropriate treatment and prevention of complications. Healthcare providers employ various diagnostic methods to confirm the presence of a blood clot in the legs.

Physical Examination and Medical History

The diagnostic process typically begins with a thorough physical examination and review of the patient’s medical history. The healthcare provider will assess symptoms, risk factors, and any recent events that might have contributed to clot formation.

Imaging Techniques

Several imaging techniques can be used to visualize blood clots in the deep veins:

  • Duplex Ultrasound: This non-invasive test uses sound waves to create images of blood flow in the veins.
  • Venography: A contrast dye is injected into the veins, and X-rays are taken to visualize the blood flow.
  • CT or MRI scans: These advanced imaging techniques can provide detailed views of the veins and any potential clots.

Blood Tests

Specific blood tests can help assess the likelihood of DVT:

  • D-dimer test: Elevated levels may indicate the presence of a blood clot.
  • Complete blood count (CBC): To check for conditions that might increase clotting risk.
  • Coagulation studies: To evaluate the blood’s clotting ability.

How accurate are these diagnostic methods? While no single test is 100% accurate, combining multiple diagnostic approaches significantly improves the accuracy of DVT diagnosis. The choice of diagnostic method often depends on the patient’s specific situation and the availability of resources.

Treatment Options for Deep Vein Thrombosis

Once diagnosed, prompt and appropriate treatment of DVT is essential to prevent complications and promote recovery. The treatment approach may vary based on the severity of the clot, the patient’s overall health, and other individual factors.

Anticoagulation Therapy

Anticoagulants, commonly known as blood thinners, are the primary treatment for DVT. These medications prevent the existing clot from growing and reduce the risk of new clots forming. Common anticoagulants include:

  • Heparin (unfractionated or low molecular weight)
  • Warfarin
  • Direct oral anticoagulants (DOACs) such as rivaroxaban, apixaban, and dabigatran

The duration of anticoagulation therapy can range from three months to indefinite, depending on the underlying cause and risk factors.

Thrombolytic Therapy

In severe cases or when anticoagulation alone is insufficient, thrombolytic drugs may be used to dissolve the clot. This treatment carries a higher risk of bleeding and is typically reserved for life-threatening situations.

Mechanical Thrombectomy

In some cases, a minimally invasive procedure to physically remove the clot may be recommended. This can be particularly useful for large clots or in patients who cannot tolerate anticoagulation therapy.

Supportive Measures

Additional treatments to manage symptoms and prevent complications include:

  • Compression stockings to reduce swelling and improve circulation
  • Elevation of the affected limb
  • Pain management
  • Early mobilization as advised by the healthcare provider

What factors influence the choice of treatment? The selection of treatment depends on various factors, including the size and location of the clot, the patient’s overall health, the presence of other medical conditions, and the risk of bleeding. A personalized approach is essential for optimal outcomes.

Preventing Deep Vein Thrombosis: Strategies and Lifestyle Changes

Prevention plays a crucial role in reducing the incidence of DVT. By adopting certain lifestyle changes and following preventive measures, individuals can significantly lower their risk of developing blood clots in the legs.

Stay Active and Mobile

Regular physical activity and avoiding prolonged periods of immobility are key to preventing DVT. Consider the following strategies:

  • Take frequent breaks to walk and stretch during long trips or periods of sitting
  • Perform simple exercises while seated, such as ankle rotations and leg lifts
  • Maintain an active lifestyle with regular exercise

Manage Weight and Diet

Maintaining a healthy weight and following a balanced diet can reduce the risk of DVT:

  • Aim for a body mass index (BMI) within the healthy range
  • Consume a diet rich in fruits, vegetables, and whole grains
  • Stay hydrated by drinking plenty of water

Quit Smoking

Smoking increases the risk of blood clots and various other health problems. Quitting smoking can significantly reduce the risk of DVT and improve overall health.

Use Compression Stockings

For individuals at higher risk, wearing compression stockings can help improve blood flow in the legs and reduce the risk of clot formation.

Follow Medical Advice

If you have risk factors for DVT or are undergoing medical procedures, follow your healthcare provider’s recommendations:

  • Take prescribed anticoagulants as directed
  • Follow post-surgery mobilization instructions
  • Discuss the use of hormone therapies with your doctor

Can preventive measures completely eliminate the risk of DVT? While these strategies can significantly reduce the risk, it’s important to note that some risk factors, such as age and genetic predisposition, cannot be modified. However, combining multiple preventive approaches can substantially lower the overall risk of developing DVT.

Complications of Deep Vein Thrombosis: Understanding the Risks

While DVT itself is a serious condition, it can lead to potentially life-threatening complications if left untreated or if the clot breaks free and travels to other parts of the body.

Pulmonary Embolism

The most severe complication of DVT is pulmonary embolism (PE). This occurs when a blood clot breaks off and travels to the lungs, blocking blood flow. Symptoms of PE include:

  • Sudden shortness of breath
  • Chest pain that worsens with deep breathing
  • Rapid heart rate
  • Coughing up blood

PE is a medical emergency that requires immediate attention. It can be fatal if not treated promptly.

Post-thrombotic Syndrome

Even after treatment, some individuals may develop post-thrombotic syndrome (PTS), a long-term complication of DVT. PTS can cause chronic pain, swelling, and skin changes in the affected limb. Symptoms may include:

  • Persistent leg pain and swelling
  • Skin discoloration
  • Varicose veins
  • Leg ulcers in severe cases

Chronic Venous Insufficiency

DVT can damage the valves in the veins, leading to chronic venous insufficiency. This condition affects blood flow back to the heart and can cause:

  • Leg swelling and heaviness
  • Skin changes, including discoloration and thickening
  • Increased risk of leg ulcers

How common are these complications? The risk of complications varies depending on factors such as the size and location of the clot, timely diagnosis and treatment, and individual health factors. With proper treatment, many patients recover from DVT without experiencing severe complications. However, the potential for these serious outcomes underscores the importance of early detection and appropriate management of DVT.

Living with Deep Vein Thrombosis: Long-term Management and Quality of Life

For individuals who have experienced DVT, long-term management is crucial to prevent recurrence and maintain a good quality of life. Living with DVT often involves ongoing care and lifestyle adjustments.

Adherence to Treatment Plan

Following the prescribed treatment plan is essential for managing DVT and preventing complications:

  • Take anticoagulant medications as directed
  • Attend regular follow-up appointments with healthcare providers
  • Monitor for signs of bleeding, which can be a side effect of anticoagulants

Lifestyle Modifications

Adopting and maintaining healthy lifestyle habits can significantly improve outcomes for individuals with a history of DVT:

  • Engage in regular physical activity as recommended by your healthcare provider
  • Maintain a healthy weight through proper diet and exercise
  • Avoid prolonged periods of immobility
  • Quit smoking if applicable

Managing Symptoms and Complications

Some individuals may experience ongoing symptoms or develop complications such as post-thrombotic syndrome. Management strategies may include:

  • Wearing compression stockings to reduce swelling and improve circulation
  • Elevating the affected limb when resting
  • Using prescribed medications for pain management
  • Participating in physical therapy or rehabilitation programs

Emotional and Psychological Support

Living with DVT can have emotional and psychological impacts. Seeking support through:

  • Support groups for individuals with DVT or blood clotting disorders
  • Counseling or therapy to address anxiety or depression related to the condition
  • Open communication with family, friends, and healthcare providers about concerns and challenges

How can individuals with DVT maintain a good quality of life? By actively participating in their care, adhering to treatment plans, and making necessary lifestyle changes, many people with DVT can lead fulfilling lives. Regular communication with healthcare providers and staying informed about the condition are key to managing DVT effectively in the long term.

Understanding Deep Vein Thrombosis is crucial for early detection, effective treatment, and prevention of complications. By recognizing the symptoms, addressing risk factors, and following appropriate treatment and prevention strategies, individuals can significantly reduce their risk of developing DVT or manage the condition effectively if it occurs. As medical research continues to advance, new treatments and prevention methods may emerge, offering hope for improved outcomes for those affected by this serious condition.

What Causes Blood Clots? – Symptoms

What are blood clots?

Blood clots are differently sized clumps of blood that have formed inside your body. Clotting is important to prevent excessive bleeding if you are injured or cut. However, when a blood clot blocks blood flow to important areas of your body, it can be harmful, even deadly. Blood clots can occur in your arms and legs, abdomen (stomach), heart, lungs, brain, and kidneys.

There are two different types of blood clots. These include clots that stay in place and don’t move (thrombosis) and those that break away from the spot where they developed and move to different areas inside your body (embolism). Depending on what the clot blocks or where it moves, a blood clot can be deadly.

Blood clot symptoms

Symptoms are different depending on where the blood clot is located. If the clot is in your arms or legs, you may experience pain (that feels like an intense cramp), swelling, and tenderness. Your skin may be red and warm to the touch where the clot is located. If the blood clot is in your abdomen, you may experience severe stomach pain, vomiting, and diarrhea.

Blood clots that travel to your heart cause a heavy feeling or pain in your chest, pain in your upper body, shortness of breath, sweating, nausea, and light-headedness. If the clot moves to your lungs, you could experience sharp chest pain, a racing heart, shortness of breath, sweating, and fever. You may cough up blood. A blood clot in the brain may cause weakness in your face, arms, or legs, speech and vision difficulties, headache, and dizziness. Many of these symptoms are the symptoms associated with other conditions, such as heart attacks and stroke.

If you suspect you have a blood clot, see a doctor immediately.

What causes blood clots?

Your body reacts to an injury or cut by clotting your blood just the way it should. These types of clots are not a problem. Sometimes a blood clot will form without a trigger (such as an injury or cut). This is more likely to happen with certain risk factors or conditions. Risk factors include:

  • Prolonged sitting (often the case with travel when you are forced to sit for long periods in an airplane, a train, or a car)
  • Prolonged bed rest (often the case with surgery or illness)
  • Pregnancy
  • Smoking
  • Obesity
  • Birth control pills/hormone replacement therapy/breast cancer medicines
  • Certain cancer types (pancreatic, lung, multiple myeloma, or blood-related cancers)
  • Trauma (serious injury)
  • Some types of major surgery
  • Age (especially over the age of 60)
  • A family history of blood clots
  • Autoimmune disorders
  • Diseases related to chronic inflammation
  • Certain infections (HIV/AIDS, hepatitis C, or Lyme disease)

How are blood clots diagnosed?

Whether you go to your doctor’s office or an emergency room, the doctor will examine your symptoms. The doctor also will ask you about your medical history, your family’s medical history, and the medicines you are taking. The doctor may order a blood test to send to the lab. A blood test also can diagnose an autoimmune disorder or certain infections. The test involves inserting a small needle into a vein in your arm to draw a sample of blood. There are several lab tests that can check for abnormal clotting and for the presence of antibodies that interfere with clotting.

Can blood clots be prevented or avoided?

Blood clots are highly preventable. To prevent or avoid a blood clot, know your personal risk factors and control the risks you can. For example, if you smoke, stop. If you are obese, lose weight. If you take birth control pills, talk to your doctor about an effective alternative. If you are inactive, get moving. If you have a family history of blood clots, talk to your doctor. Your doctor may determine whether you should be taking blood-thinning medicine to prevent clots.

There are several situations in life that increase your risk for blood clots. These include:

  • When you are pregnant
  • When you are immobile
  • When you have just had major surgery
  • When you have cancer

Blood clot treatment

A blood clot is treated based on where it is located. Oral blood thinner medicines are the most common treatments for blood clots. Some medicines can be given through a catheter (a long, thin tube) inserted into the area of the clot. Some clots can be surgically removed. Talk to your doctor if you are pregnant. Medicines may involve risks to your unborn child. If your blood clot is due to an infection, your doctor may be able to treat the infection and reduce the risk of a clot.

Living with blood clots

If detected early, a blood clot can usually be treated successfully. If it was not treated early, your quality of life depends on the seriousness of the damage. For example, a blood clot can cause stroke, even death. If you’ve successfully survived a blood clot, you may live with the fear of having another. In that case, living with blood clots involves focusing on prevention. If you are being treated with blood thinner medicines, you have to be careful not to cut yourself (even when shaving). The medicine can make it difficult to stop the bleeding.

Questions to ask your doctor

  • How can I tell the difference between symptoms of a blood clot and another condition?
  • How much time does it usually take for a blood clot to travel to a danger zone once it breaks apart?
  • If I have one of the risk factor diseases or conditions, should I be taking a blood thinner?
  • How do I know if I need to see a doctor if I cut myself while taking blood thinner medicine?
  • Can a blood clot be passed through your urine or stool?

Resources

American Society of Hematology: Blood Clots

Centers for Disease Control and Prevention: Understanding Blood Clots

Thrombosis (Blood Clots) | Boston Children’s Hospital

Listen

Thrombosis is a blood clot that develops within veins or sometimes arteries in the body. Thrombosis may be serious or inconvenient but often occurs as a complication of a procedure, medication, or other disease. If left untreated a thrombosis can cause long-term problems; such as chronic swelling, pain, or even permanent damage to internal organs.

Thrombophilia refers to anything that increases one’s tendency to develop blood clots. Thrombosis in children is uncommon and is most often seen in children with complex medical problems or procedures. Thrombophilia can be considered the opposite of hemophilia, a disorder that prevents blood from clotting.

How is thrombophilia classified?

Thrombophilia refers to a group of disorders that increases a child’s tendency to develop dangerous blood clots. There are two main types of thrombophilia:

  • Inherited thrombophilia is caused by certain genetic conditions.
  • Acquired thrombophilia is caused by lifestyle factors or medical conditions, including immobility, obesity, sedentary lifestyle, trauma, smoking, or oral contraceptive use.

How we care for thrombosis

Children and young adults with blood clots are treated through the Dana-Farber/Boston Children’s Thrombosis and Anticoagulation Program. Through our unique program, we can quickly identify children who need anticoagulation medications (or “blood-thinners”) using established monitoring and risk identification guidelines. Children outside of the hospital visit our outpatient center staffed by pediatric hematologists and pediatric hematology nurse practitioners with specialized expertise in the diagnosis and treatment of thrombosis.

Our areas of research for thrombosis

For many children with rare or hard-to-treat conditions, clinical trials provide new options. Participation in any clinical trial is completely voluntary. We will take care to fully explain all elements of the treatment plan prior to the start of the trial, and you may remove your child from the medical study at any time. Currently, our hematology team is studying several new oral blood thinners in children for treatment and prevention of blood clots. We are also involved in an international study of the length of anticoagulation needed to treat thrombosis. Your hematologist may mention opportunities to participate in these studies, but you should feel free to ask about current research studies relevant to your child.

Researchers at Dana-Farber/Boston Children’s perform scientific and clinical research on platelets and related aspects of hemostasis and thrombosis. A particular focus is antiplatelet therapy, including the characterization of:

  • how newly discovered molecules and mechanisms could help control platelets and clotting
  • how antiplatelet drugs affect normal blood clotting (coagulation) and aspects of the immune system (e.g., inflammation)
  • the relationship between the strength of antiplatelet treatments and the balance between thrombosis (uncontrolled clotting) and hemorrhage (uncontrolled bleeding)
  • how tests of platelet function could help guide antiplatelet therapy in the clinic

Thrombosis | Symptoms & Causes

What are the symptoms of thrombosis?

Thrombosis symptoms in children can vary significantly depending on the size and location of the blood clot, and each child may experience symptoms differently. A thrombosis may occur anywhere in a child’s body, but most are in the legs or arms (deep-vein thrombosis or DVT) or lungs (pulmonary embolism). Other types of thrombosis include sinus venous thrombosis and arterial thrombosis.

Children with a thrombosis in the legs or arms may have the following symptoms:

  • swelling
  • pain
  • redness and warmth
  • low-grade fever
  • in some cases, you may even be able feel the clot, like a knot or rope under the skin

If a child has a pulmonary embolism, they may experience:

  • chest pain
  • shortness of breath, often beginning suddenly

A pulmonary embolus is a life-threatening medical emergency, and you should seek help immediately if you suspect this condition in your child.

It is important to understand that some thrombosis symptoms may resemble those of other more common medical problems. Because some of these symptoms can also point to other conditions, it’s important to have your child evaluated by a qualified medical professional for an accurate diagnosis and prompt treatment. If you have a family history of thrombosis, it is important to bring this up during evaluation for these symptoms.

What causes thrombosis?

There are three categories of causes of thrombosis: damage to the blood vessel (catheter or surgery), slowed blood flow (immobility), and/or thrombophilia (if the blood itself is more likely to clot).

Causes of thrombosis depend on whether your child has inherited or acquired thrombosis. Inherited thrombophilia is caused by certain genetic conditions while acquired thrombophilia is caused by lifestyle factors or medical conditions.

Possible factors for acquired thrombophilia include:

  • immobility
  • obesity
  • sedentary lifestyle
  • trauma

In teens and adults, risk factors also may include smoking or oral contraceptive use. Some patients with chronic inflammation or rheumatologic disorders may develop antiphospholipid antibody syndrome, a disorder where antibodies produced by the patient cause thrombosis to occur.

Thrombosis | Diagnosis & Treatments

How is thrombosis diagnosed?

The first step in treating your child is forming an accurate and complete diagnosis. If thrombosis is suspected, imaging is done to confirm the diagnosis and to define where the blood clot starts and ends. Thrombosis is sometimes found accidentally but mostly because patients develop signs and symptoms of a blood clot. 

If your child is suspected of having a thrombosis, diagnostic tests may include:

  • a physical examination to evaluate symptoms of a blood clot
  • ultrasound, an imaging technique that uses high frequency sound waves and their echoes to make images of the inside of your child’s body
  • magnetic resonance imaging (MRI), an imaging exam that uses a large magnet, radio waves, and a computer to produce two- and three-dimensional images of your child’s body’s organs, tissues, and bones
  • computed tomography (CT or CAT) scan, a non-invasive procedure that uses X-ray equipment and computers to create detailed, cross-sectional images of your child’s body
  • analysis of blood samples to evaluate whether your child’s blood is clotting normally and identify any abnormalities in the levels of certain proteins
  • genetic tests may be performed to check for hereditary disorders (inherited thrombophilia)

There may be other diagnostic tests your doctor will discuss with you depending on your child’s individual situation. After we complete all necessary tests, our experts meet to review and discuss what they have learned about your child’s condition. Then we will meet with you and your family to discuss the results and outline the best possible treatment options.

What are the treatment options for thrombosis?

Your child’s treatment team will determine a specific care plan. In most cases, thrombosis is treated with anticoagulation medications (blood thinners). These medications prevent the clot from growing and decrease the risk of its breaking apart and causing further complications. Your child may need to continue taking these medications for several months after initial treatment.

Examples of anticoagulation medication your child’s physician may prescribe include:

  • injections under the skin (also called subcutaneous injections) of a low molecular weight heparin such as enoxaparin (Lovenox) or dalteparin (Fragmin)
  • oral agents such as warfarin (Coumadin)
  • intravenous heparin
  • antiplatelet agents such as aspirin, clopidogrel (Plavix), or prasugrel (Effient)

Other treatments may include wearing compression stockings, remaining active, and applying warm packs to improve blood flow and pain caused by the clot.

Of course, your child’s team of doctors will help determine the best approach for your child’s unique situation, based on a number of factors, including:

  • your child’s age, overall health, and medical history
  • the severity of the disease
  • your child’s tolerance for certain medications, procedures, or therapies
  • how your child’s doctors expect the disease to progress
  • your opinion and preferences

What is the long-term outlook for children with thrombosis?

Some deep vein thromboses may resolve without treatment. Treatment is given to help get rid of the blood clot and to minimize complications of thrombosis. If the blood clot remains, other veins will enlarge to bypass the blockage. Sometimes these veins are visible, like varicose veins. After a blood clot some people develop long-term pain and swelling in the leg called post-thrombotic syndrome, which is caused by reduced blood flow and damage to the affected vein. Some patients also have changes in skin color, which may not develop for a year or more afterward.

Blood clots in the thigh are more likely to break off and travel to the lungs than blood clots below the knee or in the arms. A pulmonary embolism can be a life-threatening emergency, requiring immediate medical attention.

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Causes of thrombosis and inflammation of a thrombus

Thrombophlebitis is an inflammation of a thrombus located in the lumen of a venous vessel. The disease is a vicious circle: inflammation of the vein contributes to the increase in blood clot, and the processes occurring inside the blood clot increase inflammation.

The main cause of vein thrombosis is varicose veins. There are other factors that can cause complete or partial blockage of the venous vessel. All of them can cause life-threatening complications that are difficult to treat. It is best to know the possible causes of the disease, to prevent them.

If a superficial vein is affected, thrombophlebitis is called superficial. When a deep vein is blocked, thrombophlebitis will be called deep. Often, the process begins with superficial vessels, and then goes into the deep vein system.

Both types of disease, regardless of the cause of thrombophlebitis of the lower extremities, are complicated by chronic venous insufficiency. It, progressing, is manifested by darkening of the skin, edema, poorly healing trophic ulcers. The most dangerous complication is the separation of a blood clot with its subsequent entry into the pulmonary artery system or into the cerebral vessels. But if the treatment of thrombosis and thrombophlebitis was started on time and taking into account the cause of the disease, such consequences can be avoided.

Causes of pathology

Doctors name the following causes of thrombophlebitis. These are:

  • Varicose veins of the lower extremities, in which the blood flow in the dilated areas is so slowed down that all the conditions for thrombosis occur. This cause accounts for 70% of all superficial thrombophlebitis.
  • Injury to the venous wall. Superficially located veins can be injured by impact, friction with bone fragments, and falling. Also, their puncture and catheterization is considered an injury, which is also carried out on the legs. In response to injury to the wall, its components are activated, which cause the formation of a thrombus in the damaged area.
  • Prolonged immobilization, especially due to the need to consolidate the fracture. While the deep veins continue to provide outflow from the limbs, the superficial ones are partially compressed by plaster, blood flow slows down in them, and as a result, a blood clot forms.
  • Condition after treatment of varicose veins with sclerotherapy.
  • Chronic asymptomatic carriage of bacteria when they are in the bloodstream and can inflame existing blood clots.
  • Clotting diseases.
  • Increased blood estrogen concentration.
  • Vasculitis, including lupus.
  • Pancreatic, lung, stomach cancer causing migratory thrombophlebitis.
  • Increase in the level of homocysteine ​​in the blood.
  • Diseases of the liver in which the level of heparin in the blood decreases.
  • Homocystinuria.
  • Antiphospholipid syndrome.

The main cause of deep vein thrombosis in the lower extremities is called varicose veins. This condition develops as a complication of superficial thrombophlebitis, when a thrombus grows in the direction of the communicating veins (connecting the superficial system with the deep one), and, destroying their valves, breaks into the deep veins.

When smoking, taking contraceptives, obesity, as well as anomalies of the vascular wall, the risk of thrombophlebitis increases several times.

causes, symptoms, signs, diagnosis, treatment, prevention

Causes

Classification

Symptoms

Complications

Diagnosis

Treatment

Thrombophlebitis is a chronic disease of the circulatory system, in which, after damage to the inner wall of the vein, an inflammatory reaction develops.

It is characterized by the rapid appearance of blood clots in this place due to the adhesion of platelets when passing through the inflamed area. As a result, a thrombus forms here, blocking the vessel and disrupting blood flow.

The incidence of the disease depends on many factors, and one of them is age. In people under 30 years of age, pathology is extremely rare, but in patients after 60 years of age it is one of the most frequently diagnosed pathologies, and in most cases these are women.

Causes and provoking factors of thrombophlebitis

Thrombophlebitis of the lower extremities, and this variant of the disease is more common than others, in 60% of all cases occurs as a concomitant disease of varicose veins. The main cause of pathology at a young age is thrombophilia.

Other provoking factors include:

  • pregnancy;
  • hormone replacement therapy;
  • long-term use of oral contraceptives without the consent of a doctor;
  • smoking;
  • thrombocytopenia;
  • both fungal and bacterial infections;
  • excessive body weight;
  • oncological formations;
  • advanced age;
  • long wearing of a cast or bed rest;
  • long-term use of cytostatics.

Recent studies have shown that genetics is of great importance in the development of venous thrombophlebitis, and thrombophilia comes to the fore, in which platelets stick together without damaging the venous wall.

What is the difference between thrombophlebitis and varicose veins? With varicose veins, only the expansion of the vein occurs, and thrombophlebitis is characterized by its blockage by a thrombus.

Classification of thrombophlebitis

Thrombophlebitis of the veins of the legs has a certain classification, which is associated with the depth of the lesion, localization, duration of the course.

According to the depth of the lesion, deep thrombophlebitis and superficial thrombophlebitis are distinguished. By localization, it can be local or migratory, when the inflammatory process moves through the vein.

The duration of the lesion is acute or chronic, with periodic exacerbations. Three forms of thrombi are distinguished by blocking the vein:

  • occlusive, when the blocking of the vein by a blood clot occurs completely, and there is a risk of gangrene;
  • ischemic, when a thrombus and edema from inflammation completely block the vessel, and necrosis of nearby tissues develops;
  • non-occlusive, when inflammation, swelling and thrombus do not completely block the blood flow, but it slows down, and tissue nutrition becomes difficult.

For reasons of development, thrombophlebitis is divided into 4 groups:

  • the first – varicothrombophlebitis, which occurs with existing varicose veins;
  • the second is post-injection, occurring at the injection site of an intravenous drug from a needle;
  • the third is infectious, developing due to the development of pathological microflora in the lesion;
  • the fourth – aseptic, when inflammation occurs without the participation of microorganisms.

Symptoms of thrombophlebitis

Thrombophlebitis has specific symptoms, but they will depend on the location of the affected vessel. If the pathology appears against the background of varicose veins, the veins of the legs are most often affected. The main manifestation is painful dense purple subcutaneous cords, as well as redness, increased pain during palpation.

If the inflammation is strong enough, the described symptoms are accompanied by redness, fever in this place, swelling. The most dangerous location of such inflammation is the knee, popliteal region and femoral part of the leg.

Another sign of thrombophlebitis is that if you lower your legs down to the floor, they immediately experience bursting pain. Edema in this case begins with the lower part of the leg, and then rises higher.

Acute thrombophlebitis is of particular danger, because it can suddenly disrupt the blood supply to the legs and possibly form emboli, and this is life-threatening. The main manifestation is a tense swelling of the leg with sharp, persistent pain. In the future, the swelling goes higher, can spread to the inguinal region and even to the lower abdomen.

If a thrombus forms in the inferior vena cava, there is intense swelling of the lower torso and legs. The veins of the anterior abdominal wall at the same time expand, there is a risk of developing thrombosis of the vessels of the liver and kidneys.

Superficial thrombophlebitis on the hands usually occurs after trauma to the vessel wall during an injection or insertion of a venous catheter. Typical manifestations begin in the antecubital fossa. The main symptoms are soreness, the appearance of compaction, redness, swelling along the vessel. However, such a lesion never affects the deep veins.

Complications of thrombophlebitis

The main danger of thrombophlebitis is that a blood clot can break off at any moment and go through the vessels along with the blood. If it enters the pulmonary artery, it will cause PE, which causes death. If a blood clot enters the coronary vessels, a heart attack can develop, and a stroke can develop into the vessels of the brain.

Thrombophlebitis diagnostics

When the first symptoms of the disease appear, it is necessary to contact a phlebologist or a vascular surgeon. If a pulmonary embolism is suspected, the best diagnostic option is a spiral CT scan of the chest, which can detect any, even small abnormalities.

Angiopulmonography is another method for diagnosing thrombophlebitis, when a contrast agent is used to examine a branch of the pulmonary artery. If deep thrombophlebitis develops, ultrasound is effective. Also, this study helps to quickly identify the disease during pregnancy and before childbirth.

Ultrasound is best performed in conjunction with Doppler, which allows you to understand exactly how blood moves through the vessels and at what speed it moves. To detect blood clotting disorders, a coagulogram is performed, which allows you to identify genetic breakdowns, due to which platelets themselves begin to stick together with each other. Sometimes it is recommended to determine the blood D-dimer.

Treatment of thrombophlebitis

A few years ago, the best treatment for thrombophlebitis was crossectomy, but as recent studies have shown, this operation is too traumatic and causes many dangerous complications.

Therefore, today the ideal option is thrombectomy, and the operation for thrombophlebitis is performed under general anesthesia. However, it all depends on the location of the thrombus and its size.

Scoping helps expand the vein and improve blood flow in it. And a method called “Invagination stripping” helps to remove a blood clot from even the most inaccessible areas.

At the initial stage of the disease, according to the doctor’s prescription, patients can take special medicines. The main drugs for thrombophlebitis are anticoagulants that thin the blood and prevent its clotting. With the infectious nature of inflammation of the veins, antibiotics are prescribed. To improve the tone of the veins and reduce stagnation in them – angioprotectors. Antiplatelet agents, phlebotonics are also used, and non-steroidal analgesics are used to relieve pain.

According to the latest clinical guidelines, thrombophlebitis can also be treated with a laser. This safe, low-traumatic technique helps to get rid of ascending thrombophlebitis.

Other effective therapies include intermittent pneumocompression and electromyostimulation with the Veinoplus device. But gymnastics and active physical exercises should be abandoned, as this can cause a blood clot to break off and enter large vessels. Do not rely on hirudotherapy (treatment with leeches) – this method has too low efficiency. As for nutrition, it remains the same, however, if there is excess weight, it is better to get rid of it.

What is forbidden to do with thrombophlebitis of the lower extremities? In order for the treatment to be truly successful, as a preventive measure to prevent exacerbation of thrombophlebitis, you should stop wearing high-heeled shoes and bad habits. You should not go to the bath or sunbathe diligently and, of course, you should not wear socks, stockings or stockings with a tight elastic band – this provokes the development of edema. You need to lead a healthy lifestyle, choose shoes according to size and avoid hypothermia.

The author of the article:

Magomedov Maksud Gadzhievich

head of the inpatient department at Krasnye Vorota metro station, KMN, phlebologist, proctologist

work experience 24 years

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