Blood Clots: How They Get Dissolved

When you get a cut, your blood changes from a free-flowing liquid into a clump of gel — that’s a clot — to stop the bleeding. That’s like if a hose could patch itself after it springs a leak.

It’s a complicated process where platelets, a type of blood cell, and lots of different proteins all jump in at just the right time to plug things up.

As the wound heals, your body has another process to break them down. If a clot forms when it’s not supposed to — inside a blood vessel, for example — you might need a little help to make that happen.

How the Body Clears Clots

When your body senses that you’ve healed, it calls on a protein called plasmin. Here’s the clever part: Plasmin is actually built into the clot itself. It’s there the whole time, but it’s turned off. It just hangs out and waits.

To turn it on, your body releases a substance known as an activator. It wakes up plasmin and tells it to get to work tearing things down. That mainly means breaking up the mesh-like structure that helps the clot work so well.

How Medicine Clears Clots

Doctors use different medications based on the type of clot you have:

Blood thinners. Also called anticoagulants, these are some of the more common drugs for a deep vein thrombosis (DVT). That’s a blood clot that happens in one of your large veins, usually in your leg. Blood thinners are also used to help prevent clots after a stroke or pulmonary embolism (when a blood clot travels to an artery in your lungs).

Blood thinners don’t dissolve the clot, but they can stop it from getting bigger and keep new ones from forming. That gives your body time to break up the clot.

Different blood thinners work in different ways:

• Direct oral anticoagulants (DOACs) keep your body from making fibrin, the protein the forms the clot’s mesh.
• Heparin keeps one of your body’s key clotting proteins, thrombin, from doing its job.
• Warfarin (Coumadin) slows down your liver’s ability to make the proteins you need for clotting.

Thrombolytics. These clot-busting drugs are used for serious conditions, like a pulmonary embolism. Unlike blood thinners, they do break down the clot. They work by turning on plasmin, which jump-starts your body’s natural process for clearing things out.

How Long Does It Take to Recover?

It’s not something you feel instantly. A DVT or pulmonary embolism can take weeks or months to totally dissolve. Even a surface clot, which is a very minor issue, can take weeks to go away.

If you have a DVT or pulmonary embolism, you typically get more and more relief as the clot gets smaller. The pain and swelling from a DVT usually start to get better within days of treatment.

Symptoms from a pulmonary embolism, like shortness of breath or mild pain or pressure in your chest, can linger 6 weeks or more. You might notice them when you’re active or even when you take a deep breath. Exercise can help with this.

A blood clot puts serious stress on your body. So it’s not just about clearing it away, but also giving your body and mind time to recharge.

Long-Term Effects

Sometimes a clot can leave behind scars and other damage that can cause problems.

Continued

Almost half of people who get a DVT may end up with post-thrombotic syndrome. That’s where swelling, pain, or skin color changes last much longer. You also may get sores called ulcers.

About 4 in 100 people with a pulmonary embolism have long-term lung damage known as pulmonary hypertension. This means you have high blood pressure in your lungs, which can lead to issues like shortness of breath, tiredness, and chest pain.

Leg clots (aka deep-vein thrombosis): an immediate and long-term health hazard – Harvard Health Blog

When it comes to under-the-radar health conditions, deep-vein thrombosis is at the top of the list. Most of my patients have never heard of this common problem. Yet deep-vein thrombosis puts more than one-quarter million Americans in the hospital each year, and complications from it are responsible for upwards of 100,000 deaths.

Deep-vein thrombosis (DVT) is the medical term for a blood clot that forms in a leg vein. Some DVTs cause no symptoms; others hurt, or make the leg swell. There are two big worries with a DVT:

Pulmonary embolism. A piece of a clot can break away, travel through the bloodstream, and become lodged in the lungs. This is called a pulmonary embolism. Almost all DVT-related deaths are due to a pulmonary embolism.

Post-phlebitis syndrome. A clot can permanently damage the vein it is lodged in. This problem, called post-phlebitis syndrome, causes persistent leg pain, swelling, darkened skin, and sometimes hard-to-heal skin ulcers. Up to 40% of people with a DVT develop post-phlebitis syndrome.

Treating DVT

Deep-vein thrombosis is initially treated with an anticoagulant. Today there are many choices, such as one of the newer oral direct acting agents, intravenous heparin or subcutaneous low-molecular weight heparin or fondaparinux. Anticoagulants can stop a DVT from getting larger and can prevent new clots from forming. Use of these drugs substantially decreases the risk of developing a pulmonary embolism.

But anticoagulants can’t quickly dissolve a clot that has already formed. That’s the job of drugs called thrombolytics (commonly known as clot busters), such as streptokinase and alteplase. Studies have had mixed results. However, they are sometimes considered in people with massive leg clots to prevent long-term leg swelling and pain (called post-phlebitis syndrome).

Delivering a clot-dissolving drug directly into the clot—instead of having it circulate through the bloodstream via standard intravenous delivery—allows the use of a lower dose, which decreases the risk of bleeding elsewhere in the body.

Not everyone with a DVT needs direct clot-dissolving therapy. Anticoagulants, along with support stockings to reduce swelling and improve blood flow, are enough for most people. For those with a very large clot, especially one high up in the leg or in the pelvis, direct injection of a thrombolytic agent may help protect the affected vein from post-phlebitis syndrome.

Prevention is preferable to treatment

Anyone can develop a DVT, although some people are more likely to have one than others. You are at increased risk if you or a close family member have had a DVT before, have an inherited condition that causes your blood to clot more readily than normal, have cancer, are immobile for a long time (confined to bed, long-duration plane or car trip, etc.), or use birth control pills.

Here are some good ways that everyone can use to help prevent a DVT from forming:

• Stay physically active. At work or at home, get up from your chair frequently. Short walks contract the muscles in your legs that help pump blood back toward your heart.
• Avoid dehydration. This is especially important when you are going to be sitting for a prolonged time, such as in an airplane.
• Move your legs. If you are bedridden and can’t take frequent walks, contracting your leg muscles will help prevent blood from pooling and clotting.
• Maintain a healthy body weight. Obesity increases the risk of DVT.
• If you are hospitalized for some reason, ask your doctors and nurses to make sure you are receiving measures—such as wearing special stockings or getting low-dose heparin—to prevent blood clots.

Deep Vein Thrombosis – Signs of Pulmonary Embolism

The main goals of DVT treatment are to:

• Stop the clot from getting bigger.
• Prevent the clot from breaking off and traveling to your lungs.
• Prevent future blood clots.

Several medicines are used to treat and prevent DVT. Common ones include warfarin or heparin. These thin your blood so that clots won’t form. Warfarin is taken as a pill and heparin is given intravenously (in your veins). Warfarin can cause birth defects. Women who are pregnant should not take warfarin. If you can’t take heparin, your doctor may prescribe another type called a thrombin inhibitor. Newer treatment programs recommend NOACs (novel oral anticoagulants) as preferable medicines in most settings. Brand names include Eliquis, Pradaxa, and Xarelto.

Anticoagulants can cause you to bleed more easily. For example, you might notice that your blood takes longer to clot when you cut yourself. You may bruise more easily as well. If you have any unusual or heavy bleeding, call your doctor right away.

Some other medicines can affect how well an anticoagulant works. Talk to your doctor before you take any new medicine. This includes over-the-counter medicines and vitamins. Certain foods rich in vitamin K, such as dark green vegetables, also can have an effect.

There are other treatment options if you can’t take medicine to thin your blood, or if a blood thinner doesn’t work. Your doctor may suggest putting a filter in your vena cava. This is the main vein that carries blood from your lower body to your heart. This filter can catch a clot as it moves through your bloodstream and prevent it from reaching your lungs. This treatment is more common for people who have had several blood clots travel to their lungs.

Blood Clots: Risks, Symptoms, Treatments, Prevention

Overview

What is a blood clot?

Blood clots are gel-like collections of blood that form in your veins or arteries when blood changes from liquid to partially solid. Clotting is a normal function that stops your body from bleeding too much when you get hurt. However, blood clots that form in some places and don’t dissolve on their own can be dangerous to your health.

Normally, a blood clots start as a response to injury of a blood vessel. At first, the blood stays in one place. Two substances — platelets (a type of blood cell) and fibrin (a firm string-like substance) — combine to form what is called a platelet plug to stop up the cut or hole.

When a blood clot forms where it should not have developed, it is called a thrombus. A blood clot is also called a thrombus. The clot may stay in one spot (called thrombosis) or move through the body (called embolism or thromboembolism). The clots that move are especially dangerous. Blood clots can form in arteries (arterial clots) or veins (venous clots).

The symptoms of a blood clot, and the recommended treatment, depend on where a clot forms in your body and how much damage it could cause. Knowing the most common blood clot signs and risk factors can help you spot or even prevent this potentially life-threatening condition.

Which blood clots pose the most health risk?

Any blood clots that form in arteries (arterial clots) or veins (venous clots) can be serious. You should call your healthcare provider immediately if you suspect a blood clot.

A clot that forms in one of your body’s larger veins is called a deep vein thrombosis (DVT). A stationary blood clot, or one that stays in place, may not hurt you. A blood clot that dislodges and begins moving through the bloodstream can be harmful.

One of the most pressing blood clot concerns is when a DVT makes its way to your lungs and gets stuck. This condition, called pulmonary embolism (PE), can stop blood from flowing and the results can be very serious, even fatal. In fact, as many as 100,000 people in the United States die from DVTs and PEs every year.

Arterial clots in the brain are called strokes. Clots can form in the heart arteries, causing heart attacks. Blood clots can also form in the abdominal blood vessels, causing pain and/or nausea and vomiting.

You don’t need to be worried about blood clots that you might see during your period causing these kinds of symptoms or effects.

Who is most at risk for blood clots?

Some risk factors put certain people at higher risk for developing a blood clot.

Blood clots become more common as people get older, especially when they are over age 65. Long hospital stays, surgeries and trauma may significantly increase your risk of blood clots.

Other factors can increase your risk to a lesser degree. You might be more at risk if you:

Some factors are based on lifestyle choices. Risks might be higher if you:

• Are overweight or obese.
• Live a sedentary (or inactive) lifestyle.
• Smoke cigarettes.

Symptoms and Causes

What are the most common symptoms of a blood clot?

Blood clot symptoms will depend on where a clot forms in your body. Some people may experience no symptoms at all. Blood clots can occur in the:

• Abdomen: Blood clots in the belly area can cause pain or nausea and vomiting.
• Arms or legs: A blood clot in the leg or arm may feel painful or tender to the touch. Swelling, redness and warmth are other common signs of blood clots.
• Brain: Blood clots in the brain (strokes) can cause a range of symptoms, depending which part of the brain they affect. These clots may cause problems speaking or seeing, inability to move or feel one side of your body and sometimes seizure.
• Heart or lungs: A blood clot in the heart will cause symptoms of a heart attack such as crushing chest pain, sweating, pain that travels down the left arm, and/or shortness of breath. A blood clot in the lungs can cause chest pain, difficulty breathing, and sometimes can lead to coughing up blood.

Diagnosis and Tests

How are blood clots diagnosed?

Blood clot symptoms can mimic other health conditions. Doctors use a variety of tests to detect blood clots and/or rule out other causes. If your doctor suspects a blood clot, he or she may recommend:

• Blood tests can, in some cases, be used to rule out a blood clot.
• Ultrasound provides a clear view of your veins and blood flow.
• CT scan of the head, abdomen, or chest, may be used to confirm that you have a blood clot. This imaging test can help rule out other potential causes of your symptoms.
• Magnetic resonance angiography (MRA) is an imaging test similar to a magnetic resonance imaging (MRI) test. An MRA looks specifically at blood vessels.
• V/Q scans test circulation of air and blood in the lungs.

Management and Treatment

How are blood clots treated?

The goal in treating blood clots, especially DVTs, is to prevent the blood clot from getting larger or breaking loose. Treatment can reduce your chances of developing more blood clots in the future.

Treatment depends on where the blood clot is and how likely it is to harm you. Your doctor might recommend:

• Medication: Anticoagulants, also called blood thinners, help prevent blood clots from forming. For life-threatening blood clots, drugs called thrombolytics can dissolve clots that are already formed.
• Compression stockings: These tight-fitting stockings provide pressure to help reduce leg swelling or prevent blood clots from forming.
• Surgery: In a catheter-directed thrombolysis procedure, specialists direct a catheter (a long tube) to the blood clot. The catheter delivers medication directly to the clot to help it dissolve. In thrombectomy surgery, doctors use special instruments to carefully remove a blood clot.
• Stents: Doctors may decide if a stent is necessary to keep a blood vessel open.
• Vena cava filters: In some cases, a person might be unable to take blood thinners, and a filter is put into the inferior vena cava (the body’s largest vein) to catch blood clots before they can travel to the lungs.

Prevention

How can you prevent blood clots?

You can reduce your risk of blood clots by:

• Enjoying regular physical activity.
• Do not smoke.
• Eating a healthy diet and making sure that you stay hydrated.
• Maintaining a healthy weight.
• Controlling medical problems such as high blood pressure and diabetes.
• Make sure you are up to date with cancer screening.

Living With

When should you call the doctor about a blood clot?

If you think you have a blood clot, you go to the nearest emergency room or call 911. Call 911 right away if you have chest pain, trouble breathing or problems seeing or speaking that come on suddenly.

What should you know about living with a higher risk of blood clots or if you have already had a blood clot?

If you are concerned about your blood clot risk in certain situations, such as when you are traveling or after a surgery, your doctor can give you more information on other habits that can help.

If you are able to walk around while you are traveling, you should make sure you do so at least once every couple of hours. If you are traveling by air, your provider might suggest you wear compression stockings. You can do exercises that move your feet and legs while you are sitting.

If you have a blood clot, your provider might suggest that you take anticoagulants for a certain period of time. Some people may need to take them for life. Make sure you understand how you should take this medication and what types of interactions you should avoid. It is important to have regular follow with a provider who is specifically discussing blood thinner medication with you.

A note from Cleveland Clinic

A blood clot can be serious, even fatal. If you know you are at risk for blood clots, you can help yourself by moving around, by eating well and maintaining a healthy weight and following your healthcare provider’s suggestions on medication and lifestyle changes. (For instance, if you smoke, stop.)

When Deep Vein Thrombosis Causes Long-Term Damage

Pulmonary embolism, a blood clot in your lungs, isn’t the only serious complication that can result from a blood clot deep in your veins. Although many people with deep vein thrombosis (DVT) recover completely, up to 40 percent continue to experience symptoms in their arms or legs for years after their initial diagnosis.

Known collectively as post-thrombotic syndrome or post-phlebitic syndrome, symptoms can be painful and debilitating, according to the National Blood Clot Alliance.

Post-Thrombotic Syndrome Facts

Normally, small valves inside veins ensure that blood flows in the right direction and doesn’t leak backwards. When clots form in veins, however, these valves can be damaged and become leaky. Damaged valves allow fluid to pool in the arms and legs.

Complicating matters, clots that do not heal completely can block blood flow from the veins back to the heart, says Jae Sung Cho, MD, division director of vascular surgery and endovascular therapy at Loyola University Medical Center in Maywood, Ill. “The residual blood clot impedes blood flow, and the valve function may be impaired,” he explains. This can lead to a number of symptoms.

Post-thrombotic syndrome symptoms include:

• Pain or aching
• Leg or arm swelling
• Heaviness
• Cramping
• Redness
• Skin discoloration or dark pigmentation
• Bluish fingers or toes
• Dry skin or eczema
• Varicose veins

If a vein is completely blocked, smaller veins nearby may enlarge to help blood move past the blockage. If these smaller veins get large enough, symptoms are usually mild. However, for some people, the smaller veins that help blood bypass a blockage do not get big enough to drain all the blood that has pooled in the arms or legs. Then, symptoms worsen.

Severe post-thrombotic syndrome can lead to sores or ulcers, which can be chronic and tough to treat. These sores affect 5 to 10 percent of people with the condition.

Post-thrombotic syndrome is a lifelong condition. Symptoms may come and go over time. They also might not develop right away.

Though it’s generally believed that the condition develops 5 to 10 years after DVT, a clinical review of post-thrombotic syndrome, published in the Journal of Thrombosis and Haemostasis in 2013, suggests that symptoms may plateau one to two years later. The researchers note that a third of those who develop severe post-thrombotic syndrome have symptoms that continue to worsen six years after their initial DVT diagnosis.

RELATED: Deep Vein Thrombosis: Not Just a Leg Problem

Easing Pain and Other Symptoms

When it comes to reducing complications associated with DVT, including post-thrombotic syndrome, prevention is key.

“Anyone who has had a blood clot in the past needs to be cautious,” Dr. Cho says. “As we get older, we become more prone to develop blood clots. For those who already have a history, their risk is even higher, so they need to take more precautions. This may include taking blood-thinning medications, known as anticoagulants, for the rest of your life.”

Aside from medication, if you experience swelling after DVT, it’s important to wear fitted compression stockings to improve blood flow throughout the day while you’re sitting or standing. Various types exist including above-the-knee stockings for swelling in the thigh, and sleeves (known as gauntlets), for arm swelling or pain. Your doctor can tell you what would be best for you.

If compression stockings are not effective, your doctor may recommend that you use a device called a compression pump to improve blood flow.

Other ways to ease symptoms of post-thrombotic syndrome include:

• Elevating your arm or leg above your heart while lying down or sleeping
• Losing excess weight
• Exercising to strengthen the muscles in your arms and legs

Swimming, in particular, can help, Cho says, because “the hydrostatic pressure of water helps reduce swelling in the limbs.”

Certain over-the-counter and prescription medications can also help ease pain associated with post-thrombotic syndrome. But, if you’re taking a blood-thinning medication, you should not take drugs that contain aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, because NSAIDs increase bleeding risk. Pain-relieving medications that could be considered include acetaminophen, tramadol, and oxycodone.

The Truth About Traveling Blood Clots

Diagnosing DVT and PE

DVT and PE aren’t always detected for what they are. “The symptoms are quite subtle, and sometimes it’s a nagging pain in the leg that people don’t pay much attention to,” Dr. Silverstein said. “You think you pulled a muscle — you don’t think it could be a clot.”

However, because PE can lead to sudden death, it’s critical to seek medical treatment right away if you think you might be experiencing any of the telltale symptoms. According to the Centers for Disease Control and Prevention, about 350,000 to 900,000 people in the United States develop DVT or PE (or both) every year. About 100,000 of them die, and most are sudden deaths because the fatal pulmonary embolism goes unrecognized.

That need not be the case, however. “As long as we make a prompt diagnosis and treat it, patients do extremely well,” Silverstein said.

Most often, DVT can be diagnosed with Doppler ultrasound. A sonographer uses an ultrasound machine, sending sound waves through the leg, to observe blood flow in your veins.

To diagnose PE, doctors may order a CT scan or a specialized X-ray of your lung, called a lung ventilation/perfusion scan, that also can show how much blood is getting to your lungs. During the ventilation part of the scan, you inhale a small amount of a radioactive gas. Radioisotopes also are injected into your bloodstream to allow doctors to see where blood flows to your lungs.

A blood test known as D-dimer measures a substance found in your blood when a clot dissolves. High levels may suggest blood clots. If your levels are normal and you have few risk factors for PE, it could indicate that you don’t have PE.

RELATED: 6 Simple Steps to Avoid Deep Vein Thrombosis

Managing DVT and PE Blood Clot Disorders

Sitting while traveling long distances in a plane or car can increase your risk for DVT and PE, and “the longer the flight, the higher the risk,” Silverstein said.

Women who take hormones, whether birth control pills or estrogen therapy, also are at increased risk, as are pregnant women and women in the six weeks after childbirth. People who have to spend an extended amount of time in bed, most often because of hospitalization and recovery from an illness or surgery, also have heightened risk.

Treatment involves medications that thin your blood and slow its ability to clot. Blood thinners won’t break up clots, Silverstein said, but they will stop the clot from growing and prevent further clots. “The body has a natural way of healing itself, and eventually the clot disappears on its own,” he said.

If a pulmonary embolism is life-threatening, your doctor can administer a thrombolytic, an agent that will dissolve the clot quickly. Because thrombolytics can cause you to bleed, they’re used only when your life is in danger. “Thrombolytic therapy has to be done in a hospital setting,” noted Silverstein.

Sometimes, though not often, surgery is required to remove the blood clot.

“The complication of PE that we worry about most is death,” Silverstein said. “If you have repeated clots, over time they can damage your lungs, and that can lead to chronic heart disease. Most of the time, that doesn’t happen.”

Once you’ve had a PE, you are at greater risk of having more. Other factors that could further increase your risk include:

• Being sedentary or bedridden
• Being overweight
• Undergoing surgery or breaking a bone
• Having stroke, chronic heart disease, high blood pressure, or paralysis
• Smoking

Age is also a risk factor. “The older you are, the higher your risk,” Silverstein said, “particularly after age 55.”

Never ignore DVT or PE symptoms, thinking they will go away, especially if you have risk factors. Because the signs — if any — will be subtle, err on the side of caution.

Do Blood Clots Go Away on Their Own?

Minor blood clotting, natural blood coagulation, is part of healing from bruises cuts. These clots are typically broken down by the body and go away on their own, once your injury has healed, but never take chances. Blood clots can be very dangerous if they go undiscovered and untreated. That’s why it’s important to err on the side of caution. Always seek medical attention if you suspect a clot, or show symptoms of vein problems, described below, that may require vein treatment.

Who Is Likely to Get Blood Clots or Vein Problems?

If you’ve recently had a surgical procedure, are prone to blood clots through family history, or are traveling long distances without stretching your legs, you could be vulnerable to blood clots that require expert vein treatment.  Vein problems, from spider veins to varicose veins, to the most serious DVT emergencies (deep vein thrombosis) should always be investigated to ensure your vein health. Vascular exams are quick, convenient and painless at your NJ vein clinic.

Remember, blood clots may have no symptoms. Blood clot risk factors include:

• Immobility
• Genetics
• Recent surgery or injury/trauma
• High blood pressure
• High cholesterol
• Obesity
• Pregnancy or birth control pills
• Smoking
• Age (especially when over 60)
• Underlying disease, like diabetes or inflammatory conditions
• Recent placement of an IV line (intravenous medication or blood administered)

Signs That You May Have Vein Problems

Watch for these symptoms of vein disorders or blood clots and seek vein treatment at our local vein clinics:

• Small webs (clusters) of red or blue-ish veins under facial skin, chest, legs or other areas (usually superficial spider veins)
• Bulging or discolored veins that may feel solid, often in the legs (varicose veins)
• Pain in the legs or a heavy feeling
• Pins-and-needles or numbness in lower legs
• Swollen ankles (possibly due to partially blocked veins, possible local blood clotting, and chronically poor circulation)
• Darkened, thickened skin on lower legs/ankles
• Sores or wounds near ankles that heal slowly, which can lead to serious, quickly-spreading infections (cellulitis)
• Pain or a pulling sensation in your thigh or lower leg*
• Red, swollen area that feels hot to the touch*

*These can be signs of a DVT blood clot, which requires emergency care. A DVT can travel to the lungs causing breathing difficulty, pulmonary embolism, and even death.

Why Vein Treatment Matters

Even slight vein problems can compromise your quality of life, if not diagnosed and treated promptly. Over time, the condition of your veins can deteriorate and can interfere with healthy circulation throughout your body. Even when circulation is not completely blocked with a DVT blood clot, your health can still be at risk from smaller clots or vein valve problems. Chronic poor circulation slowly robs your extremities of oxygen and nutrients needed for cell growth.

Where to Get Expert Vein Treatment in NJ

At the Vein & Vascular Institute, we have several locations in New Jersey offering convenient diagnosis and treatment for vein problems. With proper vein care, as recommended by your vein doctor, we can help you prevent (avoid worsening of) vein problems and maintain your vein health for life. Contact the Vein & Vascular Institute in NJ, today.

Posted in: Vein Treatment

90,000 Insidious blood clot. How it is formed and why it comes off. Society news

Up to 20 cm

“A thrombus is a blood clot. The size of a thrombus is from a few millimeters to 20 cm in length. A thrombus forms inside a vessel, ”says Yuri Shevtsov.

In a healthy body, blood flows through the vessels, like, figuratively speaking, water in a river. But the river – under certain conditions – is covered with ice. This also happens with our body. When we are healthy, the blood clotting and thinning processes are balanced.But if certain circumstances happen, the same platelets, which in a good way protect us from blood loss, can thicken. Until large and small blood clots. In arteries and veins.

“But since we started talking about pulmonary embolism,” Dr. Shevtsov narrows the scope of our conversation, “the process of thrombus formation, which can block the pulmonary artery, takes place in the venous system. Another serious disease, phlebothrombosis, can develop from a thrombus formed in the venous system.

It all starts with the formation of a blood clot in the legs. It is in the lower extremities that the venous blood pressure is strongest. According to various sources, the same phlebothrombosis of deep veins is diagnosed annually in 150-300 people per 90,015,100 thousand population 90,016. That is, in relation to our region, every year up to 4.5 thousand people know about their disease for the first time .

“The drama of the situation lies in the fact,” continues Yuri Nikolaevich, “that the disease usually starts with very minor symptoms.Deep veins and deep veins are hidden under the bunk. People usually treat barely sensitive discomfort without problems. Well, it hurts a little bit. Well, my leg was swollen a little. Why worry? It will pass by itself in a couple of days. However, the disease does not wait, the doctor warns. – And precious time leaves like sand through your fingers. The disease becomes chronic. That’s when a person finally pays attention that his leg has become purple-blue, and it is not only difficult for him to walk – the pain does not allow him to live normally.Not to mention the fact that he is not able to work ”.

Yuri Shevtsov.
Photo by Yuri Korenko

Blocks the lumen

Reason phlebothrombosis – a thrombus in a deep vein has grown to a critical size. And if the lumen of the blood vessel is blocked by three quarters or more, then nutrition is practically not supplied to the tissue cells. With all the mentioned consequences – cyanosis, swelling. Moreover, the other leg looks quite healthy.

“And when we ask such a patient how long ago his problems began, he replies that he felt unwell one or two or three days ago. But in fact, the patient has been sick for several months already, the doctor states. – Examination of the patient for ultrasound confirms the chronic nature of the disease. We find both fresh blood clots and old ones. If people were more attentive to themselves, they would seek help at the earliest stages of the disease, when treatment is most effective. “

But blood clots are so insidious that they come off the wall of their own vessel. Forming in the deep veins of the leg, if they are weakly attached to the vessel, they rush upward with the blood flow.

“ Pulmonary embolism , like phlebothrombosis, proceeds with minimal manifestations – the doctor pays special attention to this. – When we question patients who have been saved from thromboembolism, they usually remember that they felt discomfort in their legs for several months.There was slight swelling, soreness. But they didn’t go anywhere, didn’t do anything ”.

The conditions when the river freezes are clear: frost. And what affects the thickening of the blood?

“There are three factors without which thrombosis cannot occur,” the doctor replies. – They were once described by the German physiologist Virchow . The disease is caused by: slowed down blood flow, damaged vascular walls and increased blood clotting. In the presence of one factor, thrombosis is possible, but not 100%.When the two conditions are combined, the likelihood of thrombosis is quite serious. Three factors in a complex – thrombosis is almost inevitable. ”

Slow blood flow. When does it happen? For example, with varicose veins. But almost half of the adult population suffers from this. Such people need to be especially careful not to get one or another factor from Virchow’s triad.

And what leads to blood thickening ? Stay in the heat. A person sweats – the blood reacts.Dries up. Not everyone thinks about it, but a lot of water leaves a person with breathing. So you need to drink water. Approximately two liters every day.

Hot drinks thicken the blood. There are many alcoholics who live with thrombosis.

Taking hormones , especially uncontrolled, also increases the activity of the blood coagulation system.

Beware of injuries – this is the third factor according to Virchow. Bone fractures are especially dangerous.In addition, now quite widespread operations for prosthetics of joints – knee, hip. During the rehabilitation period, you need to strictly follow the doctor’s recommendations in order to exclude the possibility of complications in the form of thrombosis.

The scourge of civilization

“The lack of exercise did not benefit anyone, and the sedentary lifestyle is the scourge of civilization,” Shevtsov says. – Here we are sitting with you now. And for ourselves we create a risk factor for thrombosis. The muscles in the legs do not contract. Blood in the veins of the lower leg, thigh, small pelvis stagnates.True, we do not talk for so long, but many people spend their days at the computer. ”

Those who have sedentary work need to get up from their chair at least every two hours and walk around the office. It is best to even relax on the couch for about 15 minutes, placing a roller under your feet. I understand, it’s unreal. But then, sitting at the table, do gymnastics with your feet as often as possible: as if alternately press the gas and brake pedals.

The risk group also includes surgeons, hairdressers, salespeople, lecturers, conductors.Because people of these professions stand for hours – at an operating table, a lectern, a music stand.

The doctor strongly recommends everyone to wear compression hosiery.

– These can be knee-highs, stockings, which can improve the function of the musculo-venous pump, – said Yuri Nikolaevich.

– Do you need to wear it according to feelings? – I asked curiously.

– When sensations arise, it is too late, – answered the interlocutor. – There is nothing better than prevention, especially when it comes to thrombosis.Sensations, as you say, arise when the disease has already firmly taken hold of a person. And people are ready to bite their elbows. But time has passed.

Feel the blood clot. Expert – on the dangerous symptoms of vascular diseases | Treatment Methods | HEALTH

What are the first signs of vascular diseases and how does varicose veins differ from thrombosis? The questions of AiF-Kazan readers are answered by Head of the Department of Vascular Surgery of the Interregional Clinical Diagnostic Center, Doctor of Medical Sciences, Cardiovascular Surgeon of the Highest Category, Associate Professor of the Department of Cardiovascular Surgery of Kazan Medical University Roman Bredikhin.

When should you operate the stars?

– How to understand if I have internal varicose veins? Nadezhda, Kazan

– Signs of varicose veins are always there: either the so-called vascular “spiders”, “stars” appear on the legs, or larger veins that look like worms wriggling under the skin. If “stars” appear, you need to contact a phlebologist – a specialist in vein diseases or an even more general doctor – a vascular surgeon.To determine which type of treatment is right for you, you need to perform an ultrasound scan of the veins.

So, isolated vascular “stars” are a purely cosmetological problem, they can be removed on an outpatient basis by sclerotherapy. But if they are the result of varicose changes in the saphenous veins, then such changes usually require surgical intervention. Drug therapy is often necessary.

Roman Bredikhin during the operation. Photo: From the personal archive of Roman Bredikhin

– My son is 33 years old, diagnosed with varicose veins.Can the operation be performed free of charge? Alfiya Zufarovna, Leninogorsk

– Varicose veins are curable. In our department, about 500 such free operations are performed annually. Usually, after 1-2 weeks, a person can already go to work.

To get free help, you need to come to our clinic’s office, where your son will be examined and put in a queue for a free operation.

– Is it possible to operate on varicose veins at the age of 70? Zulfiya, Kazan

– There are two most effective treatments: surgery and compression hosiery, and they usually complement each other.Modern medicine does not consider age as a contraindication to surgery and allows you to cure varicose veins at any stage and at almost any age, if there are no serious complications. Modern operations are minimally invasive. They can even be performed under local anesthesia.

– In 2004, there was an operation for varicose veins. But varicose veins appeared again. Alfinur, Buinsk

– The recurrence rate reaches 30-40%. Often, varicose veins occur as a result of the progression of the disease, sometimes due to an inadequately performed first operation.It is possible to recover, but, unfortunately, not with stockings, pills or ointments, but only with a second operation. According to the current recommendations, such operations can only be performed in expert-level hospitals (in Kazan, this is the MKDTs or RCH). First, you need to do an ultrasound scan and take a referral from the surgeon for a consultation with the ultrasound data. If you contact us, we will examine you, show you what needs to be done in terms of diagnostics and put you in a queue for a free operation. According to the state guarantee program, this queue lasts no more than 1 month.

How to feel a blood clot?

– My leg hurts. Is it possible to identify the first signs of thrombus formation on your own? Vera Leonidovna, Kazan

– Thrombus is a blood clot formed in a vessel. If it is formed in a vessel, then its narrowing or complete blockage leads to impaired blood circulation in the organ that feeds this vessel. The signs of thrombosis are always bright, but different, since there are a lot of vessels and they supply blood to different organs.Thrombosis is always an acute condition. If a blood clot forms in the vessels supplying the brain, the person is paralyzed, speech is impaired, there are signs of a stroke. If a blood clot forms in the heart, then a heart attack occurs, its signal is severe chest pain.

If a blood clot forms in the leg, the leg becomes cold, sharp pains appear in it, comparable to an electric shock, gangrene develops. With a blood clot in the venous system, blood outflow is impaired. If the vein is subcutaneous, then the place where the blood clot formed begins to ache, the skin over the vein turns red, palpation of the vein becomes like a lace or a pencil.In order not to bring oneself to such a state, one must try to prevent the formation of a blood clot.

To do this, you need to understand if you have vasoconstriction – to undergo an ultrasound of the vessels and heart, to take an ECG. For example, a blood clot forms in the arteries when it is narrowed by 70% or more. In the cavity of the heart, thrombi are formed during its uneven work (arrhythmias). In the veins – with their varicose transformation.

It is necessary to make a coagulogram – an analysis that allows you to find out how the blood clotting system works, an analysis for D-dimer and homocysteine.If the coagulogram, homocysteine ​​and D-dimer are normal, then the risk of blood clot formation in you is the same as in all healthy people.

Shunt or stent?

– Is an operation always necessary if an ultrasound scan showed changes in the vessels? And what is the difference between bypass surgery and stenting? Rifkat, Kazan

– Operation on vessels is done only for certain indications. The degree of narrowing of the arteries on ultrasound (usually the question of the operation is raised if the narrowing has reached 60-70 %%) – only one of them.The clinical picture and localization of the lesion are very important. In any case, the patient is prescribed specialized medications in the hope that the vessels will stop narrowing. That is, in most cases, not an operation is needed, but conservative therapy.

There are two main types of treatment: open or endovascular. It is possible, for example, to restore blood circulation using open surgery methods – to let blood bypass a narrowed or closed vessel – that is, to sew an artificial vessel. This is called bypass surgery.The bypass vessel is sutured through a surgical incision. The second way is to restore the permeability of the vessel from the inside. In this case, a stent is inserted into the vessel – a “frame” that expands the vessel lumen.

This type of operation is performed through a puncture in the vessel, without its incision (usually the punctured artery on the arm or on the thigh). Almost any artery can be stiffened. Most often, puncture of the femoral artery or radial artery is used for this.

– Why not stent all patients?

– Because the results of surgical treatment are different on different vessels.For example, open surgery on the vessels of the neck to prevent stroke (carotid arteries) is usually more effective than stenting. There stenting is offered only to those patients who cannot undergo surgery. And if we talk about surgical treatment of the iliac artery, stenting usually gives the best results in this localization.

Can leeches cleanse blood vessels?

– Is it possible to do without a stent, to clean the vessel by other means? Z .Abdulkhakova, Nizhnekamsk

– Preparations that would completely remove atherosclerotic plaques from blood vessels do not exist today. There are only rules of life and behavior that prevent further narrowing or slightly level it.

– Will the stents come off if you put leeches?

– There will be no migration of stents when using leeches. They are firmly fixed. But there is no evidence base for effective results from taking leeches, so I do not approve of this method of treatment.

– A year ago they put a stent in my carotid artery. Can I have a neck and neck massage? Is it possible to do neck gymnastics with turns forward and to the sides? Will the stent move? K. Kayumova, Kazan

– You can do both massage and gymnastics. This will not move the stent. But the stent needs to be monitored: every year an ultrasound of this vessel should be done. After all, it so happens that the stent is placed, but the disease does not go away. Again, a narrowing may form – either in this vessel, where the stent is located, or in another.

For almost two hours Roman Bredikhin answered questions from readers. Photo: AiF

– 10 years ago I had a bypass. Three years ago I did coronary angiography: one shunt clogged and the same process began in the second. Can a stent be inserted if I have angina pectoris? A. Aksilov, Kazan

– From my point of view, you need to go to a cardiologist with a complaint that conservative therapy is not helping you. Re-conduct coronary angiography and, on its basis, evaluate the indications for coronary stenting.A stent can give you a few more years of normalcy.

– Did a bypass of a vessel on the heart 3.5 years ago. Now coronary angiography has shown that the narrowing is progressing in another vessel – one of the vessels is clogged by 60%. What can be done? Albert, Kazan

– Without studying your specific case, you can only give general advice: according to Russian and international recommendations, you need to take antiplatelet agents (which thin the blood). These are acetylsalicylic acid preparations: the doctor selects them individually, based on risk factors.You also need to take statins, which can stop vasoconstriction and, in some cases, even reduce it. More detailed, individual recommendations can be given only after studying the examination results: cardiogram, ultrasound of the heart. One of the main tips is not to smoke, otherwise medications work very poorly and blood vessels continue to narrow. And not only in the heart, but also in the brain, in the legs.

The disease is inherited?

– My father had obliterating endarteritis, his leg was taken away.The sensitivity of my foot has been disturbed lately. Am I getting this disease? V. Nerobov, Kazan.

– Obliterating endarteritis occurs before the age of 40. Considering that you are about 80 years old, it is unlikely that you have the same diagnosis. However, you may have atherosclerosis, which is most common in older people. In case of leg pain, the first step is to do an ultrasound of the arteries of this leg in order to check if blood is entering it. If abnormalities are found, consult a vascular surgeon.

– My husband was diagnosed with “generalized atherosclerosis with damage to the arteries of the lower extremities.” Narrowing of the common femoral artery – 50%, on the right – 51%, on the left – 39%. The husband can walk only 50 meters without stopping. Valentina Nikolaevna

– Narrowing of the common femoral artery by 50% cannot cause restrictions in walking. Maybe during this time the disease has progressed, maybe some vessel has closed. You need to look again at the ultrasound of the vessels, maybe the narrowing is stronger than you say.Or look for another reason. It often happens that the restriction in walking occurs not due to damage to the vascular bed, but due to diseases of the joints, spine.

– I had an operation for lymphostasis. But erysipelas recurs – three times a year. What to do? Alevtina Antonova

– You are confusing two different diseases: lymphostasis and erysipelas. Yes, they are interconnected: due to the fact that erysipelas occurs, lymphostasis increases.And in the presence of lymphostasis, erysipelas progresses. Unfortunately, there are no radical cases of lymphostasis treatment in the world today, only palliative ones. But in Kazan, a center for the treatment of lymphostasis has been created, where this disease is fought with methods of conservative therapy.

The main symptom of lymphostasis is severe edema of the extremities. No wonder this disease is called elephantiasis. There is a complex therapy for lymphatic edema. It includes, first of all, a special type of manual massage with bandaging.The massage allows you to reduce the edema by a few centimeters, and then the leg is bandaged, that is, the edema is not allowed to develop. After that, a special, non-stretchable knitted fabric of the so-called flat knit is selected. Patients wear it with pleasure, because it gives a good effect, the leg takes on a normal shape.

With regard to recurrent erysipelas, you need to take antibiotics for two to three years, which will prevent the erysipelas from progressing. If there are relapses, then there is a flaw in your treatment regimen.To correct it, contact an infectious disease specialist.

What is the bruise talking about?

– Bruises appear on the arms and legs from the slightest pressure, what should I do? Who should I contact? E. Pavlova, Kazan

– A bruise is a hemorrhage. Its appearance suggests that either the blood coagulation system is disturbed, or that the vessel wall has become unnecessarily fragile. If this is a one-time, isolated phenomenon, then it is enough to pass a general blood test, so that the functions of platelets, the cells responsible for blood coagulation, are necessarily studied in it.And second, you need to take a coagulogram. If these two indicators are normal, but the condition continues to progress, then you need to go to a rheumatologist – a specialist who will check if you have autoimmune diseases.

– Revealed occlusion of the left vertebral artery neck. Is it possible to restore blood flow to the left vertebral artery? Vladislav Mikhailovich, 71 years old

– Take a referral and go to the Vascular Surgery Department of the ICDC. We do such operations.But the method of the operation (and the indications for it) will become known only after specialized diagnostics (for this we will make you a multispiral computed tomoangiography of the neck vessels). Sometimes it is an operation, sometimes stenting.

How to get along with thrombosis – Archive

“Our doctors, Dr. Sukles and Dr. Kaljusaar, came up with the idea to open a special room for thrombosis treatment, because the results of thrombosis treatment were not impressive,” says Airi Pyder. – The fact is that thrombosis develops completely asymptomatic.And one day a person suddenly feels severe pain in his leg. Sometimes the pain is accompanied by a feeling of heaviness and swelling. It seems as if the leg is bursting from the inside. After two to three days, an enlarged superficial venous network becomes noticeable. ”

The worst is a detached blood clot

The external manifestations of thrombosis depend on how deeply the vein with the thrombus formed in it is located and how strongly the thrombus – a blood clot – blocks the movement of blood through it. If a blood clot, for example, is in the ileum or in the femoral vein, then the swelling spreads to the entire leg, the skin turns blue and seems cold.A person’s condition deteriorates sharply, the temperature rises, chills appear, and weakness is felt. But when small veins are thrombosed, it is quite difficult to detect the disease, since in this case the symptoms are almost not manifested. And the doctor focuses only on the patient’s complaints of pain that manifests itself while walking.

Signs of deep vein thrombosis:

• Swelling of the legs (usually occurs on one leg).

• Pain in the leg, better lying down and worse standing up.

• One leg may be warmer than the other.

• The color of the skin on the leg may change: the leg turns red, may take on a purple tint.

• The coverage of the lower leg or thigh on the affected leg is greater than on the healthy one.

• The veins of the legs protrude above the surface of the skin.

In some cases, deep vein thrombosis can cause gangrene of the limb. But the most common complication of deep vein thrombosis in the legs is thromboembolism, when a detached blood clot enters the pulmonary artery.The fact is that during the first four to five days from the moment of its formation, the thrombus is weakly connected to the vein wall and can break off with muscle tension or a sudden increase in venous blood flow. A torn off thrombus is carried away with the flow of venous blood into the heart, and then into the vessels of the lungs and causes a pulmonary infarction.

In this case, a person experiences sudden pain in the chest, possibly fainting, which quickly passes and is replaced by a cough, difficulty and painful breathing.The travel of a blood clot, when it enters a large branch of the pulmonary artery, can result in sudden death from acute heart and respiratory failure. Therefore, the main goal of treatment is to prevent such a course of events.

Signs of thromboembolism

pulmonary artery:

• Sudden feeling of shortness of breath.

• Pain in the chest, worse with deep inspiration and expiration.

• Rapid pulse.

• Sputum with blood streaks.

• Loss of consciousness.

The family doctor will order a special ultrasound examination to evaluate the blood flow in the veins, as well as a blood test. Sometimes a procedure called angiography may be needed, in which the doctor injects dye into the veins to trace their progress.

Death from thromboembolism. What does “blood clot come off” mean? | | Infopro54

Thrombus is a blood clot formed in a blood vessel or in the heart itself. It can grow and eventually clog the vessel, leading to death.

Thrombosis – the process of thrombus formation.

Thrombophlebitis is a thrombosis, in which the vein wall becomes inflamed and a clot forms that blocks its lumen.

Thromboembolism is a complication when a blockage of the blood channel occurs. By “detachment of a blood clot” is meant the separation of a blood clot from the wall of a vein or artery.

The most dangerous are cases when the blood vessels of the heart, lungs and brain are clogged.

Thrombus formation

The formation of blood clots is of great importance to the body. This process protects the person from blood loss. With poor clotting, even a small wound can lead to death.

However, when blood clots begin to appear more intensely, a health threat is created. The causes of their occurrence can be strong blood viscosity, vascular damage, slow blood flow. Clogged vessels are unable to deliver the necessary oxygen to the organs, and as a result, their cells begin to die off.If the events are poor, the separation of a blood clot can lead to a stroke.

Stroke

Stroke is a severe violation of the blood circulation in the brain. Lack of oxygen causes brain cells to die. A person who has not received timely assistance will not be able to return to normal life.

There are two types of strokes: hemorrhagic and ischemic. The cause of the first is a rupture of the vessel, and the second is a clogging of a vein or artery with a thrombus. The latter is found several times more often.

Thromboembolism

The main threat of thromboembolism lies in its surprise. For example, if a pulmonary artery is blocked, then the person dies in a few seconds. He may not even be aware of the disease. And when this happens, he has enough time to ask for help.

Deep vein thrombosis

Separate arterial and venous thrombosis. The second is differentiated by the type of veins. In ninety percent of cases, superficial vein thrombophlebitis occurs, in the remaining ten deep vein thrombosis.

Deep veins – veins located in the muscle canals. When they are clogged, blood has the ability to get to the heart only through small vessels. In most cases, it proceeds with the following symptoms:

• Edema in the area of ​​a blockage of a vein;
• Painful sensations during exertion of the legs;
• Hyperthermia – different temperature of the extremities;
• Discoloration of the skin, most often the entire limb.

Prevention

As mentioned above, there are three main causes of blood clots: high blood viscosity, vascular damage, slow blood flow.Both acquired and hereditary factors lead to them. The following groups of people are at greatest risk:

• Women expecting a baby. The threat of thrombosis during pregnancy increases sixfold.
• People with a sedentary lifestyle. Since the lack of movement causes a slowdown in blood circulation.
• Smokers. The action of nicotine leads to an increase in blood clotting.
• People with obesity, high blood pressure or varicose veins.
• Those who are systematically stressed.
• Alcoholics.
• Patients with diabetes mellitus, chronic lung disease, atherosclerosis.
• Adherents of strict diets and those who drink little liquids.

A healthy lifestyle can help reduce the risk of blood clots. Therefore, the advice here is rather commonplace:

• Give up alcohol and cigarettes.
• Reduce stress.
• Drink plenty of fluids and eat a balanced and healthy diet.
• And of course more movement. Sports activities, running, walking.

Blood clots can be predicted by the flow of blood

Blood clotting can be quickly and accurately assessed using a device that simulates blood vessel tortuosity.

The blood clotting system is about two dozen proteins called clotting factors, and platelets, or platelets. The clotting factors with platelets mutually influence each other, accelerating or slowing down the formation of a blood clot: the clotting system must be tuned very precisely so as not to clog blood vessels with unnecessary blood clots and prevent internal bleeding – both can lead to very serious consequences.

A blood clotting meter that simulates the curves of real blood vessels. (Photo: Texas A&M University College of Engineering)

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Naturally, clotting depends on the form in which we have the necessary proteins with platelets. It happens that some coagulation factor is too much, or too little, or a mutation has got into its gene and now it does not work as it should. By measuring the level and activity of a particular factor, one can say whether a person needs to take anticoagulants to prevent thrombosis, or, conversely, he should be afraid of unstoppable bleeding.

But such analyzes do not take into account the fact that blood flows through vessels that bend, bend, expand, narrow, etc. As the staff of Texas A&M University wrote in an article in Scientific Reports , changes in blood flow affect the coagulation response, so that the likelihood of blood clots should be assessed taking into account blood hydrodynamics. To do this, the researchers designed a device that simulates thin curved blood vessels: a small portion of blood is pumped through them (to which drugs that affect clotting can be added), and a special sensor monitors how the pressure in artificial vessels changes.

The device was tested on patients in a children’s hospital, whose blood is saturated with oxygen by extracorporeal membrane oxygenation (ECMO). On the one hand, extracorporeal oxygenation usually increases the risk of blood clots, so patients are almost always given anticoagulants. On the other hand, it is known that blood passing through the ECMO apparatus loses platelets and coagulation proteins, and there is another danger – that internal bleeding will begin, especially if there are too many anticoagulants.

The experiment showed that the vascular coagulation meter quite accurately determines how much the patient’s blood tends to create blood clots. The analysis takes only 10-15 minutes, which is much faster than a conventional clotting test; in addition, the authors of the work say that their method is quite simple, and incorrect results are obtained with it less often. It is possible that this apparatus will soon be widely used, especially where it is necessary to very quickly and accurately assess blood clotting.

Thrombophlebitis of the veins of the lower extremities

During treatment, it is necessary to prevent the spread of the process to deep veins (the risk of developing pulmonary embolism), reduce the manifestations of inflammation and prevent the re-development of the disease.

In the presence of thrombophlebitis of varicose veins without spreading to deep veins, treatment at home is possible. With the threat of development of pulmonary embolism and severe inflammation, treatment in a hospital is indicated.Regardless of the treatment regimen, elastic compression, pharmacotherapy and local treatment are required.

Elastic compression consists in tight bandaging for 7-10 days around the clock, then the application of compression hosiery in the daytime.

Pharmacotherapy includes the use of drugs that strengthen the vein wall (Detralex, Cyclo 3 Fort, Ginkor Fort, Troxevasin), preventing further thrombus formation (aspirin), anti-inflammatory drugs (ketoprofen, diclofenac).

Topically – ointments that dissolve blood clots (heparin ointment, Lioton-gel), as well as ointments or gels that reduce inflammation (ketonal-gel).

As an analgesic effect, it is possible to apply cold to the affected vein area within 2-3 days from the onset of inflammation locally.

Anticoagulants are prescribed if there is a risk of thrombotic complications. They usually start with intravenous anticoagulants (low molecular weight heparins) and then move on to oral anticoagulants.Oral anticoagulants are given for several months to prevent recurrence. When using anticoagulants, it is necessary to regularly take tests and monitor the manifestations of bleeding (redness of urine, discoloration of stools, bleeding gums, bleeding from the nose) blood). Hirudin, getting from the glands of leeches into the blood, lowers its viscosity and coagulability.Along with this, the spasm of arterial vessels disappears. Leeches can be placed at the same time, 5-10 pieces per limb along the affected vessel, repeat the procedure after 5-6 days. The skin on the limb should be shaved and washed with warm water without soap. For quick suction of leeches, the skin is lubricated with a glucose solution or sweet water. The leech should not be removed by force, since it falls off by itself after pumping 10-20 ml of blood. It is not recommended to use leeches for anemia, low blood clotting, in the first months of pregnancy and during treatment with mercury preparations.

As a means of direct action on blood clots, fibrinolytics are used, which in the early stages of the process lead to clot lysis. Fibrinolytic drugs include fibrinolysin, streptokinase, urokinase, trypsin, chymotrypsin.

If thrombophlebitis is combined with deep vein thrombosis, thrombolytic drugs are prescribed by mouth.

Physiotherapeutic methods (ultraviolet irradiation, sollux, infrared rays, etc.) are used in the chronic stage of superficial thrombophlebitis, during the period of thrombus formation.Spa treatment (Pyatigorsk, Sochi-Matsesta) can be allowed strictly individually only with long-term chronic superficial thrombophlebitis without exacerbations and trophic disorders.

At high fever or suspicion of purulent thrombophlebitis, antibiotics are used.

In the absence of the effect of conservative treatment, surgical removal of the vein or its section is indicated, depending on the severity of the process.

COVID, thrombosis and thrombodynamics – Science – Kommersant

Thrombodynamics – a test for early diagnosis of disorders of the blood coagulation system, identifying the risks of bleeding and thrombus formation.The developer of the test is GemaCor Labs (a resident of Skolkovo).

At the very beginning of the COVID-19 pandemic, Chinese doctors in Wuhan noticed a violation of the blood coagulation mechanism, especially in seriously ill patients. The patients had active thrombus formation, that is, the formation of blood clots in the arteries and veins. Thrombosis, as it turned out, is one of the most common complications of coronavirus infection, which often leads to the death of patients. The first patient with coronavirus who died in Russia died precisely because of bilateral pulmonary embolism.

In Russia, the first person who became interested in the problem of thrombosis in coronavirus infection was a corresponding member of the Russian Academy of Sciences, professor at Moscow State University. MV Lomonosov Fazli Ataullakhanov, who organized a study to assess the state of blood coagulation in patients diagnosed with COVID-19 in Russian clinics and attracted several dozen young doctors as volunteers, including students and employees of the Skolkovo Institute of Science and Technology (Skoltech) … By examining blood coagulation in various ways, it is possible to timely detect the onset of the hypercoagulability process and significant vascular thrombosis and prescribe anticoagulants (drugs that reduce blood clotting) to the patient, primarily heparin.To track the coagulation processes, Professor Ataullakhanov decided to use an innovative device for blood testing “Thrombodynamics Recorder”, developed by the HemaCor company and the Rusnano portfolio company, which allows you to accurately determine the state of hypercoagulation.

“Our method of thrombodynamics is one of the laboratory tests, but it is fundamentally different from them,” says Ilya Spiridonov, General Director of HemaKora. “In the usual or routine tests that are now used in

clinic, blood or plasma is mixed in a test tube with various coagulation activators, and then the time during which the blood clotted is measured.But after all, in the body, blood begins to clot where there is some damage to the blood vessels, and a blood clot grows from the site of damage. That is, in a spatial sense, this is a very heterogeneous process. Our test uses a localized coagulation activator. It contains exactly the same protein that is exposed into the lumen of the vessel at the site of damage to the wall, where there is a wound. And from this place in our cuvette, a thrombus begins to grow in the same way as from the site of damage it begins to grow in a vessel.By assessing with the help of video microscopy the rate at which the clot grows, its density, maximum size and the period during which it began to grow, we can predict the patient’s tendency to thrombotic complications.

In addition, the thrombodynamics method helps to select the optimal dose of anticoagulants. If, at the moment when the effect of the drug ends, thrombodynamics is performed, it is possible to understand whether it was possible to normalize coagulation. This is especially true for critically ill patients with COVID-19.“Apparently, the coronavirus itself is very procoagulant in its action, because it inflames the vascular wall and gives a powerful activation of the coagulation system and standard doses of anticoagulants in some cases may be inadequate,” emphasizes Ilya Spiridonov.

“Thrombodynamics Registrar” was registered by Roszdravnadzor at the end of 2012 and is currently used in about 200 clinics. In 2015, sales began to Europe, in 2019 – to the United States, and recently a distribution contract was signed with one of the Asian countries.Last year, about 100 thousand test systems were delivered to Russia and abroad.

“Thrombodynamics recorder” is used to determine hypercoagulability in a variety of pathologies, and whether it will be widely used in the treatment of COVID-19, the study conducted by Professor Ataullakhanov will show. Its observation part, which was held on the basis of ten hospitals with the participation of thousands of patients with coronavirus infection, has recently ended. She showed that the method allows you to identify a group of patients who are subject to more careful observation for thrombotic events.