Venous Thrombosis

Venous thrombosis – blood clotting inside the veins, either deep or superficial veins.┬áComplications depend on the location of the venous thrombosis and the thrombus development.

venous thrombosisCAUSES of thrombosis

In the ’20s, a famous pathologist, Virchow indicated that there are three main causes for blood clotting in the veins. These factors are called Virchow triad:

  • Changes in the vein wall;

  • Changes in blood flow;

  • Changes in blood composition.

Changes in the vein wall

Blood vessels are “protected” by a special type of cells called endothelial cells – flat cells. With special properties that prevent blood clotting. Any alteration of endothelial cells or any influence on them can cause blood clots in the cell or under the cell.

Smoking or low concentrations of oxygen can damage endothelial cells.

Changes in blood flow

Slow flow of blood circulation due to sedentary and prolonged standing (persons who are long-standing or seated). Another cause of changing the blood flow is the changing of the diameter or the length of the vein – as in the case of varicose veins.

Changes in blood composition

The most common cause of the change in blood composition is the dehydration. It occurs when people consume alcohol or other beverages with caffeine, such as tea, coffee and other beverages. Unfortunately, they have a diuretic effect: The consumption of such liquid, our body eliminates them, mostly in the form of urine. As a result, the blood becomes more concentrated and more likely to coalesce.

The uses of hormonal treatments or diuretics lead to changes in the composition.

Laboratory investigations

  • Doppler – the most relevant method of venous investigation;

  • Thermography – an infrared device used to determine the temperature difference between the two legs – useless if there is thrombosis in both legs;

  • Blood tests – do not always give accurate results;

  • Phlebography – injection of a contrast agent in the venous level.

Testing for thrombosis

Painful and swollen feet are the most common symptoms of thrombosis. However, not only thrombosis causes these symptoms, and some thromboses are asymptomatic.

Blood tests: there are a number of tests used in emergency departments / accidents. They are based on the identification of biochemical markers in the bloodstream which promotes thrombosis.

Doppler ultrasound is the best diagnostic test in present. There are several types of ultrasound Doppler.

Treatment of thrombosis

No treatment – annual or biannual evaluation is recommended for patients who have occupations with risk (athletes, jobs that stand more upright, jobs in the field of aeronautics).

Preventive medical treatment – prescribing tonics medication or venous compression socks.

Curative treatment – prescribing medicines for toning the veins and ensuring optimal blood parameters; prescribing compression socks in personalized needs of patients; sclerotherapy or to laser treatment of the superficial varices.

The usual treatment – is to thin the blood using anticoagulants. Typically, this involves injecting heparin, a process with immediate effect, while oral anticoagulant treatment is lengthy.

The treatment starts with a particular dose for 3 days, followed by performing some blood tests to determine the correct dosage of medication.

The correct level is obtained by measuring the clotting time using a classical test, recorded.

The human body is able to destroy the majority of clots, so heparin is used to prevent clot formation during in which other body destroys existing thrombosis.

Traditionally, doctors prescribe oral anticoagulation for 3 to 6 months and to scan periodically the legs.

In very rare cases, if there is a massive venous thrombosis, the risk is either to block the veins, either to get into the lungs and can cause pulmonary embolism, can be made either thrombolysis injections or can be mounted filters in vein to stop clot when it is off.

Ambulatory Surgery – sclerosis and fibrosis of the saphenous vein or the collateral vein by easy surgically methods under the local anesthesia, achieved with very good aesthetic results. No need for hospitalization and patients leave on their own feet within 2 hours after the intervention.

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