Mixed risk factors
In this group, factors associated with blood coagulation: high levels of homocysteine (an amino acid that provokes the formation of blood clots and atherosclerotic plaques) and fibrinogen (a protein dissolved in blood plasma).Deep vein thrombosis: symptoms and treatment
Signs and symptoms of Deep Vein Thrombosis
Deep vein thrombosis has several specific symptoms, but it can be asymptomatic. Circulatory problems are indicated by:
severe swelling at the site of occlusion of the vessel;
discoloration of the skin, often throughout the limb;
unexpressed pain, which intensifies with a load on the legs;
significantly warmer or hotter leg with thrombosis (hyperthermia).
Cases of asymptomatic course are more dangerous. Due to untimely treatment, the disease can flow into serious complications, causing irreversible consequences.Deep vein thrombosis: symptoms and treatment
If the temperature of the foot rises
One of the most striking signs of the rapid development or complication of deep vein thrombosis is local hyperemia. It is impossible to accurately measure the temperature of the leg, but it is tactile to feel that one limb is warmer than the other. This symptom is a reason for immediate hospitalization, so as not to miss further complications, in particular, pulmonary embolism.
Diagnosed with deep vein thrombosis by a complex of methods. At the first stage, the doctor collects the patient’s history, which collects data on the presence of the development factors of the disease: congenital, acquired and mixed.
At the second stage, the patient is examined, a blood test and a coagulogram. These studies should capture the visual signs of deep vein thrombosis, demonstrate indicators of blood coagulation and its characteristics.
The third stage – an instrumental examination, is carried out to clarify the diagnosis and determine the nature of the disease.
The basis of instrumental diagnosis of deep vein thrombosis is ultrasound duplex scanning of veins. This method evaluates the basic hemodynamic parameters and reveals structural changes in the walls of blood vessels.
The procedure is lengthy, but only it shows the presence of several pathologies, including deep vein thrombosis. If ultrasound duplex scanning of veins is not possible, the disease is diagnosed by other methods:
multispiral computed tomography;
The choice of diagnostic method remains with the doctor.
Treatment is selected depending on each specific case. There are two main treatment options for thrombosis:
Drug treatment is the most common way to treat leg thrombosis. Most often it is used independently. If surgical intervention is necessary, concomitant therapy is medication.
The therapy of deep vein thrombosis should solve five problems:
decreased thrombus growth;
an exception to the development of pulmonary embolism;
prevention of venous gangrene by combating swelling;
restoration of the lumen of the vessel;
A patient with diagnosed deep vein thrombosis is placed in a hospital, in the surgical or, if available, angio surgery unit. Strict bed rest is necessary for the patient until the pronounced swelling is eliminated and the risk of developing floating thrombosis is eliminated. Drug therapy for DVT is based on drugs from four groups:
Drug group Description
Anticoagulants The main group of drugs for thrombosis. Used to reduce blood coagulation and prevent the development of blood clots.
Antiplatelet agents A group of drugs to prevent the development of blood clots. Reduces the ability of platelets and red blood cells to adhere to the endothelium of blood vessels.
Nonsteroidal anti-inflammatory drugs Medicines to relieve the main symptoms of DVT: an inflammatory reaction of the venous wall and pain manifestations.
Phleboactive drugs Medications to improve venous and lymphatic blood flow. Increase the tone of the venous walls and relieve swelling.
Antibiotics for deep vein thrombosis are rarely used. Indications for their appointment:
high risk of septic complications;
pustular skin lesions.
Anticoagulants are the most effective group of drugs for the treatment of deep vein thrombosis. The result of their action is one: a decrease in coagulability. But according to the mechanism of its achievement, anticoagulants are:
Direct anticoagulants directly interfere with the coagulation process, inhibiting one of its factors. The most common coagulant – heparin, interferes with the operation of thrombin.
Indirect coagulants do not directly affect blood coagulation factors. They inhibit the synthesis of substances that are involved in coagulation. At the first stage of DVT treatment, direct anticoagulants are prescribed, most often heparin. Its dose and duration of therapy depend on a number of factors, the main of which is temporary indicators of blood coagulation.Deep vein thrombosis: symptoms and treatment
In the second stage, direct anticoagulants are replaced by indirect ones. During the transition, it is necessary to take drugs of both groups at the same time, for three to four days.
The duration of drug therapy for thrombosis is from three months to six months since during this period, relapse is possible.
The most common method for surgical treatment of deep vein thrombosis is to install a cava filter, a small tool for filtering blood flow and trapping blood clots.
This method is one of the most effective in preventing the development of pulmonary embolism. A cava filter is inserted into the inferior vena cava using a catheter. It does not interfere with natural blood flow, but effectively traps blood clots. Kava filters are temporary and permanent, the choice of a particular one depends on the characteristics of the patient.
A filter element is placed under local anesthesia in departments with a vascular specification. The procedure itself, nominally, is not complicated, but it requires a set of equipment and several specialists, including an anesthetist.
There are also other surgical treatments for DVT:
ligation of the main veins.