Venous Thrombosis
What is Deep Venous Thrombosis?
While clotting of the blood can occur anywhere within the circulatory system, it occurs most frequently in the veins. The most worrisome blood clots, those which can travel to the lungs, occur in the large veins of the thigh and pelvis. This usually follows either some sort of injury (including surgical trauma, for example, related to knee replacement surgery) or, alternatively, a prolonged period of time without moving (for example, being bedridden in a hospital or nursing home, or an extended airplane flight).
DVT occurs most commonly in older people. Other risk factors include smoking, sedentary, a prior history of DVT, or a known tendency to form clots.
Vascular specialists are certainly involved with the diagnosis of DVT, commonly by ultrasound examinations of the veins in the lower extremities, pelvis, and abdomen. Along with hospital-based physicians such as those found in the emergency department or the intensive care unit, vascular specialists oversee the management of DVT, conventionally by deliberate thinning out of the blood (anticoagulation) or, upon occasion, by catheter-based dissolving of the blood clot itself (thrombolysis). In unusual circumstances, vascular specialists may insert filtering devices into the inferior vena cava (the major vein leading blood back to the heart) or may place stents in partially blocked or externally compressed veins in the pelvis.
Risk Factors:
- Injury - including surgical trauma, eg. Knee replacement surgery
- Prolonged period of time without moving eg: bedridden in a hospital or nursing home, extended airplane flight
- Other risk factors advanced age, smoking, sedentary lifestyle, prior history of DVT or a known tendency to form clots or as noted lower extremity injuries or operations, being on some medications especially hormones
Symptoms:
- Most patients have no symptoms
- Discomfort along the affected vein - swelling, pain, warmth, redness along the length of the vein with the blood clot
Diagnosis:
Commonly by ultrasound examination of the veins in the lower extremities, pelvis, and abdomen. Also can be discovered with a physical exam.
Treatment
Medications:
Blood thinners / anticoagulants- stops the blood clot from getting larger by reducing the ability of the blood to clot. Over time it helps to reduce the size and consistency of the clot.
Thrombolysis:
If the clot is large and extensive and is causing severe pain, medications are administered via the bloodstream or subcutaneously with the intent of quickly treating the blood clot and preventing post-thrombotic complications. This will require hospitalization and monitoring.
Surgical Thrombectomy:
Surgical procedure to remove the blood clot from the artery or vein.
IVC Filter:
Type of filter placed in the inferior vena cava one of the largest veins in the body for preventing a large blood clot from passing into the heart and lungs. Only used for patients at high risk for DVT.
What is Superficial Vein Thrombosis?
A superficial venous thrombosis, sometimes called VTE, is a blood clot existing in a vein close to the surface of the skin, commonly in the arms or legs. Unlike deep vein thrombosis, or DVT, a superficial venous thrombosis is less likely to cause serious complications but it can still cause pain and discomfort.
Blood clots and VTE are common, with millions of hospital patients experiencing this complication following procedures.