Thrombosis of the veins of the lower extremities: diagnosis and treatment
Few people pay attention to such features as occasional pain in the muscles of the legs, stiffness, feeling of heaviness and fullness. Sometimes this is the first symptoms of acute thrombosis, and ignoring them can be costly to the patient. A man who now was moving normally in the absence of treatment tomorrow just won’t be able to get out of bed, if not, it may suddenly die.
Thrombosis of the veins of the lower extremities, acute disease associated with the formation of a blood clot (thrombus) in the lumen of the venous vessel. As a result, the outflow of venous blood, rich in carbon dioxide and products of metabolism, deteriorates or stops completely. As a result of impaired tissue metabolism.
More serious complications can occur in isolation of venous thrombi and the presence of their fragments in the heart, and then to the lung, which may lead to pulmonary embolism and death.
The formation of a blood clot in the lumen of the vein is associated with several pathological processes:
- a breach in the structure of the venous wall damage, weakness of the valves;
- the slowing of blood flow due to narrowing of the vein caused by inflammation (phlebitis);
- increase blood clotting.
These three things are called «Virchow Triad».
Depending on the etiology there are:
- congestive venous thrombosis in varicose veins, prolonged bed rest;
- inflammation (thrombophlebitis) resulting from injuries, allergic and post-infectious nature;
- thrombosis arising from violations of the hemostatic system in tumors, diseases of the endocrine system and liver.
Depending on location there are:
- thrombophlebitis of the superficial veins of the lower extremities;
- deep vein thrombosis of the lower extremities.
In regard of a blood clot with the wall of the vein distinguish types of thrombosis:
- Occlusive — is characterized by complete overlap of the lumen of venous thrombotic mass.
- The wall occupies only a part of the lumen of the vessel.
- Floating — thrombus, fixed to the vessel wall in the form of leeches, i.e. «head» and the transmission «hanging» the rest of the «tail».
The mechanism of formation and structure are distinguished:
- a white thrombus consisting of fibrin, platelets, and leukocytes;
- red, which in its composition has a red blood cells, formed during the rapid coagulation of blood and is localized mainly on the veins;
- mixed — having a white «head» and the red «tail»;
- hyaline thrombosis, which is formed from the platelets precipitated plasma proteins, and grossly hemolytic of erythrocytes.
Deep vein thrombosis can be identified by the following features:
- a sharp pain syndrome along the vein;
- blue discoloration of the skin in the affected area;
- swelling of the affected limb;
- a feeling of heaviness in the leg;
- cramps of calf muscles;
- the increase in body temperature and increased shivering in the event of an exacerbation.
In most cases, the initial symptom of thrombosis — sudden pain in the lower extremities, aggravated by physical exertion. The patient is difficult to move, he feels heaviness, mild swelling in extremities, there is swelling. This is due to violation of the outflow of venous blood and its stagnation below the site of thrombosis.
Deep vein thrombosis of the lower limbs does not always have a distinct classical appearance. It often happens that the first symptom becomes threatening complication — pulmonary embolism, when the clot or fragments break off and migrate to the lungs.
If the above symptoms are accompanied by fever, shortness of breath, chest pain or cough, it is necessary to call an ambulance.
Deep vein thrombosis has late symptoms, when the color of the skin above the ankle acquires a brownish tint, which arises from the contact with the skin of red blood cells from stretched veins. It makes the skin very vulnerable to inflammation and can lead to the formation of venous ulcers.
Deep vein thrombosis affects the veins located in the muscles of the legs, most often the femoral vein, and has a second name — phlebothrombosis. Whereas in the case of lesion of the superficial saphenous vein takes place superficial thrombophlebitis.
To diagnose deep vein thrombosis, quickly determine the location of the clot and will help method the duplex ultrasound angiotenzinovye with color Doppler mapping.
This method gives you the most comprehensive information about the state of the vessels, allows to assess the dynamics of the disease and the effectiveness of treatment.
Diagnosing deep vein thrombosis, also take into account:
- the anamnesis of the patient: patient complaints, description of anxiety symptoms;
- inspection and functional tests: symptom levenberga, samples Homans, Mayo — Pratt, Mahler, Level — Lubri;
- laboratory tests: blood count, C-reactive protein, determining the level of prothrombin index, coagulation tromboelastogramma;
- instrumental methods of research vessels: venography, lebanonese, contrast-enhanced CT venography, photoplethysmography, etc.
Deep vein thrombosis requires a comprehensive study of the parameters of the thrombus, the level of danger it poses.
If, among other symptoms, there are signs that are suspicious for pulmonary thromboembolism, prescribe x-rays of the lungs, in particular, scintigraphy with a radioactive marker.
Superficial thrombophlebitis deserves no less attention, especially if he has a habit of returning after treatment and to migrate. This is a classic symptom of the presence of a malignant tumor in the body.
Treatment should be comprehensive:
- Drug therapy is aimed at eliminating blood clots, inflammation and pain. Injections of heparin, anticoagulants in the control of blood. In addition, the use physical therapy.
- Surgery — removes all trombirovania, the varicose veins.
- Thrombolysis — a procedure for dissolving blood clots with thrombolytics, which, unfortunately, are not always effective and has a number of contraindications.
- The use of Vena cava filters devices from metal in the form of umbrellas. This device is installed in the lumen of the inferior Vena cava and becomes a trap for the migrating fragments of the blood clot, preventing their movement out of the veins of the lower extremities in the vessels of the lungs.
Surgery provides rapid and safe restoration of normal blood flow.
Apply different techniques of surgical treatment:
- Venous angioplasty — the procedure of extension of the narrowed vessel with a catheter inserted in the lumen of the vein with subsequent stent — a metal frame for the receptacle;
- Bypass grafting — the creation of a shunt to bypass the narrowed portion of the vein to restore its blood flow;
- Thrombectomy — removal of thrombus from arteries, veins by surgery.
Despite the fact that traditional medicine has an effective treatment recipes using herbs and diet, deep vein thrombosis is easy to run. Self-medicate, the patient loses precious time and risking to be in a wheelchair or suddenly die.
Deep vein thrombosis is a disease affecting the majority of men who have bad habits, overweight, genetic predisposition, and especially those who are engaged in this sedentary lifestyle. The risk group also includes women taking contraceptives, pregnant and nursing mothers.
Prevention is to neutralize risk factors, which are:
- Smoking, leading to disturbance of elasticity of blood vessels;
- injury vessels;
- high blood clotting and medications that increase blood coagulation, promote the formation of blood clots;
- age-related changes;
- long trips and flights;
- dehydration of the body.
To prevent deep vein thrombosis and related complications helps diet with the exception of foods that contain large amounts of vitamins K, S. it is Important to abandon the use of alcohol and spicy food, drink water at least 2 liters a day. It is recommended to include in the diet of tea of blood-thinning herbs and some vegetables: peppers, garlic, artichoke.
For strengthening vascular walls necessary to Supplement the diet:
- seaweed and seafood;
- fermented milk products with low fat content;
- vegetables with red and bright orange in color: carrots, beets, tomatoes;
- onions and garlic;
- olive oil;
- green tea.
Obligatory condition of prevention is to change lifestyle in terms of physical activity — a daily half-hour Hiking at least.
The most effective means of prevention is considered a drug with the use of aspirin in helping blood thinners.
You need to remember: venous thrombosis is a common dangerous disease that requires serious treatment, but it is possible to protect yourself and your loved ones, time noticing disturbing symptoms and contact physician.