What is venous thrombosis ?
It is a condition characterized by the formation of blood clots (thrombi) in the venous system, in different parts of the body. A blood clot can cause local complications (swollen leg) or “climb” to the heart and cause serious complications (pulmonary embolism = blood clots in the pulmonary arteries) which can be life-threatening.
Alexandru Mischie says that the factors that cause venous thrombosis can be multiple:
- fractures (hip or leg)
- hip replacement or knee
- knee arthroscopy
- surgery – major intervention
Iatrogenic (provoked by):
- Central Venous Catheters
- Estrogens (birth control pills or hormone replacement)
Major trauma / spinal cord
- bed rest> 3 days
- stroke with paralysis
- history of DVT or MET
- heart failure or respiratory failure
- congenital malformations of the venous system (eg. Agenesis of the inferior cava)
- immobilization (travel by plane or car)
- pregnancy (postpartum / antepartum)
- advanced age
- AFL (antiphospholipid syndrome)
- AT ↓↓ (severe antithrombin deficiency)
- Lupus anticoagulant
- 20210 PT (prothrombin gene mutation) homozygous or heterozygous
- Protein C / S – severe deficiency, family history
- factor V Leiden, homozygous or heterozygous
- elevated factor VIII and IX
Venous thrombosis can be treated with:
- anticoagulants (blood thinners)
- thrombolytic (clot melters)
- stents (open the vein for blood to move normally);
- venous filters (stop migration of blood clots to the lungs)
- variceal sclerosis.
- catheter-based embolectomy (thrombus fragmentation in pulmonary embolism)
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What is the catheter-based embolectomy (thrombus fragmentation in pulmonary embolism) ?
It is indicated when anticoagulants (blood thinners) or thrombolytics (melt clots) fail to remove the blood clot. The procedure is called catheter-based embolectomy and involves advancing a catheter to the pulmonary arteries (where is the thrombus) and mechanical fragmentation by advancing and withdrawing repeatedly a catheter in order to break the trombus into smaller pieces which can then be melted by the drugs.
What are stents for venous disease ?
Stenting of veins are aimed at openning the vein for blood to move normally. Recommended as a last resort in post-thrombotic syndrome. Is identical as a coronary stenting procedure, only the stent is mounted on a vein.
What is an inferior vena cava filter:
If you can not take anticoagulants, there is a possibility your doctor recommends implanting a venous filter. Dr. Mischie explains that the procedure follows the classical venous catheterisation technique: a catheter is introduced into the inferior vena cava ; this catherer has on top of a filter in the form of a perforated cone), whose role is to “capture” any thrombi that originate from leg veins or pelvis. Both during the procedure and later complications can occur:
- In 10% of patients : thrombosis at the site of introduction;
- In 20% of patients: recurrent venous thrombosis;
- In 40% of patients: post-thrombotic syndrome;
- Occlusion of the inferior cava: 33% of patients to 9 years;
- Migration / thrombosis of the filter.
Varicose veins are dilations of the veins, which sometimes may contain thrombus and cause complications. Treatment options can be: laser ablation or injection of a sclerosing agent. By puncturing a vein in the leg a catheter is introduced to the place of venous dilation; then the catheter is withdrawn slightly and the dilated tissue is “burned” by the laser (the catheter tip has a laser attached) or by injecting a foam (sclerosing agent). Local anesthesia is required. The procedure lasts 30 minutes.
All data on this site is purely informational and should not be considered medical advice. If you need a medical oppinion consult a physician.