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Neurology, Ophthalmology, Cardiology, Oncology, Obesity, Endocrinology, Vascular surgery - Causes, Symptoms, Diagnosis, Treatment, description of the disease.

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Sunday, 17.02.2019, 14:39
Main » Vascular surgery » Deep vein thrombosis of lower extremities 
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Deep vein thrombosis of lower extremities


Deep vein thrombosis of lower extremities


The arteries blood enriched with oxygen flowing to the other organs and tissues. Furthermore, blood, giving oxygen and nutrients to tissues takes so-called "slag," and goes through the veins to the heart. In the lower limbs, there are three types of veins. This surface, which are under the skin, and deep veins located deep in the muscles. These two types of veins are connected by perforating veins. They have valves that allow blood to flow in only one direction, namely from the superficial veins to the deep. Deep leg veins empty into the widest vein in our body - the inferior vena cava, which in turn empties into the right atrium. When deep-vein thrombosis of lower extremities in the lumen of the vein thrombus is formed, which breaks the flow of blood in the deep veins into the inferior vena. Most often, thrombosis formed in the veins of the pelvis, femur, tibia, rarely in the arms, chest or other areas.

When deep-vein thrombosis in the legs may appear swelling, pain and sensation of heat. The development of this disease is dangerous occurrence of such conditions as pulmonary embolism. In this condition, a blood clot, detached from the wall of a deep vein leg sweeps through the blood of the inferior vena cava enters the right side of the heart, and then out of it into the pulmonary artery. There's a blood clot gets stuck and breaks the bloodstream. Manifestations of this condition depends on the number and caliber of blocked clot pulmonary arteries. Usually, it manifests a sudden shortness of breath, sharp chest pain and hemoptysis. In severe cases, this condition can be fatal.

Symptoms of leg DVT


Not always when deep-vein thrombosis may occur down any of its symptoms. Manifestations of thrombosis depend on the location of the thrombus and in half the cases of deep vein thrombosis are asymptomatic feet. This is due to the fact that abnormal blood flow can be partially restored through the perforating veins of the subcutaneous veins.

The main signs of deep vein thrombosis legs are the following features:
Swelling in the legs
Pain Expander nature, worse when walking or standing and decreasing at an elevated position feet
Discoloration of the skin in the form of cyanosis


The causes of deep vein thrombosis leg
The mechanism of thrombosis



The mechanism of thrombosis associated breakdown in blood clotting. When the blood becomes more viscous and the vessel on which it runs are obstacles to the normal blood flow, there are conditions conducive to thrombosis. When the wall of the vein formed by a small blood clot, it causes inflammation that leads to the formation of other blood clots.

Stagnation of blood in the legs contributes to the development of deep vein thrombosis of lower extremities. This condition occurs when a person can not move for a long time. As a result, clots are formed.

Trigger mechanisms are the following:

  • Trauma or excessive physical exertion
  • Infection
  • Prolonged bed rest in surgical, therapeutic or neurological interventions
  • Puerperium
  • Use of oral contraceptives (at their reception marked thickening of the blood)
  • Cancer (especially lung cancer, stomach and pancreas)
  • Bleeding disorders
  • Long trips (so-called economy class syndrome, caused by long and frequent airplane flights)


Typically, deep vein thrombosis occurs in the lower extremities. But recently became diagnosed thrombosis and in-hand. Here are some reasons for the occurrence of deep vein thrombosis of the upper extremities:

The presence of upper extremity vein catheter. A prolonged stay in the vein catheter is its stimulation leads to the formation of a blood clot on her wall.

The presence of pacemaker or an implanted heart kardiodefibrillyatora.

The presence of malignant tumors in the veins

Intense physical activity on the upper limbs. This type of thrombosis occurs in athletic people (weight-lifters, swimmers, baseball players). In this case the trained muscles of the shoulder belt compress the deep veins and disrupt cross them.


Diagnosis of deep vein thrombosis of lower extremities
Violation of patency of deep leg veins




Prior to the instrumental methods of examination, the doctor usually has a number of so-called resin impregnated samples, which are held by an elastic foot-binding. Next, the doctor evaluates the patient's experience, the nature of filling of veins, the blood flow through them. Usually for the diagnosis of deep venous patency, so-called march test. In this case the patient's leg is bandaged elastic bandage from the toes to the groin crease, after which the patient should walk for a while. If the patient is marked with arching pain in the legs, and subcutaneous veins not subside, then it indicates a violation of the patency of deep veins, caused by thrombosis.

Modern diagnosis of diseases of blood vessels, including veins of the lower extremities is performed using the following invasive and noninvasive methods of investigation:

Phlebography (distal ascending) - the most accurate diagnostic method for detection of deep vein thrombosis. In one of the saphenous veins of the foot below the tourniquet compressing the vein at the ankle, a contrast agent is introduced to direct the movement of contrast into the deep veins. Further investigation is carried out X-ray of the lower extremity. The presence of thrombi detected on the radiograph as a filling defect of contrast.

Doppler ultrasound and duplex scanning - methods based on ultrasound examination of blood vessels. These methods allow us to determine changes in blood flow velocity, the state of the walls and valves of the veins and blood clots themselves.
Impedance plethysmography. Allows you to determine the rate of change of volume of blood filling the veins leg.

Radionuclide scanning. This method consists in the fact that in the vein of the foot is introduced specific radioactive drug that accumulates in the thrombus. After that, scans, showing the location of the thrombus level.

Treatment of deep vein thrombosis of lower extremities


Treatment of deep vein thrombosis leg is medical therapy, minimally invasive interventions, rarely need traditional surgery. It is important to remember. That must be treated in the hospital, because of the potential development of dangerous complications (pulmonary embolism).

We list the main points of the treatment of deep vein thrombosis:
Strict bed rest in hospital with leg elevation. This is necessary in order to improve the outflow of venous blood from the legs, which serves as a prevention of further blood clots.
Heparin - an anticoagulant, which prevents the formation of blood clots by reducing other blood clotting. Heparin prevents the growth of already formed a blood clot, but he can not dissolve. Usually heparin is indicated for deep-vein thrombosis intravenously. Heparin treatment usually lasts about 7 days
Direct anticoagulant - a drug that is administered after heparin, usually within 6 months. This is such a drug like warfarin. It thins the blood, which helps prevent the formation of new clots. When treating drugs that lower the coagulation, must constantly monitor the performance of coagulation - coagulation. An overdose of anticoagulant therapy may lead to bleeding.

Thrombolytic therapy is effective in the early stages of forming a blood clot. At later stages of thrombolytic therapy can cause fragmentation of the thrombus and lead to pulmonary embolism. Thrombectomy - surgical intervention to remove a blood clot from the lumen of the vein. This procedure is performed under such a heavy form of thrombosis as a blue flegmaziya, which is only effective surgical treatment. Delay in treatment can lead to gangrene - necrosis of tissues.

When deep-vein thrombosis of lower extremities may occur as a condition of a floating thrombus. This is a condition where the blood clot is attached to one end wall of the vein and the other end it is free. In this type of clot is particularly high probability of separation and the development of pulmonary embolism. Therefore, the diagnosis of a floating thrombus shows such intervention, as the installation of cava filter, special filter impervious to blood clots in the current inferior vena cava, which prevents thromboembolism. Thrombolytic therapy in this setting without thrombus cava filter can not be carried, due to the development of thromboembolism.

Prevention of deep vein thrombosis of lower extremities


Simple preventive measures aimed at prevention of thrombosis include early motion after surgery, the use of elastic bandages or stockings (which are compressing the superficial veins accelerate blood flow in the deep veins), the exclusion of risk factors. Postoperatively, many doctors prescribe to patients small doses of heparin and aspirin, which also reduces blood clotting.


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