Deep Vein Thrombosis - Causes, Prevention, Symptoms and Treatments

What Is Deep Vein Thrombosis?

Deep vein thrombosis (DVT) is a condition involving blood clot formation in the deep veins, it usually occurs in the legs, or sometimes it can be seen in the arms also. Deep vein thrombosis is a severe condition as the blood clot has the potential to block the brain supply to other internal organs, which leads to organ failure or strokes. Pulmonary embolism is a very serious complication caused by deep vein thrombosis; this is a condition in which blood clots in the deep veins of the legs cause leg swelling, pain, and redness. This clot can also break off, travel up the veins, and lodge in the lungs, causing a pulmonary embolism. Togetherly it is known as venous thromboembolism.

What Are the Causes of Deep Vein Thrombosis?

Deep vein thrombosis is caused by clot formation in the deep veins.

Following are the causes of deep vein thrombosis -

1. Genetic inheritance of the disorder causes excessive blood clot formation.

2. Injury to the small blood vein leads to clot formation.

3. During surgery, damage to the vein leads to clot formation.

4. Less physical activities and prolonged sitting or bed rest increase the chances of the development of blood clots.

5. Pregnancy.

6. History of deep vein thrombosis in the family.

7. Overweight.

8. Tobacco smoking or chewing habits.

9. Pre-existing varicose veins.

10. Administration of birth control pills or hormone replacement therapy.

11. History of autoimmune disorder.

12. Cancer can be a cause of deep vein thrombosis due indication of chemotherapy for the treatment of cancer.

13. Heart attack increases the risk of the development of blood clots and pulmonary embolism.

14. An individual with inflammatory bowel disease is more likely to develop deep vein thrombosis.

15. People over 40 years have a higher risk of developing deep vein thrombosis.

16. Some syndromes like hypercoagulable states and peculiar vein anatomy can predispose a person to deep vein thrombosis.

What Are the Signs and Symptoms of Deep Vein Thrombosis?

Deep vein thrombosis has been seen in the deep veins of the lower extremities. Around 25 % to 30 % of individuals are asymptomatic, but different signs and symptoms are associated with deep vein thrombosis.

1. Redness over the affected leg.

2. Swelling is present over the affected area.

3. Pain and tenderness are present.

4. Rise in temperature over the affected leg.

5. Swollen veins.

6. Change the color of the leg to purple or blue.

7. Abdominal pain.

What Is the Difference Between Superficial Thrombophlebitis and Deep Vein Thrombosis?

Superficial thrombophlebitis and deep vein thrombosis belong to the same classification of thrombophlebitis. Thrombophlebitis refers to clot formation and inflammation.

In superficial thrombophlebitis, clot formation is present in the superficial vein, just beneath the skin surface, and it is not a very serious condition. It can subside in five to six weeks with supportive treatment. No surgical treatment is required.

In deep vein thrombosis, the clot is formed in the deep veins of the lower extremities due to several causes. Deep vein thrombosis can lead to severe complications like pulmonary emboli, strokes, ischemia to certain internal organs, and many more life-threatening conditions. It can be treated by medical and surgical intervention.

How to Diagnose Deep Vein Thrombosis?

Deep vein thrombosis is diagnosed by performing the following investigations.

1. Recording the patient's medical and family history.

2. Conducting a physical examination by evaluating pulse, temperature, blood flow, and blood pressure.

3. Inspecting the site of inflammation.

4. Doppler Ultrasound - In doppler ultrasound investigation, sound waves are used to determine the blood flow and pressure.

5. Duplex Ultrasound - This investigation combines doppler ultrasound and ultrasound sonography.

6. Venography - It is a type of X-ray that captures the image of the blood flow.

7. MRI (magnetic resonance imaging) is advised to determine the conditions of clots and blood flow.

8. CT (computerized tomography) scan - It is done to check the blood flow and venous involvement. CT (computerized tomography) chest scan is done to check clots in the lungs.

MR Angiography (magnetic resonance angiography) - In this investigation, doctors inject a dye into the vein, capture a detailed picture through the MRI (magnetic resonance imaging) machine, and study the blockage.

What Are the Treatment Modalities for Deep Vein Thrombosis?

Deep vein thrombosis is a curable condition, but if it is not diagnosed early, it can lead to life-threatening situations.

Several objectives are taken care of while planning the treatment for deep vein thrombosis-

1. Prevent blood clot formation.

2. Stop the clot from getting bigger.

3. Avoid the breaking of the clot so that it may not be able to travel to the lungs.

4. Prevention of long-term complications.

• Surgical Treatment -

Iliofemoral deep vein thrombosis needs to be treated to prevent a pulmonary embolism. We treat deep vein thrombosis by first placing an inferior vena cava filter (IVC) in the inferior vena cava. This is a filter, like a sieve, that is positioned in the infrarenal inferior vena cava filter (IVC) to catch any free floating clots from traveling up and blocking the pulmonary veins. After this, a needle puncture is made in the popliteal vein (the deep vein behind the knee), and a special catheter is used to suck out clots from the deep veins. The next step is to place a perfusion catheter in the thrombosed venous segment, and an infusion of a thrombolytic agent (clot busting-medicine) like tissue plasminogen activator (TPA), or urokinase is started. Check venograms every 12 hours to monitor clot resolution and reposition the perfusion catheter. Typically a fresh thrombus would be lysed within 24 hours of thrombolysis.

• Medical Treatment -

Blood thinning medicine like Heparin can be given intravenously to help recanalize the occluded veins; this can be done in patients who are poor candidates for thrombolysis.

Blood thinners are also known as anticoagulants; these may not dissolve the

spot-formed blood clot but may help prevent blood clots formation.

• Supportive Treatment -

Compression stockings are advised to wear over the legs to eliminate swelling. These compression stockings have elastic in them for pressure application to the affected area. Even after surgery, doctors advise wearing the stocking.

What Are the Ways to Prevent Deep Vein Thrombosis?

Deep vein thrombosis is a preventable condition. Basic lifestyle moderation will help to prevent the risk of developing deep vein thrombosis.

• Regular exercise.

• Walking.

• Preventing prolonged immobilization, like sitting for a long duration for a long-haul flight, would prevent deep vein thrombosis.

• Quit smoking.

• Weight management.

• Leading an active and healthy lifestyle with good eating habits.

• Minor physical activity should be performed during pregnancy, the post-surgical procedure, or on bed rest after being diagnosed with any disease.

Conclusion -

Deep vein thrombosis is a serious condition that is characterized by blood clot formation in the legs. It is a manageable condition with given treatment modalities and prevented by obtaining a healthy and active lifestyle.