Venous Thrombosis - Deep Venous Sinus Thrombosis Treatment

Venous Thrombosis is a disease in which a blood clot is formed, and it remains in the place where it formed, and the blood clot is mainly formed in the veins in the lower leg and the thigh which mainly interfere with circulation, and it may break off and travel through the blood stream (embolize). In the figure given on the right side is of the deep vein thrombosis in the calf with clot formation (shown in red) along the length of a vein. It is a very dangerous disease and up to 1 in 10 people who suffer a pulmonary embolism will die if it is not treated. So proper treatment is required. Risks include prolonged sitting, bedrest, or immobilization (such as on long plane or car trips), recent surgery or trauma (especially hip, knee or gynecological surgery), fractures, childbirth within the last 6 months and the use of medications such as estrogen and birth control pills.

What causes venous thrombosis?

Venous thrombosis or Deep venous thrombosis (DVT) affects mainly the veins in the lower leg and the thigh. Blood is more prone to clot if one or more of the following factors occur:

• It involves the formation of a clot ( thrombus ) in the larger veins of the area
• The clinical evaluation of patients with suspected DVT is facilitated by an assessment of risk factors
• This may interfere with circulation, and it may break off and travel through the blood stream (embolize).
• The clinical assessment of patients with suspected DVT is often difficult because of the interplay between risk factors and the nonspecific nature of the physical findings.
• The Wells clinical prediction guide quantifies the pretest probability of DVT.

Blood is more prone to clot if one or more of the following three factors occur:

• Changes in the blood vessel wall
• Changes in blood flow
• Changes in blood constituents

Sign and Symptoms of Venous Thrombosis

Here are the list of some of the common sign and symptoms of venous thrombosis

• Leg pain in one leg only
• Leg tenderness in one leg only
• Swelling (edema) of only one leg
• Increased warmth of one leg
• Changes in skin color of one leg, redness
• Venography of the legs
• Doppler ultrasound exam of an extremity
• Plethysmography of the legs
• D-dimer blood test

Superficial Venous Thrombosis Information

Varicose veins do sometimes develop during pregnancy and tend to become more severe with each subsequent pregnancy, although they regress somewhat after delivery. Comparatively severe varicose veins are always liable to become inflamed after delivery and this is known as superficial phlebitis, or superficial thrombosis. The superficial varicose vein, usually on the inner side of the thigh or on the inner side of the calf, becomes slightly inflamed and then extremely tender. The vein itself can be felt as a firm, rather hard, very tender, cord-like structure lying immediately beneath the skin.

The inflammation may extend along the vein for several centimetres and may be extremely painful on standing or walking. If this sort of inflammation should occur in the region .of a varicose vein, it should be reported to the midwife or doctor, who usually arranges for the leg to be bandaged and rested as much as possible until the inflammation has subsided. There is no specific or dramatic cure for superficial phlebitis or thrombosis and the painful swelling may continue for several days. The only real consolation is that the phlebitis results in obliteration and cure of the affected varicose vein.

Above all, there is no need to worry about superficial thrombosis because it never causes any real harm and although the terms 'thrombosis' and 'phlebitis' can conjure up in most people's minds pictures of terrible complications, no serious complications or disasters ever follow a superficial thrombosis. It is merely a rather painful and annoying, but quite safe, complication of childbirth.

Deep Venous Thrombosis Information

A deep venous thrombosis is a condition where the veins in the centre of the leg become thrombosed. This mayor may not be associated with superficial varicose veins but is very seldom associated with a superficial phlebitis. A deep vein thrombosis (DVT) is a blood clot in the deep veins, usually within the leg, although it can occur elsewhere in the body. These deep veins go through the muscle and cannot be seen beneath the skin. Deep venous thrombosis is unlikely when newly delivered mothers get up on the day after delivery and wear proper bedroom slippers with 2 cm heels.

The condition usually starts on about the 5th day following delivery and the first thing noticed is a tightness in the middle of the calf in one leg. There is a certain discomfort or even pain on walking, and the calf is tender, especially between the two parts of the main muscle. The worst type of shoes to wear after delivery are those without a heel or with just a strap across the front of the foot so that the toes have to be curled up to keep the slipper in place. Women at risk of thrombosis will be given special stockings to wear after delivery to minimize the risk of venous thrombosis.

Deep venous thrombosis used to be considered a potentially dangerous condition since it Wasfeared that a blood clot could be dislodged from the thrombosed vein in the calf and. could circulate back to become lodged either in the heart or the lungs - a condition known as a pulmonary embolus, which is not only painful but can also be very serious.

A woman who develops a deep venous thrombosis is usually instructed to rest in bed as much as possible. A crepe bandage is put on the foot and the leg to above the knee. There may be some swelling or oedema of the foot, or the ankle itself and even the calf of the leg may feel thickened and swollen. Pain may be felt in the back of the leg if the foot is forcibly pushed upwards, which is why there is pain on walking or' on leaning forward

A simple antibiotic such as penicillin or ampicillin may be administered. In some hospitals heparin is given by injection every 6 hours, or as a continuous intravenous drip to reduce the coagulability of the blood. The heparin usually relieves the pain in the leg within a few hours. After 24 hours a slower-acting anticoagulant drug, such as Warfarin, is given for 7-10 days or even longer. If such thrombosis can be shown, by tests,to extend above the knee, anticoagulant therapy may be continued for 3 months.

Treatment of venous thrombosis

Treatment of DVT is intended to prevent the development of a pulmonary embolus and to prevent another DVT. Some treatment are below list

• The standard treatment has been an anticoagulant medication called heparin, which was given through the vein
• Patients with altered mental status or hemiplegia should be given nothing by mouth to prevent aspiration. Intravenous fluids should not be hypotonic solutions.
• Warfarin usually takes several days to become fully effective, so heparin is continued until the warfarin has been fully effective for at least 24 hours.
• Seizures should be treated with appropriate anticonvulsants. Fosphenytoin is recommended for treatment of seizures in those patients who require a parenteral formulation
• Warfarin causes an increase in the time it takes blood to clot (known as the PT). The PT is monitored to determine if the blood is sufficiently anticoagulated