Deep-vein thrombosis is the formation of
in veins deep inside the legs. The condition is usually caused
by sluggish blood flow when a person lies or sits still for long periods of
time, such as during prolonged bed rest after surgery or in cases of paralysis.
Prevention of thrombosis is one of the reasons your are told to get up and walk
around as soon as possible after having an operation.
Deep-vein thrombosis is more common among women over 35 who smoke and take
birth-control pills, or women who are or recently have been pregnant. Deep-vein
thrombosis is not always a serious condition but, if a piece of a blood clot
breaks off and travels to your lungs, it can
block an artery,
which can be life threatening. Deep venous thrombosis (DVT) affects mainly the
veins in the lower leg and the thigh.
Risk Factors associated with DVT:
A Risks include
Bed rest or immobilization (such as on long plane or car trips),
surgery or trauma (especially hip, knee or gynecological surgery),
Childbirth within the last 6 months and the
use of medications such as estrogen and birth control pills.
Risks also include
A clot in a vein in your leg can cause a variety of symptoms, including pain,
tenderness, swelling, redness, and a feeling of warmth on the skin over the
clot. Specific symptoms include:
leg tenderness in one leg only
swelling (edema) of only one leg
increased warmth of one leg
changes in skin color of one leg,
Deep-vein thrombosis can be diagnosed by
Radionuclide scanning - In a radionuclide scan, the tracer either is
injected into a vein or swallowed. Once the tracer enters the body, it
travels through the bloodstream to a target organ, such as the thyroid,
heart or bones. Different tracers tend to collect in different organs. The
tracer emits gamma rays, which are similar to X-rays. These gamma rays are
detected by a gamma camera and analyzed by a computer to form an image of
the target organ. Sites of potential problems emit more intense gamma rays
and appear as bright spots on the scan. PET scans, gallium scans and bone
scans are all types of radionuclide scans.
ultrasound - DVTs are most commonly detected nowadays by use of ultrasound -
scientists say they can now use this method to detect even the smallest of
clots. A water-soluble gel is placed on the
transducerand the skin over the veins of the extremity being tested. To
examine the arteries: Blood pressure cuffs will be put around the thigh,
calf, and ankle to examine the legs. In the arms, the blood pressure cuffs
are placed at different points along the arm. A conductive paste is applied
to the skin over the arteries being examined. The cuff will be inflated
above the normal systolic blood pressure for the extremity. The transducer
is placed near the cuff, and the pressure in the cuff is released slowly.
When the "swishing" is detected, it is recorded as the blood pressure. This
is repeated for each cuff.
D-dimer blood test
venography of the legs
These imaging and blood tests can provide information about the condition of
the veins in your legs and the flow of blood through them.
If the blood clots are small and confined to your calf, you may not need
The clots may break up and dissolve by themselves,
especially if you walk around frequently.
Too much bed rest is
Medical compression stockings
are often worn to cover the length of the whole leg to give support to the
veins and reduce swelling.
If you have a serious case of thrombosis, your doctor may prescribe
drugs that thin your blood and prevent clotting, especially if there is a
risk of a pulmonary embolism. This usually initially involves giving high
doses of the drug heparin by injection. Patients are also
a similar drug, warfarin, in tablet form, which they may stay on for several
months. When taking these blood thinning drugs patients usually have regular
blood tests to make sure they are getting the right dose and are not at risk
of a haemorrhage. Clots that are located in the deep veins in the thigh or
behind the knee are more likely to break off and travel to the lungs. It is
important to take the medication exactly as directed by your doctor or
pharmacist to ensure that you are not at risk to develop another DVT or
Surgery to remove a clot is sometimes necessary.
Anticoagulants may be prescribed as a preventive measure for high risk people or
people undergoing high risk surgical procedures. Minimize immobility of the
legs. In order to reduce the risk of DVT include treatment, such as reducing
excess body fat, quitting cigarettes,
exercising regularly and switching to a
high fibre, low fat
Exercise the legs regularly – take a brisk 30-minute
walk every day. Lower extremity
exercises such as simple
elevating the foot of the bed, and active and passive ankle motion to
increase blood flow through the femoral vein.
Maintain a weight that's appropriate for your height
Avoid sitting or lying in bed for long periods of time without moving
Women, particularly those over the age of 35, should consider the risks
and benefits of taking the contraceptive pill