What is Deep Vein Thrombosis ?
Deep vein thrombosis is the occlusion of deep-seated veins in the body, namely veins. Vein thrombosis is a disease of the vein, not a blockage of the artery. Although both are blockages, these two diseases are very different from each other. (Ven=vein; thrombosis=coagulation)
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It is most commonly seen in the leg veins.
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It is most common when there is a clot in the leg vein. The most important finding is foot swelling and pain.
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A blood thinner should be started as soon as the diagnosis of vascular coagulation is made. This treatment continues for at least 3-6 months.
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Blood-thinning drugs prevent the formation of new clots by diluting the blood and minimize the possibility of the clot to be thrown into the lungs.
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Blood-thinning drug treatment cannot clear the existing clot.
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If the clot is in a small number of veins, this treatment may be sufficient, but if most veins in the leg are closed with clots, the leg swelling can be treated with these drugs. It may not improve and the swelling may last a lifetime.
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There are treatment methods that completely clear the clot. These can only be done with angiography.
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Not every patient may require clot removal treatment with angiography. If the clot has reached the veins in the inguinal region and the patient's leg swelling is evident, angio treatment is recommended.
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Cot removal treatment with angio is very effective, especially if the clot has just formed (first 15 days). It is also partially effective from 15 days to 30 days.
What is Vein, What Does It Do?
Vin means vein. In the body, the veins are located in two regions. Deep veins or superficial veins. The deep veins are between the externally invisible muscles and together with the arteries. Because they are much more important, they are protected deeply. The flow in these veins is unidirectional and always towards the heart. There are multiple valves or valves in all deep veins, more so in the legs. There is a cap on the legs every 5-10 cm. The purpose of the valves is to carry the blood to the heart in one direction, that is, there is no backward flow in these vessels, the flow is always true to the heart. If there is a backward flow, it is called venous insufficiency, venous leakage or venous reflux.
If the deep veins are clogged with clots (deep vein thrombosis), it becomes difficult for the blood in that region to be transported to the heart, blood accumulates in that region and causes that region to swell. opens. This is the case in the arm or leg.
In other words, in two cases, venous flow becomes difficult and problematic, and patients complain:
Venous insufficiency or valve insufficiency
Deep vein thrombosis, that is, occlusion of these vessels by clotting.
Deep Vein Thrombosis in Leg
Deep vein thrombosis It most commonly occurs in the leg veins. It usually occurs in one leg, 5% of the time it occurs in both legs. Especially in young women, it is more common on the left.
Deep vein thrombosis in the leg veins starts suddenly. He calls this "acute deep vein thrombosis". The leg swells gradually or suddenly; It is a swelling that is sometimes painful and sometimes painless. It is painful and difficult to step on the ground.
Vein clot in the leg usually starts in the veins of the calf muscles and progresses upwards. The further it moves upwards, towards the abdomen, the more severe the disease. Extension of the clot to the inguinal vein is a bad finding, and the severity of the disease is high in these patients.
Is Vein Thrombosis an Important Disease?
In general, any type of vein thrombosis is an important disease because the treatment normally used is not an adequate treatment and some patients may have lifelong problems. If any vessel in the body is occluded, usually side ways or spare veins are opened to restore the flow, but these pathways are usually not as sufficient as the occluded main vein. This leads to the continuation of complaints in patients.
The disease is acute, that is, in the early stage, in the first month after deep vein thrombosis (DVT) occurs. If it has been present for more than a month, it is called late stage or chronic deep vein thrombosis.
What are the Symptoms of Deep Vein Thrombosis?
Coagulation usually occurs in one leg (more common in the left leg). It gives the following types of complaints or symptoms:
Leg swelling: It is the most important symptom. It usually starts in the ankle area. disease up d If it progresses correctly, the foot swelling may extend above the knee. Swelling in the legs decreases when lying down and elevating the foot.
Pain: Foot and leg swelling is seen in almost every patient, but pain occurs in some patients and not in others.
Toe or foot bruising: It is very rare and disappears as soon as blood thinners are started. If it doesn't go away, it may be an indication of serious disease.
Clot to the lung(pulmonary embolism or pulmonary embolism): This is the most frightening situation, but if early diagnosis is made and blood thinners are started, the possibility of the clot breaking into the lung is very high.
Patients' complaints are much more pronounced when standing. When lying down and elevating the foot, the swelling decreases, sometimes disappears completely. But this is a false recovery. Swelling reappears when the patient stands up again. As the days go by, the formation of new vessels and the elevation of the foot while lying down, the foot swelling decreases and even disappears completely. But this does not mean that the veins are opened. Because the blood thinners given are not drugs that dissolve or dissolve the clot. In some patients, the clot is small and this treatment is sufficient. In some patients, the clot is too much and if not treated, they may experience lifelong problems.
What is Pulmonary Embolism?
Pulmonary embolism is when the clot in the leg vein is thrown into the lung. Pulmonary embolism causes sudden onset of shortness of breath, a sharp pain in the chest, and sometimes coughing up blood. If the amount of clot thrown is small, it may not cause a big problem. However, large clot fragments may cause serious problems.
This disease is seen in everyone, but it is more common in some people.
It is more common in advanced age (after 40 years of age). But it can rarely be seen in young people.
During pregnancy and after pregnancy, in the puerperal period
Using birth control pills
In some tumor diseases,
After some major surgeries (especially orthopedic prosthetic surgeries),
Fractures and sprains of the foot (especially the leg� �after casting)
Patients who stay in bed for too long and cannot move enough
People who have a genetic tendency to clot Fuck. This is revealed by genetic testing.
Treatment in Leg Deep Vein Thrombosis
Starting blood thinners
Raising the leg with rest in the first days
Use of compression stockings
Moving the leg in a short time
Opening the vessel with angiography in a group of patients with bad leg swelling
When the leg veins coagulate, blood thinners are started immediately. This is the main treatment, but blood thinners dilute the blood but cannot clear the existing clot. If the clot remains in the veins, it will damage the valves in the leg veins, which are important for blood circulation, in a short time. This leads to lifelong complaints such as foot swelling and pain with walking in some of the patients. It should be used for at least 3 months.
Compression stockings are recommended to patients, except for blood thinning. Compression stockings are worn first while standing. It is removed while lying down. It is also recommended to be worn for at least 2 years under normal conditions.
Angio Treatment in DVT
Angio treatment is simply entering the vein and completely clearing the clot.
The blood thinners used in every patient in venous thrombosis are not drugs that can clear the clot. There are drugs that can open or clear the clot, but it can only be used through angiography in deep vein thrombosis. This drug is not used in all patients because it usually requires hospitalization and has a risk of bleeding.
There are two types of treatment for deep vein thrombosis with angiography:
Thrombolysis with a drug called thrombolitic (clot dissolver): For this Hospitalization and at least one night hospital stay are required. This drug is administered directly into the clot in the vein after entering the vein with angiography. It is like irrigation with dripping water in the fields. A long 1-2 mm thick plastic catheter with many very thin holes is inserted into the clot, and from there 10-20 or even medicine is given for long hours. This medicine can dissolve the clot. Occasionally, control angio films are taken.
Thrombectomy, that is, dissolving the clot by mechanical methods or removing it from the vein. There are systems that administer drugs.
Chronic Deep Vein Thrombosis
If deep vein thrombosis has been present for more than a month (it may be years), it may be chronically or late stage deep vein thrombosis. It is said that there is no cure for the disease at this stage, but this is also not true.
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