"I'm only 26 years old, and I was diagnosed with thrombosis" ... There are dozens and even hundreds of such messages on the Internet. Why the disease occurs, who is at risk, and what preventive measures will help to avoid making a terrible diagnosis tells Maria Alekseevna VINOGRADOVA, Candidate of Medical Sciences, Hematologist, Head of the Department of Reproductive Hematology and Clinical Hemostasiology of V.I. Society of Hematology (ASH).

What is thrombosis? How does it arise?

Thrombosis is a serious life-threatening condition during which dense clots form on the inner wall blood vessels, thrombosis can affect any part of the body. Depending on the type of the affected vessel, thrombosis is venous and arterial. Arterial thrombosis occurs in the presence of atherosclerosis, when, as a result of a violation of fat metabolism, fatty deposits and cholesterol plaques form in the arteries, narrowing their lumen and leading to problems with blood circulation, or causing heart rhythm disturbances such as atrial fibrillation.

Among the main reasons for the development of venous thrombosis is a systemic increase in blood coagulation activity in combination with a slowdown in blood flow. Any thrombosis is dangerous: it disrupts the blood supply to organs and can even lead to death.

Who is at risk?

There are many risk factors that contribute to the development of thrombosis. First of all, these are previous thrombotic episodes in a person's life: they significantly increase the likelihood of a recurrence of the disease. An important role is played by overweight, various systemic inflammatory diseases, and oncological processes.

However, thrombosis can also occur in healthy person and the likelihood increases with age. In particular, among the risk factors are long-term limitation of mobility, especially after injuries or surgical operations, taking combined oral contraceptives or other hormonal drugs, long flights. The risk of developing thrombosis can be increased by a number of specially identified hereditary predisposing factors. It is important for young women to remember that pregnancy and postpartum period may also contribute to the development of thrombotic complications.

What are the first symptoms? What can be the reason for an additional examination by a doctor? How is the diagnosis made?

The symptoms of superficial vein thrombosis - redness, itching, swelling - are more obvious and visually noticeable than the symptoms of deep vein thrombosis, at least in the early stages of the disease.

There is a misconception that deep vein thrombosis necessarily debuts brightly: it is accompanied by acute pain, significant redness and limitation of limb function. In fact, the symptoms are not always so obvious, and a person most often does not associate the pain that has appeared with problems with blood vessels, it may seem to him that his leg just hurts. If all the symptoms appear: pain, redness and swelling, you should definitely consult a doctor and undergo an ultrasound examination.

A doctor of any specialty can suspect thrombosis after examining the patient. But the diagnosis must be confirmed on the basis of Doppler ultrasound - a study of vein patency and blood flow characteristics.

The importance of diagnosing thrombosis early stage due to the risk of developing serious complications associated with the so-called "clot separation". Extremely dangerous state, called pulmonary embolism, can occur if a blood clot has formed, for example, in deep vein legs, and then by blood flow was delivered to a large pulmonary artery and plugged one of its branches. With such a blockage, the work of the entire of cardio-vascular system, significant heart failure develops, severe shortness of breath, hemoptysis may appear. This condition is a reason for emergency therapy and, unfortunately, often leads to the death of the patient.

Therefore, any diagnosis of thrombosis should be as early as possible to prevent the development of such complications.

How can thrombosis affect the course of pregnancy and the child?

From the first days of pregnancy, significant changes occur in the body of a woman, which relate to and circulatory system. The clotting activity of the blood also changes, which can increase the risk of thrombosis. As you know, during pregnancy, another organ appears that provides nutrition to the fetus - this is the placenta. If changes occur in its vessels, then this can lead to a violation of the blood supply to the fetus, a delay in its development, and often death. When it comes to pregnancy loss later dates, of course, this is very difficult for the patient: both emotionally and physically. Our task is to identify the risks of thrombosis as early as possible and prevent the development of the disease.

Is thrombosis an indication for abortion?

Any thrombotic event is an emergency and requires prompt action from us. If we are talking about life-threatening conditions such as pulmonary embolism or ischemic stroke, it may be necessary to administer special preparations that directly destroy the clot (thrombolysis). Its use during pregnancy has not yet been sufficiently studied, but it is possible. First of all, we save the patient's life, and only then we think about saving the pregnancy, otherwise you can lose both. But thrombosis is not an indication for termination of pregnancy: in the vast majority of cases, it is enough to carry out the so-called anticoagulant therapy, which is aimed at the gradual dissolution of the thrombus and restoration of blood supply to the organs. The drug and dosage are prescribed by the doctor, self-medication in this case is unacceptable - this can lead to dangerous consequences. When choosing a treatment, the doctor must assess the risk of bleeding. The patient cannot do this on his own. With timely detection of thrombosis and proper therapy, neither the life of the mother nor the life of the child suffers.

That is, if you turn to a specialist with a problem in time, you can cope with the help of drug treatment, and in extreme cases, surgery?

Absolutely right. Medical treatment always a priority surgical treatment thrombosis is now almost completely absent. The operation can help if there are local problems (for example, significant manifestations of varicose veins). It is important to influence the blood coagulation system as a whole, since any systemic change must also be affected systemically.

If it is impossible to eliminate those factors that led to thrombosis, then drug prophylaxis thrombosis should be carried out throughout life. If they can be eliminated, the duration of therapy is set from 3-6 months to several years.

Are there any measures to prevent thrombosis - what can be done at the stage of preparation for pregnancy?

Before pregnancy, all risk factors must be weighed. This is especially important in the case of the use of assisted reproductive technologies, which is associated with the use of significant amounts of hormonal drugs that can adversely affect hemostasis. Deficiency of antithrombin and other natural anticoagulants that are present in our blood to balance the action of clotting factors may also be an indication for treatment.

If the risk of thrombosis is high enough, we prescribe prophylactic therapy to the patient. Treatment is mandatory if thrombosis was already present before pregnancy or the patient has confirmed antiphospholipid syndrome, an autoimmune process in which antibodies are produced to some of her own cells.

Previous thrombosis or a combination of four and more risk factors require immediate initiation of thrombosis therapy; three factors - from the third trimester; two or more factors - treatment in the postpartum period.

Is the disease inherited?

Real Share hereditary factors the risk of thrombosis is low. A significant factor is the presence of thrombosis in relatives of the first line of kinship, especially those under 50 years of age, spontaneous and even more so recurrent development of thrombosis. Such women should be actively examined before pregnancy, as they have a very high probability of hereditary thrombophilia. More often, the cause of thrombosis is a combination of risk factors that led to the occurrence of thrombotic events.

Thus, by evaluating all the factors contributing to the development of thrombosis, we can effectively prevent the development of life-threatening consequences, preserve the health of a woman and make happy motherhood possible even in the most difficult situations.

In contact with

Thrombophlebitis is an inflammation of the walls of the veins with clogging of their clot. In the vessels of the venous system, the occurrence of pathological blood clots is more often observed than in similar arteries. Most often, thrombi form in the area lower extremities which can be seen in the photo. Distinguish between acute, subacute and chronic course. Based on the causes and nature of the process - non-purulent (clean) and purulent thrombophlebitis.

Factors causing pathology

Most pathologies are divided by occurrence into primary developing, due to direct exposure, and secondarily, against the background of another disease. This is also true for thrombosis of the veins of the lower extremities. Causes of thrombophlebitis in the case of primary and secondary developing disease lower limbs are different. Factors that cause primary inflammation and thrombosis in the legs include:

1. Injury to a separate part of the vessel - for example, due to repeated administration of a drug in the same area. (Seen in the photo characteristic manifestations).
2. Soft tissue injuries affecting the integrity of the venous wall. The risk of thrombosis develops due to damage to the inner layer. In the first case, they suffer mainly superficial veins, trauma to the lower extremities can cause damage to the deep venous vessels of the lower leg and thigh. (You can see the difference in the photo).
3. Violations of the biochemical composition of the blood. The question of why thrombophlebitis occurs with these changes can be answered by knowing what factors are the cause of blood clotting. There are 15 of them in total, and most of them, being proteins, constantly circulate in the bloodstream in an inactive state.
4. All kinds of infectious agents that cause inflammation involving the vascular walls.

To prevent the occurrence of pathology, it is important to take into account everything from which thrombophlebitis can begin to develop. In this case, it will be possible to more effectively resist the disease.

Where does vascular disease manifest itself?

In addition to the lower extremities, this disease, although less common, may affect other parts of the body. Here, the same provoking factors can be the causes of the pathology. In the area of ​​\u200b\u200bthe hands, post-injection thrombophlebitis occurs more often (in the photo you can see the characteristic location of the pathology). By analogy with the disease of the lower extremities, both superficial and deep vessels of the venous system of the shoulder, forearm and hand can be affected.

In the area of ​​​​the hands, post-injection thrombophlebitis occurs more often.

With the progression of thrombophlebitis cyanosis is added skin(as seen in the photo), numbness, loss skin sensitivity. The disease can cause necrosis of the tissues of the affected area. If it is localized in the deep components of the venous system, there is a very rapid progression. The symptoms are similar, there is a strong pain syndrome. This form is considered dangerous because in the event of a thrombus detachment, the development of pulmonary embolism is often observed, and this can cause death. To prevent the occurrence of such formidable complications can only surgical intervention.

Separately, it should be said about thrombosis of the vessels of the chest. This condition is unusual in that it occurs most often in females, and the cause is often psychosomatic. This disease is also called cord-like thrombophlebitis, since the pathological focus looks like a relatively long cord, and not a round infiltrate. The reasons for its occurrence may be:

• The presence of severe acute respiratory diseases.
• Childbirth accompanied by heavy bleeding.
• Prolonged breastfeeding.

In some pathologies, damage to the veins is observed gastrointestinal tract and liver. With advanced hemorrhoids, they become inflamed with a risk of thrombosis hemorrhoidal veins, and cirrhosis of the liver can cause thrombophlebitis of the portal venous system.

Influence of the emotional state

Studying the relationship between the occurrence of problems with psychological state person and aspects of it physical health devoted to many works. This direction at the intersection of medicine and psychology is called psychosomatics. There are well-known cases of the development of varicose veins of the lower extremities due to chronic stress.

Why does this organic pathology appear with such depressive moods? According to experts, psychosomatics manifests itself in the form of varicose veins of the lower extremities as a partial solution. psychological problems. There is a whole list of diseases that can be summed up under the term "psychosomatics". The determining factor of what kind of pathology will develop with emotional experiences, is an individual predisposition. After all, psychosomatics is regulated largely outside the human will, it is impossible to trace a specific causal relationship.

There is a whole list of diseases that can be summed up under the term "psychosomatics".

Varicose veins veins of the lower extremities often leads to symptoms of inflammation and vascular thrombosis. Therefore, information about the role played by psychosomatics in its occurrence is the subject of keen interest of psychologists. Varicose veins are a relatively harmless chronic disease, and thrombosis of the veins of the lower extremities can lead to blockage of the pulmonary artery and death.

It is hard to imagine how much more people would take care of their nervous system if the significance of such a phenomenon as psychosomatics were confirmed. To calm the shattered nerves, sometimes it is enough to watch a funny video in a circle of loved ones or scroll through a family album with a photo. Considering everything possible factors risk of the disease and understanding the mechanism of its development, in most cases it is possible to prevent thrombophlebitis or at least prevent the occurrence dangerous complications.

Thrombosis of vessels - veins and arteries: types, signs, diagnosis, treatment

Thrombosis is a pathology caused by the formation of a blood clot inside the veins and arteries, their blockage and impaired blood circulation through the circulatory system.

1. In the hospital, patients are given intravenous drugs heparin. This substance natural origin prevents further growth of a blood clot and thins the blood. "Warfarin"- a drug that lowers blood clotting and reduces the risk of developing thromboembolism. It is prescribed after a seven-day treatment with heparin. Such therapy is carried out for six months under the control of a coagulogram.
2. Thrombolytic and fibrinolytic therapy is aimed at dissolving the thrombus. Patients are prescribed drugs "Fibrinolysin", "Streptokinase", "Trombovazim", "Plasminogen".
3. Disaggregants block biochemical reactions leading to the formation of platelet aggregates and prevent the development of heart attacks and strokes. The drugs in this group include: Aspirin, Curantil, Plavix.
4. Drugs that lower LDL levels: - Levostatin, Fluvastatin; fibrates - "Fenofibrate", "Ciprofibrat".
5. Antihypertensive drugs - Nifedipine, Fenigidin.
6. A nicotinic acid - "Niacin", "Niacinamide", "Niacevit".
7. To reduce existing inflammation, glucocorticoids and non-steroidal anti-inflammatory drugs are used: Dexamethasone, Diprospan, Dicloberl, Melbek, Olfen.
8. To reduce symptoms, prescribe antispasmodics, anesthetics, vitamins C and B.

Drugs that dissolve the thrombus are injected into the patient's body not only parenterally and orally, but with the help of a catheter directly into the lesion. This technique is called. It is used in especially severe cases when conventional medicines cannot help. A thrombolytic is injected into the blood clot through a catheter, which makes it possible to eliminate even large blood clots.

Surgery

Old blood clots respond poorly to drug therapy. severe forms thrombosis require surgical treatment. The vascular surgeon decides on the necessity and method of surgical intervention.

Indications for surgery are: floating and occlusive thrombosis, a high risk of developing necrosis, or separation of a blood clot.

Operation methods:

installation of a cava filter for the prevention of thromboembolism, a dangerous

• - removal of a thrombus;
• ligation of a vein;
• Sewing of the vessel;
• Imposition of an arteriovenous shunt;
• in the affected segment.

Installation above the clot prevents it from moving through the bloodstream. Such a "trap" protects a person from migrating particles of a blood clot. The kava filter is usually installed for several years, and sometimes for life.

With thrombosis of the cavernous sinus, its drainage is indicated, followed by the appointment of loading doses of antibiotics and glucocorticoids: "Oxacillin", "Nafcillin", "Dexamethasone".

modern and safe method treatment of pathology is laser therapy, which allows to achieve a stable hypocoagulant effect and protect the patient from dangerous consequences.

ethnoscience

Facilities traditional medicine can only complement the main traditional treatment but not to be used on its own.

Prevention

Currently, the prevention of thrombosis is of particular importance. The main preventive measures:

• Use of elastic bandages
• Maintaining a healthy lifestyle
• smoking cessation,
• proper nutrition,
• Normalization and ,
• weight loss,
• Raise motor activity,
• Timely treatment of cardiac pathology,
• Limited use of hormonal drugs,
• Avoid tight clothes and high heels
• Cold and hot shower,
• sports,
• vitamin therapy,
• Intermittent use of low molecular weight heparin,
• Regular use.

Persons who have undergone a major operation and are on strict bed rest are prescribed low molecular weight heparin and mechanical compression of the calves. In seriously ill patients, a cava filter is installed in the inferior vena cava.

Thrombosis, like any other disease, is easier to prevent than to treat.. Prevention of thrombosis is aimed at eliminating factors that are triggers in the process of thrombosis.

Video: thrombosis in the program “About the most important thing”

There are many risk factors for venous thrombosis, the most significant of which are:

Age over 40 1

Age is a significant factor in assessing the risk of thrombosis. The older the person, the higher his risk of occurrence and development of thrombosis.

Obesity 1

If a person's body mass index (BMI) is over 30 (i.e., the person is obese), then they are at risk of thrombosis. Obese people have a significantly higher risk than people with a normal build.

Body mass index is calculated by the formula:

• m - body weight in kilograms
• h - height in meters /

Hospitalization in a hospital for the purpose of surgery or in case of acute or exacerbation of a chronic disease 1 .

During hospitalization (hospital stay), the patient usually for a long time is in a supine position, moves little. This is not very good for his health and increases the risk of thrombosis. If the patient has undergone surgery, he acute illness(or an exacerbation of chronic) or a catheter is installed in his vein, the risk of thrombosis also increases. Therefore, most patients undergo thrombosis prophylaxis during their stay in the hospital.

Trauma and fractures of the lower extremities 1

Trauma and fractures contribute to increased thrombosis. If the injury is on the lower limb, then the person cannot move normally, his mobility is limited. And this dramatically increases the likelihood of a venous thrombus. If you have an injury or fracture of the lower limb, you should consult your doctor about possible prevention of venous thrombosis.

Pregnancy and postpartum period 1

During pregnancy, the risk of thrombosis increases significantly. There are also additional risk factors for expectant mothers, which are detailed in the article for pregnant women. While carrying a fetus, it is very important to take care of your health, so you should consult with your doctor about the prevention of thrombosis.

Bed rest (more than 3 days) 2

Prolonged bed rest (for example, after surgery or severe injury), as well as hospital stay, increases the risk of thrombosis. If there is a risk, it is necessary to carry out extended prophylaxis after discharge from the hospital, if this prophylaxis was prescribed by a doctor.

Long trips 1

During long-distance air travel, as well as travel by train, car and other modes of transport, a person is in a sitting position for a long time, his movements are limited. This leads to a decrease in blood flow velocity, which significantly increases the risk of thrombosis. In the cabin of the aircraft, atmospheric pressure is lowered, the air is dry. All this favors the formation of blood clots, that is, blood clots.

Oral contraceptive use and hormone therapy 1

Women who take oral contraceptives containing estrogen, and hormonal agents, it is recommended to carefully monitor your health and consult a specialist about the possible risk of thrombosis.

Varicose veins of the lower extremities 1

Deep vein thrombosis can be a complication of varicose veins, as a result of which a blood clot forms in the lumen of the veins of the lower extremities, which is the cause of blockage of blood vessels.

Oncological diseases 1

Cancer is one of the leading causes of death worldwide, especially in developed countries. In cancer patients, blood clotting increases, this is due to the development of the tumor itself and, as a result, violations of the hemostasis system. Chemotherapy also increases the risk of thrombosis. Thrombosis is the second most common cause of death among cancer patients. Therefore, patients with malignant tumors you should consult with your doctor about the need for prophylaxis.

Chronic heart failure 3

Heart failure alters the blood coagulation system, resulting in swelling of the extremities, which, in turn, makes it difficult for blood to flow through the veins. In such patients, edema may be the only symptom of thrombosis, which often goes unnoticed.

Severe lung disease 1

In chronic lung diseases (complications chronic bronchitis, acute respiratory failure, severe course bronchial asthma) develop disturbances in the hemostasis system, in which the ability of blood to coagulate increases and the activity of thrombus destruction decreases.

Postponed ischemic stroke 4

If a person has had a stroke, especially accompanied by impaired motor activity, for example, in the form of paresis and paralysis, then the risk of developing venous thrombosis is high.

Acute and chronic infections, sepsis 1

In the event of severe infectious diseases(as a rule, such patients are in the intensive care unit in a hospital), especially with sepsis, the risk of developing venous thrombosis is very high.

History of venous thrombosis 1 (i.e., the person has previously had thrombosis) or in close relatives in the direct line of kinship (father, mother, sister, brother, grandparents).

The development of deep vein thrombosis in relatively young people in the absence of obvious prerequisites may be the result of genetically determined disorders of hemostasis.

The combination of several risk factors leads to a significant increase in the risk of thrombosis.

Sources:

1. Cushman M. Semin Hematol. 2007 Apr; 44(2): 62-69.
2. Hikmat AR. Ann Thorac Med. 2010 Oct-Dec; 5(4): 195-200.
3. Dean SM, Abraham W. Congest Heart Fail. 2010 Jul-Aug;16(4):164-9.
4. Rinde LB et al. J Am Heart Assoc. 2016;5(11).

Summary:

This chapter discusses risk factors for deep vein thrombosis (a condition in which blood clots form in the deep veins of the lower extremities). You will also learn about how the venous outflow is disturbed after the formation of blood clots, what happens afterwards. In about one-third of patients with deep vein thrombosis, some of the blood clots break off and enter the pulmonary artery, this is called pulmonary embolism (PE). PE is a life-threatening condition and is accompanied by shortness of breath, pain in chest, acute heart failure. V remote period after deep vein thrombosis, the so-called post-thrombotic syndrome or post-thrombotic disease develops, in which varicose veins, trophic changes in the skin, a trophic ulcer may appear.

Introduction:

Deep vein thrombosis (DVT) is a disease in which blood clots form in the deep veins of the lower extremities. DVT is quite common, with 250,000 cases of DVT and about 200,000 cases of pulmonary embolism (PEDA) diagnosed annually in the United States. While the population in the US, Europe, Russia is aging, DVT and PE are becoming more common. In about one-third of patients with DVT, clots can break off in the bloodstream, travel to the heart and then to the pulmonary artery. Thromboembolism (or separation of blood clots) is accompanied by shortness of breath, chest pain, signs of acute cardiovascular failure. In the late period after DVT, post-thrombotic disease develops, which leads to the appearance of varicose veins, trophic changes in the skin and trophic ulcers. Thus, the formation of blood clots in deep veins can lead either to pulmonary embolism, which often leads to the death of the patient, or to post-thrombotic disease, in which the quality of life is significantly impaired, a person can become disabled. Therefore, the efforts of doctors should be directed to the prevention of DVT, this disease is easier to prevent than to deal with its complications later. To effectively prevent DVT, you need to know what factors contribute to the appearance of blood clots in deep veins, that is, you need to remember the risk factors for DVT. In this chapter, we will look at the main risk factors for DVT, discuss the disturbances in venous blood flow after the formation of blood clots, and what happens to blood clots in the future.

How common are deep vein thrombosis (DVT) and pulmonary embolism (PE)?

In many cases, DVT is asymptomatic, that is, it does not appear outwardly. Therefore, it is not easy to estimate the true frequency of DVT. However, according to most sources, the incidence of clinically manifested DVT and PE ranges from 70 to 120 cases per 100,000 population. For example, in the United States, about 275,000 new cases of venous thrombosis are registered annually.

What are the causes of DVT and PE?

The main causes of venous thrombosis can be divided into two groups - these are hereditary genetic factors and acquired. Some risk factors (such as obesity) are permanent, others (such as surgery) are temporary. Some risk factors change the activity of the blood coagulation system, others contribute to thrombosis due to a decrease in the patient's activity (prolonged bed rest after injury). Venous thrombosis develops more often if several risk factors act simultaneously.

Risk factors for venous thrombosis.

Age and gender.

With age, the risk of venous thrombosis increases. This is due to the fact that older people often have other risk factors, chronic diseases. Changes in the veins themselves are more common, there is a general increase in the activity of the blood coagulation system, a tendency to thrombosis.

The dependence of the frequency of venous thrombosis on gender is less obvious, the data are contradictory. However, the risk in women is higher during pregnancy, and delivery can also be complicated by venous thrombosis. After age 45, women are at the same risk as men.

Surgical interventions.

An increased risk of venous thrombosis during and after surgical operations is associated with changes in the level of various indicators of the blood coagulation system, as well as with a decrease in activity in postoperative period especially if prolonged bed rest is needed. The risk of thrombosis during surgery is higher in older patients. The duration of the operation also has an effect. The frequency of thrombosis is higher in orthopedic and oncological operations. The risk can be significantly reduced by using compression stockings or elastic bandages during and after surgery. V Lately more commonly, special intermittent compression devices are used to improve blood flow in bedridden patients, thereby preventing venous thrombosis.

Injury.

In patients with severe associated injuries (for example, after an accident), the risk of thrombosis is significantly increased. This is due to the fact that even with minor injuries of the pelvis, spine, as well as with multiple fractures of the bones of the limbs, prolonged bed rest (immobilization) is necessary. Under these conditions, the rate of blood flow in the deep veins is reduced, venous stasis contributes to the formation of blood clots.

Chronic diseases and oncology.

The risk of venous thrombosis is increased in people with various chronic diseases, such as heart disease, lung disease, diabetes, obesity, systemic inflammatory diseases connective tissue (systemic lupus erythematosus, etc.). Also, the risk is higher in cancer patients, in patients with stroke, sepsis.

Prolonged immobilization (travel, air travel).

During long trips or during air travel, activity is significantly limited. This creates conditions under which venous blood stagnates in the deep veins, the so-called "blood stasis". This risk can be significantly reduced through the use of compression stockings during travel. It is especially necessary for overweight people who take hormonal contraceptives and those with other risk factors.

Blood coagulation disorders.

Currently known several genetic disorders that increase the risk of thrombus formation. These include antithrombin III deficiency, deficiency of proteins C and S, Leiden mutation (mutation of factor V of the blood coagulation system), antiphospholipid syndrome, prothrombin 20210A gene mutation, hyperhomocysteinemia, increased levels of II, VIII, IX or XI factors. To identify these violations, special laboratory examination. It is carried out, as a rule, in all patients who have undergone venous thrombosis, when planning a pregnancy, as well as in people with a high risk of thrombosis who are to undergo major surgery.

Taking oral contraceptives.

Replacement therapy with estrogen-containing drugs, as well as oral contraceptives, is a risk factor for deep vein thrombosis. The higher the estrogen level, the higher the risk of thrombosis. The progestins in some medications can also increase the risk of DVT. The risk is increased in women taking hormonal preparations, increases with age, it is also higher in women who smoke.

Pregnancy.

Pregnant women have an increased risk of venous thrombosis. Several factors play a role - a change in the parameters of the blood coagulation system, hormone levels, difficulty in venous outflow due to an enlarged uterus.

What happens in venous thrombosis?

Blood clots that form in the veins can partially or completely block their lumen. As a result of a violation of the venous outflow, edema occurs. If the veins are thrombosed below the level knee joint, edema may be insignificant, if large veins of the thigh are thrombosed, the edema will be greater. Severe edema develops with the so-called ileofemoral venous thrombosis, when blood clots form in the veins of the thigh and pelvis.

V acute period deep vein thrombosis (the first few weeks) there is a high risk of a blood clot breaking off with its entry into the heart and pulmonary artery. This condition is life-threatening, so treatment should be started immediately. Over time, the thrombus is fixed to the walls of the vein and the probability of a thrombus detachment is less. In the walls of the vein and in the thrombus itself begins inflammatory process, as a result of which the thrombus begins to gradually resolve. After a few months, the patency of the thrombosed vein begins to gradually recover. This process is called recanalization. It can last from several weeks to several months, until the patency of the veins is completely restored. The lumen of the vein can fully recover, but this does not mean complete recovery. The valves of the deep and superficial veins during this period, as a rule, are damaged.

Do veins return to normal after recanalization?

The answer to this question is most often negative. Normally, the walls of the veins are very thin and pliable. After DVT, the vein wall becomes rigid. This is due to the destruction of elastin and collagen fibers. The wall of the vein becomes fibrous. Fibrosis is a process of tissue change similar to scar formation. Fibrosis also affects the venous valves, which cease to function normally. All these changes lead to the fact that the symptoms of the disease remain in patients even years after DVT. The so-called post-thrombotic disease develops, which is manifested by pain, swelling, heaviness in the legs and convulsions, often trophic changes and trophic ulcers appear on the skin. It can be said that post-thrombotic disease is very similar to varicose veins, but it is more severe, more often complicated trophic ulcers. If ordinary varicose veins are perfectly treated surgical methods, then post-thrombotic disease is much more difficult to treat. Before suggesting surgical treatment, the phlebologist must carefully assess the condition of the deep veins. Surgery, which in a patient with varicose veins will lead to recovery, in a patient with post-thrombotic disease, it may even worsen the condition.

Conclusion.

DVT and PE are quite common. Risk factors can be divided into genetic and acquired. DVT and PE are more likely to occur if a person has two or more risk factors at the same time. The main measures for the prevention of venous thrombosis are physical activity, compression stockings, special medications that reduce the activity of the blood coagulation system.