Deep Vein Thrombosis

What is Deep Vein Thrombosis?

Thrombosis is the occlusion of a vessel by a blood clot, a thrombus. In deep vein thrombosis (DVT for short), this blood clot develops in a more prominent vein deep in the muscle layers, usually in the lower leg. DVT can have various causes. Obesity, lack of exercise, and advanced age, in particular, are important risk factors. These cause the blood to flow slower in the vessels and make them more susceptible overall to the formation of blood clots.

If thrombosis goes unnoticed and untreated, the blood clot can detach from the vessel wall and travel to other body parts via the bloodstream. An important example is pulmonary embolism, in which a former thrombus reaches the pulmonary vessels and can lead to circulatory problems and, in the worst case, death.

Causes and Risk Factors of Deep Vein Thrombosis

A blood clot can have various causes. In most cases, it is caused by an injury to the vessel wall, a blood clotting disorder, or a too-slow blood flow rate. Triggers can be prolonged bed rest, congenital diseases, or major surgery. Other risk factors include inflammatory diseases, familial predisposition, pregnancy, use of birth control pills, obesity, smoking, and heart failure.

In addition, patients who have already suffered a deep vein thrombosis have a significantly increased risk of developing the disease again. In rarer cases, tumors and cancers can also cause thrombosis as they increase overall blood clotting.

Symptoms: How do I Recognize Thrombosis in the Leg?

Deep vein thrombosis in the leg is accompanied by apparent symptoms in only a few cases. It often remains completely asymptomatic, making diagnosing and treating it more challenging. Nevertheless, thrombosis may show some signs that offer a clue to the condition.

Classic symptoms of leg vein thrombosis include pain in the affected leg, feelings of tightness, reddened skin, and tenderness on palpation in the leg. The affected area may also swell and feel warm.

In addition, symptoms such as shortness of breath, weakness, or dizziness may occur once the thrombus has detached from the leg and migrated to the lungs. There, it reduces blood flow through the lungs, resulting in a lack of oxygen. In this case, it is called a pulmonary embolism. Although this happens relatively rarely, a doctor should medically clarify it as soon as possible since pulmonary embolism can lead to death in the worst case.

How is Leg Vein Thrombosis diagnosed?

First, if a leg vein thrombosis is suspected, a detailed physical examination takes place. Here, special attention is paid to the legs and possible pain (especially pressure pain on the calf and sole of the foot) that may occur during the examination. In addition, potential risk factors in the person's life are clarified during

If the suspicion of deep vein thrombosis is confirmed during this initial contact, some examination methods can provide information about the possible diagnosis.

Usually, a blood test for D-dimers is carried out in this case. This is because d-dimers are formed when the body breaks down the blood clot in thrombosis. They are, therefore, a further indication of leg vein thrombosis.

If the overall findings indicate deep vein thrombosis, a duplex ultrasound examination (Doppler examination) is ordered to confirm the results. Here, an ultrasound device is used to locate and visualize the affected vein.

Therapy of Deep Vein Thrombosis

Deep vein thrombosis is usually treated in a hospital as an inpatient procedure, generally taking a few days.

Treatment is by medication with an anticoagulant, such as heparin or fondaparinux. These drugs ensure that the existing thrombus does not enlarge and can be broken down by the body as far as possible. A doctor usually prescribes continued treatment over several months to years with these anticoagulant drugs to reduce the risk of a relapse. Wearing anti-thrombosis stockings is also a helpful addition to everyday life.

In addition to drug therapy, surgical intervention may be necessary to reopen the occluded vessel (medically called "recanalization"). This is done specifically for affected veins in the pelvis or groin.

Can Leg Vein Thrombosis be Prevented?

Yes, you can prevent the development of leg vein thrombosis with various measures. This is especially advisable if you are prone to this condition due to the risk factors already described.

The simplest form to prevent thrombosis is regular and sufficient exercise. Prolonged standing, sitting, or lying down should be avoided or interrupted by breaks. In this way, the blood stays in the veins of the legs for a shorter time, and the risk of thrombus formation decreases.

Other means of preventing leg vein thrombosis are anti-thrombosis stockings. These can be especially helpful when the situations mentioned above of lack of exercise cannot be interrupted - for example, when traveling or at work. In addition, for patients with a permanently increased risk of thromboses, such as pregnant women, the elderly, or smokers, it may be helpful to wear anti-thrombosis stockings all day.

Alternatively, anti-thrombosis injections can prevent thrombosis. These are often used for patients who, for example, spend a long time in the hospital and are bedridden. Whether a therapy with anti-thrombosis injections is a sensible treatment method must be clarified individually with the attending physician.

Cure and Prognosis of Deep Vein Thrombosis

The affected person overlooks many leg vein thromboses because the patient's body breaks down the thrombus without complications or symptoms.

However, if symptomatic deep vein thrombosis occurs, the chances of recovery are very good with the help of today's medical options. In these cases, the prognosis strongly depends on timely diagnosis since subsequent treatment tactics are based on it.

In addition, the conscientious intake of the prescribed anticoagulant medication is crucial for healing and preventing thrombosis relapse.

Which Doctors and Clinics Are Specialists in Leg Vein Thrombosis?

The suspicion of leg vein thrombosis can be raised during the general practitioner's examination. However, since unique examination methods are necessary to confirm the diagnosis, a referral to the hospital is usually made to the specialist department of internal medicine.

Here, specialists in angiology, i.e., the specialization that deals with the body's vessels, can perform a more targeted examination. In addition, drug therapy for leg vein thrombosis is usually carried out in an inpatient setting by specialists in internal medicine.

In addition, with vascular surgery specialists, a decision can be made on whether the thrombus needs to be removed in surgery. In case of doubt, this surgery is carried out.

Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively, and a reliable doctor would never claim to be the best, we can rely only on a doctor's experience.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in leg vein thrombosis and are awaiting your inquiry or treatment request.

Sources:

• Kemkes-Matthes, B. et al.: Blutgerinnung und Thrombose. Stuttgart: Thieme, 2001
• Arastéh, K. et al.: Duale Reihe Innere Medizin. Stuttgart: Thieme, 2018
• Braun, J. et al.: Basislehrbuch Innere Medizin. München: Urban & Fischer Verlag/Elsevier Gmbh, 2017
• next.amboss.com/de/article/fh0kWf