Hello friends!.. If you are looking for detailed and practical information about orthopedic problems, welcome to the website of Dr. Homan Kokbi, **surgeon and orthopedic specialist in Tehran**.. Today we want to talk about one of the common but serious issues in the field of orthopedics: **Deep Vein Thrombosis** or DVT for short... This is a very dangerous issue that is completely dangerous based on your medical knowledge in this article.. Improve your health with more knowledge .... If you have any questions, be sure to consult with Dr. Kukbi!.. What is deep vein thrombosis?. Deep vein thrombosis, or DVT, occurs when a blood clot forms in one of the body's deep veins. This can happen if the vein is damaged or blood flow slows or stops. While there are several risk factors for DVT, two of the most common are:
- Injury to the body, such as a fracture
Surgery, especially surgery involving the thighs or legs
Deep vein thrombosis can have serious consequences.. If the clot breaks loose, it may travel through the bloodstream and block blood flow to the lungs.. Although this complication - called a pulmonary embolism - is rare, it can be fatal.. Even if the clot does not rupture, it can cause permanent damage to the vein valves, such as long-term damage to the leg valves.. Swelling and leg ulcers. DVT without symptoms It occurs noticeably and it is very difficult to diagnose. That's why doctors focus on DVT prevention and use different types of treatment depending on the patient's needs. Arteries are blood vessels that carry oxygen-rich blood from the heart to other parts of the body.
- Deep veins that are deep in the muscles
Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one of the deep veins... While DVT can occur in any deep vein, it most often occurs in the veins of the pelvis, leg, or thigh... ### CAUSE **Deep Vein Thrombosis**
Several factors can affect blood flow in deep veins and increase the risk of blood clots.. These factors include:
- Increasing age
- Personal or family history of DVT or pulmonary embolism
- Getting cancer
- Smoking
- Use of birth control pills or hormone therapy
- pregnancy
- Overweight or obesity
- Hereditary blood coagulation disorder
A fracture of the thigh or leg, or major surgery on the thigh, knee, or leg can affect normal blood flow and coagulation. In these orthopedic conditions, three main factors contribute to the formation of blood clots in the veins: slow blood flow, excessive clotting, and damage to the walls of the veins. The walls of the veins are smooth. slow.. the blood that If it does not flow freely and does not mix with anticoagulants, it may be more prone to clots. This is why it is important to watch for signs of DVT in people who:
- They are hospitalized
- They are immobile in a splint or cast
- Unable to move for a long time... Let's check... #### Hypercoagulability
Blood thickens or coagulates around material that does not belong in the veins....During surgery, materials such as tissue debris, collagen, or fat may be released into the blood system and cause blood clots....In addition, in a total hip replacement, preparing the bone to receive a prosthesis may cause the body to release chemicals called antigens into the blood system....During surgery, the doctor must move soft tissues such as ligaments, muscles, and tendons. or pull back to the area to be operated on.... In some cases, this can release natural substances that cause blood to clot... #### Pulmonary Embolism
A pulmonary embolism is a blood clot that breaks through the veins to the lungs....this can happen immediately after the clot forms or several days later....if the blood clot travels to the lungs, it can block blood flow to the lungs and heart....pulmonary embolism is a serious medical emergency and can lead to death... ##### Post Traumatic Syndrome
Some people who have DVT develop long-term symptoms in the legs, a condition called postthrombotic syndrome.. Post-thrombotic syndrome occurs when damage to the veins leads to venous hypertension -- or higher-than-normal blood pressure in the veins --.
This increased pressure can damage the valves that control the flow of blood through the veins. The syndrome may experience symptoms that affect their quality of life, including pain, swelling, skin changes, and leg ulcers. Symptoms of DVT occur in the leg affected by the blood clot and include:
- Swelling that does not improve by raising the limb
- Pain or tenderness
- Swollen (dilated) veins. Red or colorless skin
- Stiffness or thickening of the vein, which is called "rope". But many patients have no symptoms. In some cases, pulmonary embolism may be the first symptom of DVT. Pulmonary embolism symptoms include:
- shortness of breath
- Sudden onset of chest pain
- Cough
- Spitting or vomiting blood
### Doctor's examination
If the doctor suspects DVT, he may order certain diagnostic tests... #### tests
Duplex ultrasound.... This is the most common test for DVT.... Ultrasound uses high-frequency sound waves that bounce off the body - much like the technology used to check the health of a fetus during pregnancy.... It creates an image of the blood vessels.... Duplex ultrasound combines traditional ultrasound technology with Doppler technology, which produces a color image that shows blood flow in the body... Ultrasound is also not It's invasive and painless....it can be repeated regularly because it doesn't require radiation....if you don't have a blood clot, a duplex ultrasound may be helpful in uncovering other causes of your symptoms....rarely other imaging tests may be needed...consider, including:
- Magnetic resonance imaging (MRI) .... MRI produces detailed, cross-sectional images of structures inside the body, including blood vessels and veins .... This test is painless and non-invasive .... Although rarely used, some doctors may use MRI to look for blood clots in the pelvis and thighs .... MRI does not allow you to see both legs at the same time.. A pacemaker is used .... - Venography .... Venography, the doctor injects a contrast solution (or dye) into the vein.... the solution mixes with the blood and flows throughout the veins.... X-rays of the affected leg will then show if there are any blockages in the veins of the leg and thigh.... Venography is rarely used because it is invasive and requires blood tests.
Because DVT can occur after a fracture or major surgery, many patients are hospitalized when diagnosed. The goals of DVT treatment include:
- Preventing the enlargement of blood clots
- preventing the clot from separating and moving to the lungs (pulmonary embolism)
- Reducing the possibility of creating another clot
- Minimizing the risk of other complications
Often, the treatment of DVT is non-surgical.... #### Non-surgical treatment
Anticoagulants....Non-surgical treatment usually involves taking anticoagulants - blood-thinning drugs that prevent further clotting and help dissolve existing clots....Anticoagulants are started immediately after a clot is detected...Anticoagulants can cause bleeding problems if the dose is too high, so they sometimes need to be monitored..Depending on the medication you are taking, your doctor may order frequent blood tests to check how long your blood has been clotting. prescribe..heparin, low molecular weight heparin (LMWH) and warfarin (Coumadin)....administer, administer, do not require monitoring of blood tests and do not require dose adjustment....that is why they are widely prescribed....heparin...DVT treatment may begin with heparin or LMWH therapy....standard oral heparin is given intravenously (intravenously) while LMWH is given by subcutaneous injection, and LMWH is eliminated from the body within 12 hours....Dose is based on body weight....For most adults, each dose is the same – unlike standard heparin, where doses are often changed based on clotting time....Because LMWH does not require an IV line or dose monitoring, it can be given on an outpatient basis..Orally (by mouth).... Warfarin takes at least 36 hours to start working and 4-5 days to reach maximum effectiveness.
For this reason, both heparin and warfarin are prescribed at the beginning of treatment.. Heparin protects the patient and keeps his blood anticoagulated until the warfarin "activates".... Since the advent of Xa inhibitors, warfarin is used less often because it requires frequent blood monitoring and is influenced by diet, while Xa inhibitors do not have these problems.... All types of anticoagulants have advantages and disadvantages.... Your doctor will give you the best medication....Depending on your individual risk factors, your doctor may manage an isolated DVT located below the knee or leg with observation and monitoring through serial duplex ultrasound scans, not anticoagulant therapy....Your doctor will discuss the type of treatment that is right for you....Thrombolytics....In some cases, your doctor may recommend the use of thrombolytics....These drugs work directly through clots. Blood are used.. Only when the risk of pulmonary embolism is very high.. #### Surgical treatment
Your doctor may recommend surgery:
- if anticoagulants do not prevent your blood clots from increasing in size, or
- If you have a medical condition that does not allow you to take anticoagulants
The surgery involves placing a small device called a vena cava filter in the main vein leading to your heart.. This filter is designed to catch most of the blood clots that pass through the bloodstream before reaching the lungs as pulmonary emboli.. In rare cases, surgery may be recommended to remove the blood clot from the veins or lungs. including The length of time you will be discharged from the hospital is longer.. You will remain at risk for about 3 months.. - Movement and exercise early after surgery
- Compression socks
- Anticoagulants
#### Basic movements and physiotherapy
Most patients start walking or doing other leg exercises immediately after surgery. Simply elevating the leg while lying in bed helps increase blood flow in the veins.. In addition, a therapist will teach you specific exercises to restore joint range of motion, strengthen the lower body, and improve blood circulation in the deep veins... #### Pressure devices
Graded elastic compression stockings are tight at the ankle and loosen upward.. The pressure they provide may help circulation by preventing blood pooling in the veins.. In addition, your doctor may recommend that you use an external pneumatic compression device or a continuous compression device after surgery.. The body's ability to prevent blood clots... #### Anticoagulants
If you have joint replacement surgery, you will often start anticoagulants the day after surgery and continue them in the hospital and at home. The duration of the medication depends on the type of surgery and other risk factors. #### Additional measures
If you have experienced a traumatic injury to your lower body, you may be treated with additional preventive measures.. Rarely, if you are unable to take anticoagulants, your doctor may recommend placing a vena cava filter in the main vein leading to the heart.
