Venous thrombosis is characterised by the formation of a blood clot (or thrombus) in a vein.
Usually this affects the blood vessels in the legs.
Venous thrombosis can affect both superficial and deep veins.
If the patient has a problem with saphenous varicose veins, and superficial thrombosis may be a complication of the disease itself.
If the patient has healthy superficial veins, the onset of thrombophlebitis must lead to suspicion of the unrecognised presence of a tumour (paraneoplastic syndrome) or thrombophilia (i.e. a genetic predisposition to thrombosis).
While superficial thrombophlebitis is seen and, usually from objective disorders, the onset of a thrombosis in a deep vein is more subtle.
In these cases, of course, thrombosis in a deep vein can also be more dangerous due to the detachment of a piece of thrombus that turns into a pulmonary embolism.
Several factors may increase the risk of developing deep vein thrombosis:
- sitting or lying down for a long time (e.g. during an airplane trip or hospital stay)
- hereditary diseases that impair proper blood clotting
- trauma or surgery
- being overweight and obesity
- taking a birth control pill or hormone replacement therapy
- some forms of cancer
- a cardiac arrest
- be carriers of pacemakers
- catheters inserted into a vein.
What are the symptoms of deep vein thrombosis?
Deep vein thrombosis is often asymptomatic; in other cases it can manifest itself with swelling and pain in the leg, ankle and foot, calf cramps, warming of the affected area and changes in skin colour (which may be pale, reddened or cyanotic).
In the event that deep vein thrombosis is suspected, d-dimer dosage is now used in emergency departments around the world for resource-saving reasons.
The d-dimer is a product of degradation of the Fibrinogen (which intervenes in the process of blood clotting).
However, not everyone is aware of the significance of this examination.
If the d-dimer is negative there is almost 99% chance that there will be no thrombosis and therefore it is not necessary to go ahead with further checks.
If the d-dimer is positive (it can be positive for many reasons and therefore not only for a thrombosis) it is necessary to confirm the suspicion of thrombosis with an ecocolordoppler examination.