Deep vein thrombosis (DVT) occurs when blood circulation slows or stops in a deep vein — veins positioned in your muscle mass or alongside your bones. When blood is not circulating because it ought to, platelets and different clotting elements start sticking collectively till a blood clot kinds. The clot can limit or fully impede blood from touring to the guts, which results in swelling, ache and the looks of a bulging blood vessel within the affected space. DVTs could happen after extended immobility, resembling throughout lengthy flights or hospitalizations, or from underlying danger elements like surgical procedure, being pregnant, sure drugs or genetic situations.
Dr. Joseph Naoum, an endovascular and vascular surgeon at Houston Methodist Cardiovascular Surgical procedure Associates and Houston Methodist Clear Lake Hospital, makes use of a metaphor to elucidate why points come up when platelets and clotting elements cluster collectively: “Think about a most important freeway and its feeder roads. An accident on a feeder street would block that street, inflicting a bottleneck with out straight affecting the primary freeway,” he says. “Conversely, an accident on the freeway can plug up that route, trigger important congestion, and in addition influence visitors flowing in from the feeder roads.”
That is what occurs in our physique when a blood clot kinds in a deep vein versus a superficial one. In contrast to superficial veins (the feeder roads) that sit nearer to the pores and skin, deep veins carry out the vast majority of the work in circulating blood again to the guts. A clot can partially or fully impede blood circulation and have an effect on the whole system, inflicting extra critical issues.
Here is what you need to learn about your danger, together with merchandise which will assist with prevention and restoration, in keeping with vascular specialists.
Who’s at best danger?
As much as 80% of DVT instances happen in folks with a minimum of one recognized danger issue. Having a number of danger elements additionally will increase your danger for growing a number of DVTs sooner or later. Some common DVT risk factors embody:
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Having a household historical past of blood clots or genetic situations that enhance clotting danger
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Having surgical procedure, particularly involving the decrease extremities or neurovascular system
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Being pregnant or latest childbirth
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Some drugs, like oral contraceptives
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Having a private historical past of DVT or different blood clotting issues
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Most cancers and a few of its remedies
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Antiphospholipid antibody syndrome (APLS), a uncommon autoimmune dysfunction
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Having a number of continual well being situation involving the guts, kidneys, circulatory system or lungs
Naoum says a genetic predisposition for hypercoagulable issues, typically indicated by a household historical past of clotting, is a robust predictor of DVT. Research shows that individuals with factor V Leiden mutation or prothrombin gene mutation, for instance, have a considerably greater danger of growing DVT than these with out these genetic variants. Different inherited clotting issues that enhance DVT danger embody protein C deficiency, protein S deficiency and factor XII deficiency.
Way of life elements can enhance your danger
Whereas sure well being situations and drugs can enhance your danger of blood clots, life-style selections additionally play a major function. “Any situation that results in persistent or extended immobility can enhance the chance of growing DVT,” says Naoum.
Being sedentary or sitting for lengthy durations, particularly throughout journey or whereas recovering from surgical procedure, impacts blood circulation and will increase your probability of growing a blood clot. Sufferers in hospitals or long-term care services face a better danger as a result of their physique’s pure mechanisms for stopping clots, resembling common motion and exercise, are restricted.
Different life-style elements that enhance your danger embody having a sedentary job, having a damaged bone or a solid, being on mattress relaxation and experiencing a trauma.
Signs of DVT
In line with the American Academy of Orthopaedic Surgeons, many individuals do not expertise any symptoms of DVT. However when signs are current, they usually embody:
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Swelling within the affected leg
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Redness or discoloration of the pores and skin
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Veins that look bigger, thicker or extra swollen than typical
“Blood clots can vary from 2.5 to fifteen millimeters in diameter and, if left untreated, relying on the placement of a clot within the leg (i.e., above the groin-iliofemoral veins or the groin-knee-femoropopliteal veins) sufferers can maintain continual swelling and ulceration to their legs, often called the post-thrombotic syndrome (PTS),” says Dr. John Shao, an interventional heart specialist at Newark Beth Israel Medical Heart and RWJBarnabas Well being Medical Group. PTS results in leg ache, swelling and discoloration, and will require lifelong remedy.
“A extra critical consequence [of DVT] is that the blood clot can dislodge from the vessel wall and journey to the lungs, turning into a probably life-threatening situation often called pulmonary embolism (PE),” says Shao. Individuals with a pulmonary embolism expertise sudden shortness of breath, chest ache, cough and lightheadedness. PEs may be deadly.
When to hunt superior care and remedy choices
In the event you expertise any of the signs talked about or have DVT danger elements, you need to see a vascular specialist for an intensive workup. Shao says that “constant leg ache or swelling, particularly with concurrent shortness of breath or chest ache,” requires rapid medical consideration at a hospital or medical facility.
“An ultrasound can be carried out there to verify the blood clot’s dimension, location and acuity, so your physician can resolve on the right remedy choices,” Shao says. “We can even carry out a CAT scan, if indicated, to rule out a pulmonary embolism, which is extra harmful.”
Whereas remedy is dependent upon the blood clot, the severity of your signs and your well being, Shao says that anticoagulant drugs, like intravenous heparin, injectable Lovenox and oral warfarin or direct oral anticoagulants (DOACs), are used to skinny the blood and stop blood clots from rising. Different choices embody a catheter-directed thrombolysis or mechanical thrombectomy process to take away the clot, vein stenting and compression remedy (compression stockings or gadgets) to enhance venous return within the legs.
Lowering your danger of DVT
You possibly can’t management all danger elements for DVT, resembling inherited blood clotting issues or a household historical past of clots, however you possibly can take steps to reinforce circulation. Dr. Kofi Quaye, a board-certified vascular surgeon at Cardiothoracic and Vascular Surgeons in Austin, Texas, says compression stockings assist blood circulation and alleviate signs in folks with venous insufficiency or a historical past of blood clots.
“We advocate compression stockings as a primary type of noninvasive remedy for varicose veins,” says Quaye. In line with a 2022 study in Frontiers in Cardiovascular Medication, varicose veins (a standard signal of venous insufficiency) are related to an elevated danger of venous thromboembolisms, together with deep vein thrombosis and pulmonary embolism.
Quaye explains that understanding how your circulatory system works and the way blood clots kind may also help you see the advantages of compression remedy. “Our coronary heart works to pump oxygenated blood out to the physique by high-pressure vessels referred to as arteries, whereas the deoxygenated blood returns by the lower-pressure vessels referred to as veins,” he says. These veins have buildings referred to as valves that make sure the blood flows a technique from the legs to the guts. “That is additionally aided by contraction of muscle mass within the leg with strolling.”
If these valves turn into broken, blood accumulates within the veins till stress will increase, triggering an inflammatory course of. “This irritation, coupled with elevated venous pressures, results in the event of spider veins, varicose veins, pores and skin adjustments and even ulcerations in extreme kinds,” says Quaye.
Compression remedy utilizing stockings or intermittent pneumatic compression gadgets (IPCDs) squeeze the legs to create stress that pushes blood again in the direction of the guts. IPCDs, which encompass inflatable boots or sleeves positioned across the legs which might be periodically inflated with air, are sometimes used within the hospital to forestall DVT in high-risk sufferers.
Finest merchandise for DVT prevention
The diploma of a affected person’s signs dictates the advisable compression when it comes to the stress, or millimeters of mercury (mmHG), says Quaye. Customary over-the-counter compression stockings embody class 1 and a few class 2, whereas different courses (3 and 4) typically require a prescription.
Here is a breakdown of what every class means:
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Class 1: Gentle compression (8–15 mmHg) for minor leg swelling and discomfort
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Class 2: Gentle to reasonable compression (20–30 mmHg) for bettering blood circulation in folks vulnerable to swelling
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Class 3: Agency compression (30–40 mmHg) to handle extra extreme leg signs or situations like varicose veins or lymphedema
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Class 4: Additional-firm compression (40–50 mmHg) for superior venous insufficiency or post-thrombotic syndrome
Medical grade compression stockings
Quaye says medical-grade refers to compression of a minimum of 20 to 30 mmHg. These are finest for folks with extreme venous insufficiency or a historical past of DVT and are usually prescribed by a physician. Your supplier will inform you what size and magnificence (resembling knee-high or thigh-high stockings) based mostly in your wants.
Medical grade compression sleeves and clothes
Compression sleeves and clothes provide extra focused compression to your arms or calves. Your physician could advocate one if in case you have a particular harm or situation, resembling lymphedema or a earlier blood clot in your arm, that will increase your danger of blood clots.
Non-medical grade compression socks
Gentle compression is right for on a regular basis put on, particularly if you happen to stand or sit for lengthy durations at work or whereas touring. In line with a pilot study on prenatal vascular insufficiency within the Journal of Vascular Surgical procedure: Venous and Lymphatic Problems, it could additionally assist enhance pregnancy-related leg swelling.
Intermittent pneumatic compression gadgets (IPCD)
Your physician could advocate an intermittent pneumatic compression gadget if you happen to’ve had a DVT. These gadgets use cuffs that wrap round your legs and inflate with air to imitate the pure muscle contractions of strolling. Whereas some IPCDs are reserved for the hospital or medical workplace, there are additionally choices for dwelling use. Nevertheless, most require a legitimate prescription from a physician.
Meet the specialists
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Dr. Joseph Naoum, MD, endovascular and vascular surgeon at Houston Methodist Cardiovascular Surgical procedure Associates and Houston Methodist Clear Lake Hospital
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Dr. John Shao, MD, interventional heart specialist at Newark Beth Israel Medical Heart and RWJBarnabas Well being Medical Group
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Dr. Kofi Quaye, MD, board-certified vascular surgeon at Cardiothoracic and Vascular Surgeons in Austin, Texas
Our well being content material is for informational functions solely and isn’t meant as skilled medical recommendation. Seek the advice of a medical skilled on questions on your well being.
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