How to Prevent Deep Vein Thrombosis
Deep vein thrombosis is the development of a blood clot inside the deep veins, away from the srface of the skin.
Arteries carry oxygen-enriched blood away from the left side of the heart out to the body, while veins bring blood, now depleted of oxygen, back to the right side of the heart.
Veins must fight the pull of gravity; muscles in the feet and legs help by squeezing the veins to force the blood upwards, while one-way valves in the veins keep blood from flowing backwards.
These veins can develop problems. Deep vein thrombosis is the development of a blood clot inside a vein. These clots can break off and travel elsewhere in the body, potentially passing through the heart or lodging in the lungs – causing a potentially fatal condition known as pulmonary embolism.
What Causes Deep Vein Thrombosis?
Chronic venous insufficiency can cause deep vein thrombosis, while having a blood clot can stretch the veins and result in chronic venous insufficiency.
Blood clots are more likely to form when someone is inactive; which is why most cases occur in hospitalized patients. Prolonged sitting or bed rest enables blood to accumulate in the veins, encouraging the formation of blood clots. Surgery, especially hip, knee and gynaecological procedures, increases the risk of deep vein thrombosis because of trauma or injury to the vessels and slowed blood circulation.
The same is true of fractures and childbirth within the last six months. Taking oestrogen and birth-control pills also raises the risk because oestrogen increases the blood’s tendency to clot. The clots usually develop in the pelvis, thigh or calf, although they may be found in the arms, chest or other parts of the body.
How Can I Prevent Deep Vein Thrombosis?
Activity is the best prevention for all venous disorders. Avoid sitting, standing or lying down for long periods of time. Stop at least every two hours on long car trips to get out and stretch and walk for a few minutes. On long plane trips, stand up and move if possible, or flex and extend the ankles about 10 times every 30 minutes. While standing for long periods, flex leg muscles to help the veins work more efficiently. When sitting or lying down, try elevate the feet above the level of the heart.
For patients who are hospitalized or in a long-term care facility, elastic stockings can be work to help maintain proper circulation in the legs. Pneumatic devices mimic the action of the calf muscles with and electric pump that squeezes the plastic stocking in a rhythmic pattern to help the blood circulate. Anticoagulants to slow down the blood’s clotting time may be prescribed for people at high risk for thrombosis or for surgical patients. Getting up and walking is encouraged as soon as possible for patients who have had surgery or are hospitalized.
Quit smoking, especially if you are taking oestrogen. Cigarettes and hormone replacement therapies are a major risk factor for deep vein thrombosis.
Limit your intake of vitamin K if you are taking blood thinners as it can affect how the drug works in your body. Canola, soy beans and green leafy vegetables are all high in vitamin K.
What are the Symptoms of Deep Vein Thrombosis?
With deep vein thrombosis, typically only one leg is affected. Symptoms can include pain, tenderness, swelling, increased warmth and often redness in that leg. About half the people who have deep vein thrombosis will not have any symptoms at all.
If someone has deep vein thrombosis or a history of blood clots, and is experiencing chest pain, shortness of breath, fainting or loss of consciousness, they should go to hospital or call for emergency help immediately.
How is Deep Vein Thrombosis Treated?
Treatment for deep vein thrombosis is important to prevent complication such as pulmonary embolism.
Medication: The most common way to treat deep vein thrombosis is through the use of prescription medications known as blood-thinners. They do not actually thin the blood, but increase the amount of time it takes for the blood to clot. Heparin is the intravenous form of the drug and is given while the patient is hospitalized. A more recent breakthrough is low molecular-weight heparin, which can be given by injection once or twice a day and does not require hospitalization. Warfarin is the oral form of an anticoagulant, given in pill form. Patients taking blood-thinners need regular blood tests to monitor the clotting factor; this measurement, called INR should be between 2 and 3.
Non-Surgical Procedures: Thrombolysis is a procedure in which clot-dissolving drugs are injected through a catheter into the clot. This approach may be used to dissolve large clots. The procedure is rare, though, because it has a higher risk for bleeding complications and stroke than does blood-thinning, or anti-coagulant, medication.
Surgery: Although rarely used, a surgical procedure called venous thrombectomy can remove the deep vein clot. Another procedure involves insertion of a vena cava filter, which can be surgically inserted into the vena cava, the large vein returning blood from the abdomen. This filter prevents clots that have dislodged from reaching the lungs and the heart.
The risk factors for deep vein thrombosis include:
- Over age 50
- Prolonged inactivity, such as sitting or bed rest
- Recent surgery or injury
- Childbirth within the last six months
- Oestrogen or birth-control pills
- History of polycthaemia vera
- Cancerous tumour
- Inherited or acquired blood-clotting problems
- History of heart attack, stroke or congestive heart failure
- Inflammatory bowel disease