Blood clot in the leg
Thrombosis is a disease characterized by the formation of blood clots in the vessels. They block the lumen of a vein or artery and disrupt the normal blood supply to a specific organ or part of the body. The lower extremities become a frequent site of localization of blood clots. If a person with a blood clot in the leg does not seek medical help in time, the disease may result in death or disability.
The main complication of the pathology is the detachment of a blood clot, which, together with the blood flow, begins to travel through the blood vessels. If it reaches the arteries of the heart or lungs, they are blocked. This can result in an increase in symptoms of pulmonary and heart failure, or myocardial infarction. When a blood clot enters the blood vessels of the brain, the patient suffers a stroke. Therefore, it is so important to know the symptoms of a blood clot in the leg and seek medical help in a timely manner.
Content:
- Reasons for the formation of a blood clot in the leg
- Types of blood clots in the leg
- Symptoms of a blood clot in the leg
- Complications of blood clots in the leg
- Diagnosis of a thrombus in the leg
- Thrombus treatment in the leg
- Forecast and prevention
Reasons for the formation of a blood clot in the leg
Blood clots begin to form against the background of violations of blood coagulation processes. In those places where the vessels are damaged, clots of blood cells and fibrin fibers form. Also, the favorite place of localization of blood clots are atherosclerotic plaques.
A thrombus becomes an obstacle in the path of blood flow, so more and more blood cells join it. Another negative factor affecting the accelerated growth of a thrombus is inflammation of the vascular wall.
So, in order for a clot of blood and fibrin filaments to begin to form in the leg, three conditions are necessary:
- Disruption of blood coagulation processes.
- Violation of the integrity of the vascular wall.
- Slow blood flow.
The triggers that contribute to the development of the disease are:
- The resulting injury to the lower extremities.
- Surgical intervention on the veins of the lower extremities, or on soft tissues.
- Postponed infectious diseases.
- Prolonged sitting or lying down.
- Sedentary lifestyle, low physical activity.
- The period of gestation and the early postpartum period. In this case, thrombosis will be due to hormonal surges in the woman's body.
- DIC syndrome.
- Taking hormonal contraceptives.
- The presence in the body of a cancerous tumor of a malignant nature.
- Senile age.
- Diseases of the cardiovascular system.
- Weighed down heredity.
Types of blood clots in the leg
The most dangerous type of blood clot is considered to be a floating clot. Such a thrombus is located on a thin leg, which can come off at any time.
There are also parietal thrombi, which most often form around atherosclerotic plaques. They pose less threat in terms of separation, however, the risk of embolism remains.
Occlusive blood clots are formations that grow to an impressive size, thereby blocking the blood flow through the vessels. These blood clots often form in the lower extremities.
Depending on the location, venous thrombi are secreted, which lead to the development of thrombophlebitis (damage to the saphenous veins) and phlebothrombosis (damage to the deep veins of the lower extremities). There are also arterial thrombi that are localized in the arteries of the legs and cause a condition called arterial thrombosis.
Symptoms of a blood clot in the leg
Initially, the disease can develop latently, making itself felt only after the first complications occur.
However, about half of patients experience the following symptoms:
- Feeling of heaviness in the lower limbs.
- Swelling of the legs, not associated with heavy drinking or overwork.
- Blue skin of the legs.
- Bursting pains in the legs of varying intensity.
- Local and general increase in body temperature.
- Inflammation of regional lymph nodes.
- Pain when touching the lower limbs.
- Swelling of superficial veins, increased venous subcutaneous pattern on the legs, in the lower abdomen, in the thighs.
These are common symptoms that characterize the presence of a blood clot in the leg.
Arterial thrombosis is accompanied by the following symptoms:
- Numbness of the extremities, a decrease in body temperature below the area where a blood clot formed.
- Pain that tends to get worse.
- Loss of limb sensitivity.
- Immobility of the leg.
As for thrombophlebitis, in which blood clots are localized in the superficial veins, it is accompanied by the following symptoms:
- The veins become dense, expand.
- When touching the veins, a person experiences pain.
- The skin over the veins turns red.
Symptoms of phlebothrombosis, in which a blood clot forms in the deep veins of the legs:
- Puffiness.
- Blue skin.
- Heaviness in the legs.
- Pain in the lower limbs.
- Formation of subcutaneous blisters filled with fluid.
- General intoxication of the body.
If a patient's thrombosis develops in the arteries of the lower extremities, then in 10% of cases it will end with its amputation. Thrombophlebitis is almost always a complication of varicose veins. If thrombophlebitis is not treated, the disease will be accompanied by frequent relapses and will be complicated by the transition to deep vein thrombosis of the legs.
Complications of blood clots in the leg
If the thrombus is located in the deep veins of the lower extremities, then the patient often develops chronic venous insufficiency. This complication is expressed in edema of the legs, in violation of tissue nutrition. As the pathological condition progresses, the patient may develop gangrene, eczema, trophic ulcer.
The most serious complication of a blood clot in the leg is pulmonary embolism. In this case, small pieces of a thrombus migrate with the blood flow to the pulmonary artery. When they get into its narrow part, the vessel becomes blocked. Violation of blood flow provokes acute respiratory and heart failure, therefore, it is not always possible to save the victim.
Other complications of a blood clot in the leg include pulmonary infarction, cerebral stroke, myocardial infarction, amputation of a limb against the background of developing gangrene, suppuration of a blood clot and abscess.
Diagnosis of a thrombus in the leg
If a person suspects that a blood clot has formed in his lower limb, he should seek help from a doctor. First, you should visit a therapist who will give a referral to a phlebologist.
Already during the initial examination, the doctor will be able to make a preliminary diagnosis. To detect a thrombus in the leg, the following tests can be performed: march test, Homans test, Lovenberg test, tourniquet tests, etc.
Modern phlebology has a sufficient number of instrumental techniques that allow you to detect pathology:
- Duplex angioscanning of blood vessels.
- Doppler ultrasonography.
- Rheovasography of the lower extremities.
- Radionuclide scanning.
A clinical blood test does not allow for a diagnosis, but with thrombosis, the ESR, leukocytes, platelets will be overestimated. It is imperative that the patient donate blood for a coagulogram and a D-dimmer test. A comprehensive examination will allow you to collect as much information as possible about the patient's health and prescribe him adequate treatment.
Thrombus treatment in the leg
If a person has a blood clot in their leg, they need to be hospitalized. Provided that medical assistance is provided in a timely manner, a blood clot can be completely eliminated without surgery. However, no specialist can guarantee a relapse of the disease.
If a patient is diagnosed with arterial thrombosis, then the following treatment is shown to him:
- Performing a thrombectomy, in which the clot is removed by surgery. The operation on the vessels can be performed in an open and closed way. Most often it is carried out on an emergency basis. Local anesthesia is performed. General anesthesia is indicated for reconstructive interventions (bypass surgery, prosthetics, thrombintimectomy).
- Elimination of the root cause of the disease, which led to the formation of a blood clot.
- Prescription of antispasmodics: No-shpa, Papaverin, Baralgin. The drugs are administered intravenously.
- Intravenous administration of 10,000 U of Heparin.
- Conducting antithrombotic therapy using several drugs. Treatment is always started with the use of low molecular weight Heparin, in the future, the patient can be prescribed drugs such as: Trental, Reopolyglyukin, Aspirin, Nicotinic acids.
Treatment of thrombophlebitis with conservative methods is reduced to the following:
- UHF.
- Applying bandages with heparin ointment.
- Prescribing anti-inflammatory drugs.
- Reduction of venous stasis with the help of Troxerutin, Hydroxyethylrutoside, etc.
- If the patient develops an acute inflammatory reaction of local localization, then he is prescribed antibiotics.
- The affected limb is bandaged with elastic bandages.
- Fibrinolysin, Trypsin, Streptokinase, Urokinase and other fibrinolytics are used to dissolve the thrombus.
- Anticoagulants are prescribed to thin the blood.
Hirudotherapy has a good effect in the treatment of thrombophlebitis. For the procedure, leeches are used. The operation is prescribed for ascending thrombophlebitis of the veins of the leg and in the case when blood clots are located in the area of superficial veins of the thigh.
If the patient is diagnosed with deep vein thrombosis of the legs, then he is shown strict bed rest. The affected leg is fixed in an elevated position. To prevent the formation of new blood clots, the patient is prescribed Heparin, which is administered throughout the week. Then the patient is transferred to Warfarin. The term of its use is equal to six months. If deep vein thrombosis is diagnosed at later stages, or is complicated by severe circulatory disorders, then the patient is prepared for thrombectomy.
Forecast and prevention
When there is no chronic disturbance of blood flow, complete recovery is achieved in 70% of cases. The rest of the patients require long-term and sometimes lifelong treatment. Pulmonary embolism occurs on average in 20% of patients with a blood clot in the leg. The greatest danger in this regard is deep vessel thrombosis. In 5% of cases, the embolism is fatal.
Patients with once diagnosed with a blood clot in the lower extremities need to revise their diet, enriching it with seafood, fresh vegetables and fruits. It is equally important to lead a healthy lifestyle, give up bad habits and regularly see a doctor.
The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist
Education: Moscow State University of Medicine and Dentistry (1996). In 2003, he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.
