Deep vein thrombosis, VTE

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25 aug 2025

Deep vein thrombosis is a life-threatening condition in which blood clots (thrombi) form in the lumen of the deep veins. The clots partially or completely block the lumen of the vein, preventing the free flow of blood. The most dangerous consequence of deep vein thrombosis is the detachment of the thrombus from the vessel wall and its migration to the lungs, which can cause pulmonary embolism, which is a fatal complication.

Causes of deep vein thrombosis

The key factors in the development of DVT are the so-called "Virchow's triad" - these are three keys that simultaneously open the door to the formation of a blood clot:

Blood stagnation (due to immobilization of the limb with a plaster cast, prolonged sitting during travel, a sedentary lifestyle).
Blood clotting disorders (congenital and acquired thrombophilias).
Venous wall damage (vascular damage after trauma, surgery, injections).

 

  

 

Risk factors

Deep vein thrombosis and pulmonary embolism in the past.
Obesity (BMI ≥30 kg/m2).
Hormone replacement therapy, hormonal contraception.
Pregnancy and childbirth.
Infectious and systemic diseases.
Malignant tumors, chemotherapy, radiotherapy.
Symptoms of deep vein thrombosis

Symptoms can vary - from almost asymptomatic to pronounced clinical signs. The most typical symptoms:

Swelling of the lower limb.
Bursting pain in the leg, which increases when the affected limb is lowered.
Redness, local increase in skin temperature and tension of the leg tissues.
Dilation of superficial veins.

Diagnosis of deep vein thrombosis

Modern diagnostics is based on a combination of clinical data and instrumental research methods:

Examination and conversation with the patient to collect a detailed history and conduct a number of special functional tests to detect symptoms of deep vein thrombosis.
Ultrasound Doppler to determine the speed of blood flow and identify areas of slowing or complete blockage of blood flow caused by a thrombus.
Computed tomography (CT) or magnetic resonance imaging (MRI) to detect deep vein thrombosis, if more detailed visualization is required or if there are symptoms that allow suspecting PE.
Laboratory tests - determination of the level of D-dimer to exclude or confirm the thrombotic process.

Treatment of deep vein thrombosis:

Drug therapy. Direct and indirect anticoagulants are prescribed, which thin the blood and prevent further formation of blood clots.
Compression therapy. Compression stockings and socks exert constant pressure on the lower extremities, which prevents blood from pooling in the veins, helps improve blood circulation and reduce swelling. It is recommended to wear compression garments throughout the day, especially when sitting or standing, when the risk of blood pooling is increased.
Thrombolytic therapy (fibrinolytic therapy). Drugs that dissolve intravascular thrombi in cases where the thrombus has completely blocked the vein and is causing severe symptoms and swelling.
The installation of a cava filter in the inferior vena cava prevents the movement of thrombi from the veins of the lower extremities to the lungs or other organs. It is indicated for patients in whom the use of anticoagulants in therapeutic doses is contraindicated (due to the risk of bleeding) or ineffective (recurrence of PE or significant increase in the thrombus, despite adequate anticoagulant therapy).
Surgical treatment. Surgical treatment of deep vein thrombosis is used if the viability of the limb is at risk and, especially, if both thrombolytic and anticoagulant therapy are contraindicated.

Surgical treatment methods:

Thrombectomy is an operation performed by open surgical access, in which a thrombus is removed from the lumen of the affected vein using surgical instruments or a catheter with a special balloon.
Venous bypass is an operation in which a bypass is created around the thrombus of the vein.
Balloon angioplasty and stenting of veins is a minimally invasive procedure that involves inserting a special balloon into the vessel, which expands the blood vessel at the site of the narrowing of the vein, then the vascular surgeon inserts a catheter with a self-expanding stent into the affected area, which maintains the lumen of the vein.

 

  

 

Prevention of deep vein thrombosis:

Active lifestyle: regular exercise, avoiding prolonged immobility, taking breaks to warm up during prolonged sitting.
BMI control: maintaining a normal weight to reduce the load on the veins.
Adequate fluid intake to prevent blood thickening.
Compression stockings: use to improve the outflow of venous blood during static loads.
Control of hormonal drugs: careful use of hormonal contraceptives or replacement therapy.
Regular preventive medical examinations by a phlebologist: timely diagnosis and treatment of vein diseases.

CONCLUSION:

Deep vein thrombosis is an invisible enemy that hides in the venous tunnels, waiting for the moment to strike. But timely diagnosis, correct treatment steps and active prevention

Author: Shapovalova Iryna MD ©