Dr. Saliveros Apostolos

Blood is in liquid form so it can be transported to every part of the body through the vessels. But sometimes there is the formation of clot (instead of liquid form it takes a solid form) and the vessel lumen is blocked and then the blood cannot flow. As a result there is accumulation of liquid in the interstitial tissues (edema) and the affected leg is growing larger in diameter and there is pain. The worst scenario is for the clot to be translocated from the leg to the lung and thus cause a pulmonary embolism (a dangerous and sometimes lethal complication). This is the reason why vein thrombosis is so scaring.

In the case you experience the following symptoms you must immediately be examined by a specialist (a vascular surgeon) or if you are in a place where this is not possible (for instance if your are in an island during the holidays) then you should immediately see any doctor. Symptoms: A. Swelling of one leg (it is almost double the diameter of the healthy leg) B. Pain in this leg C. Darker colour of that leg.

In a situation like this one should be examined for vein thrombosis (this is done by ultrasound) and if there is confirmation that indeed the patient has vein thrombosis then he needs therapy (special anticoagulation medication) in order to avoid thrombus propagation to the lungs. And of course a very crucial question has to be answered : why did a thrombosis occurred (what is the cause) in order to avoid future new episodes.

Frequent questions from patients:

1. What is the cause of thrombosis? Answer : There are many causes that either stop the flow inside the vessel or change the threshold of the blood coagulation and blood can clot easily. Causes like surgery, fracture of a bone, venous catheters, not moving enough (paralysis, stroke, surgery, dementia, long flight), thrombophilia, cancer, hormones, pregnancy.
2. My leg is swollen and a have pain. What do I do? Answer : You should seek for medical advise immediately. If the doctor suspects a thrombosis he will send you for ultrasound examination to confirm or exclude a thrombosis. If a thrombosis is found they will prescribe special treatment and tell you what to do next.
3. I suffered a leg thrombosis and since my leg is swollen sometimes. Why? Answer : Thrombosis causes damage to the vein and its valves and frequently causes what we call post-thrombotic vein insufficiency. These legs need special attention and treatment (for example wearing an elastic stocking) and the doctor will tell you all the details of how to take care of your leg in order to avoid swelling and its complications.
4. Which drugs are there for vein thrombosis? Answer: there are roughly two kinds of special drugs - injection with heparin and special oral anticoagulants (pils). Your doctor will decide which medicine is best for you.
5. In pregnancy are anticoagulant drugs allowed? Answer : Yes, they are safe for the mother and the embryo and are used for over 15-20 years now.
6. I suffered a thrombosis. Do I need surgery? Answer : It depends. If the thrombosis is in the superficial vein system or in the deep one there are different approaches. If a superficial thrombosis is caused be an insufficient vein then many times the vein is operated (laser ablation or excision of the vein). In a deep vein usually there is either conservative approach (medication) or in special cases angioplasty (vein balloon or stent).
7. Is the elastic stocking necessary after a thrombosis? Answer : Usually after a thrombosis you need to wear for long periods or even for ever elastic stockings in order to avoid some complications. There are some lucky patients that do not have insufficiency and stop wearing them after sometime.