What disease can the human venous system be susceptible to? Why does this problem occur, and how to treat it? We will answer these and other questions in the presented article.
General information
Ileofemoral thrombosis is a thrombosis that affects the deep femoral and iliac veins. This disease is singled out in a separate form, since it is characterized by a rather severe course and an increased risk of developing severe pulmonary embolism.
Features of the disease
Ileofemoral thrombosis can develop not only in adults, but also in childhood. In this case, such a disease proceeds favorably, and the treatment is quite successful. Most children did not develop pulmonary embolism or rethrombosis.
As for adult patients, for them this disease brings with it quite serious complications. Therefore, it is very important to identify it in time.
Main symptoms
Thrombosis that has developed in the femoral or iliac veins is accompanied by symptoms such as:
- small brown dots that protrude on the legs and do not disappear when pressed;
- high body temperature;
- strongswelling that may occur on both lower limbs or on one of them;
- purple red or bluish skin color;
- gradually worsening pain in one or both legs, and in the groin (sometimes).
Signs of acute thrombosis. Stages
Acute ileofemoral thrombosis has several stages of development. Depending on them, the symptoms of the disease may have their own characteristics. Consider them in more detail:
- Prodromal stage. At this stage of the disease, the patient experiences pain of various localization. They can be felt in the lumbosacral region, the lower abdomen, and also in the affected area in the lower limb. The pain syndrome is aching and dull in nature. The patient also has an increase in body temperature.
- Stage of severe clinical symptoms. It is characterized by the manifestation of the classical triad. In other words, the patient has severe swelling, discoloration of the skin and pain. By the way, the latter is felt in the gastrocnemius muscle, inguinal region and anteromedial surface of the thigh. The nature of the pain is intense and diffuse. As for the edema, it captures the entire area and spreads from the groin to the foot. Sometimes swelling is observed on the gluteal muscle and is combined with a feeling of fullness and a feeling of heaviness in the lower limb.
Due to the fact that edematous tissues exert strong pressure on the vessels, there is a violation of blood flow, spasm and acute ischemia of the legs develops, expressed in sharppain, lack of sensitivity and pulsation of the artery.
As mentioned above, one of the symptoms of the disease in question is a change in the color of the skin. They may be pale or cyanotic in color. White coloration occurs due to spasm of the associated arteries. This condition is accompanied by severe pain syndromes. A blue color or a cyanotic color is observed when the iliac or femoral artery does not perform its direct functions, that is, the outflow of blood through them is almost completely impaired. In this case, a very important symptom is that a pronounced pattern of saphenous veins is visible on the patient's thigh.
In general, ileofemoral thrombosis is characterized by a satisfactory general condition of the patient. However, with the development of an acute illness, it can worsen significantly. This indicates the beginning of some serious complication.
Reason for development
The human venous system can undergo various changes. Often, patients have deep vein thrombosis. Such a disease occurs due to slow blood flow and impaired blood clotting, as well as damage to the venous walls.
The development of ileofemoral thrombosis can occur in the presence of one factor, and in the presence of several. Experts talk about the following trigger points that contribute to the emergence of this disease:
- injured;
- prolonged bed rest;
- DIC;
- infections that havebacterial origin;
- postpartum period;
- taking birth control;
- pregnancy;
- malignant and benign pelvic masses;
- aneurysms of the iliac and femoral arteries, as well as the abdominal aorta;
- popliteal cysts;
- retroperitoneal fibrosis;
- iatrogenic deep vein injury.
Most common causes
Most often, ileofemoral thrombosis of the lower extremities, characterized by stagnation of blood in the veins, develops during pregnancy. Also, this disease can occur due to prolonged immobilization and insufficiency of venous valves.
Another important factor in the development of the disease in question is the pathology of hemocoagulation, including congenital or acquired thrombophilic conditions.
Diagnosis
How is lower limb thrombosis diagnosed? The symptoms of this disease are quite pronounced. But in addition to an external examination of the patient, doctors often resort to other diagnostic research methods, which are presented in the form:
- fibrinogen scan;
- duplex scan;
- radionuclide phlebography, which is performed if the patient has intolerance to radiopaque substances;
- descending or ascending radiopaque phlebography.
Treatment
Ileofemoral thrombosis should be treated in exactly the same way as other forms of thrombosis. Most often, the treatment of this disease is carried out in a hospital. It is based on taking the following medications:
- anti-inflammatory drugs;
- antiplatelet agents;
- anticoagulants.
If the iliac or femoral artery is not severely affected, and the disease is in the initial stages of development, then techniques that contribute to the dissolution of the thrombus can be used to treat it.
If there is a threat of thromboembolism, then its prevention is carried out. This procedure is carried out with the help of ligation of the femoral vein, the installation of a cava filter or plication of the inferior vena cava.
If the patient has acute ileofemoral thrombosis, then they are transported to the hospital. In this case, the patient should be in the supine position. Before the examination, he is assigned to bed rest, after which they do an ultrasound scan and phlebography.
In the event that there are no conditions for examining a patient, then, under the supervision of specialists, he is prescribed anticoagulants, which should be taken for ten days.
According to experts, acute venous thrombosis should be treated comprehensively, using three groups of drugs:
- thrombolytics or fibrinolytics;
- anticoagulants;
- disaggregants.
It should be noted that anticoagulant treatment is based on the use of the following means:
- low molecular weight heparins;
- unfractionated heparins;
- Fondaparinux pentasaccharide.
With the development of thrombolysis, which requires the use of streptokinase or urokinase, the mortality of patients increases significantly due to an increase in the frequency of bleeding. In this regard, this method is used only in extreme cases, for example, if widespread thrombosis has developed quite recently, that is, no more than a week ago.
Thrombolytic treatment for ileofemoral thrombosis is carried out after the cava filter is installed. This is due to the fact that such therapy promotes the transfer of a blood clot to the pulmonary artery, which can lead to the development of thromboembolism.
Surgery
In ileofemoral thrombosis, a variant of surgical intervention is possible. It is performed according to vital signs and depends on the risk of developing pulmonary embolism.
It should also be noted that the operation is often performed when there is a threat of venous gangrene and when the pathological process spreads to the inferior vena cava.
You can also remove the thrombus formed in the left iliac vein retrograde. This procedure is carried out through a phlebotomy opening, which is made in the femoral vein. It should be noted that this option is not always possible, since the right iliac vein can exert significant pressure.
According to the statements of experts, the operation to remove blood clots should never be performed whenadhesive process occurring in the lumen of the vein, as well as in the presence of intravascular septa.
Complications
In case of untimely visit to the doctor, as well as in case of improper treatment of ileofemoral thrombosis, the patient may develop a rather dangerous complication in the form of pulmonary embolism. Therefore, it is very important to understand that when observing any symptom, as well as suspecting thrombosis, you should immediately contact an experienced doctor.
Disease prevention
In order to avoid the consequences of the disease in question, it is necessary to constantly carry out preventive measures that are aimed at strengthening the general condition of the patient and his vessels in particular.
Also, the key to a long and he althy life is moderate activity and proper nutrition.
To completely avoid the development of thrombosis, the patient must carefully monitor his lifestyle. You should eliminate all bad habits and see a doctor regularly.
In the event that the disease of the venous system has already begun to develop, it is necessary to observe all preventive measures that are aimed at preventing possible complications. This process includes the complete elimination of all risk factors, a moderate activity regimen, as well as properly selected anticoagulant and antiplatelet therapy.
According to experts, ileofemoral thrombosis is a rather serious disease that can cause significant damage to human he alth. However, it should be noted that this disease is treatable, including if itwas started on time. The main thing is not to despair and not give up, but follow all the recommendations of an experienced doctor.
