From the article you will learn what thrombosis is. Than it is dangerous, to what consequences it can lead. Causes of the disease, its main clinical manifestations depending on the localization of the process. Methods of revealing pathology and methods of its treatment.
Species of thrombi
Thrombosis is the process of forming a conglomerate of blood elements( platelets, erythrocytes, leukocytes) and fibrin strands on the inner wall of the vessel, which narrows or completely blocks the vascular lumen.
Such a conglomerate is called a thrombus. If its complete or partial separation from the vessel wall occurs, then an embolus is formed - a mobile pathological particle that moves with the blood stream and can settle in other vessels.
The process of thrombus formation is a normal mechanism of protecting the body in damage to vascular structures, aimed at stopping bleeding. But if it loses its locally restrictive character and( or) becomes redundant, then this condition is a pathology.
With such a disease, the formation of a clot inside the vessel leads to a disruption of the influx( in the artery) or outflow( in the vein) of the blood. Depending on the degree of the blood flow block, the pathology develops:
- decrease in the supply of oxygen and nutrients to the tissues in the arterial variant,
- violation of excretion of fluid and metabolic products from the organs in venous form.
Both variants are dangerous in that in the zone with the disturbed blood flow the processes of cell disintegration are activated and the necrosis areas of tissues are formed.
With arterial block this process proceeds faster than with venous block. Therefore, the disturbance of blood flow in the artery is a more dangerous pathology that can quickly cause death if the thrombus is located in large cardiac, pulmonary or cerebrovascular vessels.
The ability to cure a disease is determined by:
- type of vessel - arterial or venous;
- lumen diameter - the larger the vessel, the higher the risk of severe consequences, including death;
- time of the beginning of treatment - is especially important for arterial disorders and wide venous trunks;
- technical capabilities of the medical institution - the larger the center, the more modern methods of treatment and removal of obstruction of the vessel;
- age, the presence of concomitant pathology in the patient - the older the patient, the lower the restorative and protective forces of the body, and severe cardiovascular diseases significantly worsen the possibility of correction.
Vascular and general surgeons are involved in the detection and treatment of thrombosis. When the process is localized in the brain, neurologists are connected, and if cardiac vessels are blocked - cardiologists.
Types of thrombi
| Group | Specific variants of |
|---|---|
| Classical | White - consists of platelets, leukocytes and fibrin. Formed first Red - the second stage of clot formation when the conglomerate settles red blood cells Mixed - consists of several layers of white and red bundles |
| Specific | Septic - formed with infectious inflammatory changes of the vascular wall Tumor - formed in the zone of the vascular growth by neoplasm Spherical- a detached fragment of a mixed clot with mitral stenosis Vegetations - thrombotic layers in infectious-inflammatoryAgen inner shell Marantichesky heart - red clot that is formed at stagnation of venous blood due to lower blood volume circulating |
Classification thrombosis
| By type of vessel | Localization |
|---|---|
| Arterial | brain( stroke) heart( heart attack) Limbs intestinal vessels( mesenteric thrombosis) |
| Venous | cerebral venous sinuses Gate Vienna Renal Vienna jugular Vienna Vienna mesentery bowel Badda-Chiari Syndrome Paget-Shreter Syndrome Deep and superficial vein of leg Pulmonary artery |
Causes of
Pathological thrombus formation in the venous system occursand the effect of several factors that can influence both singly and all at once:
| Factor group | Specific causes |
|---|---|
| Decrease in blood flow velocity in the vessel's lumen | Long-term immobilization( operation and postoperative period, forced labor conditions, "recumbent" patientsin severe condition) External vascular compression( child bearing, oncological diseases) Violation of normal vascular development during the period of the laying of organs( pathological tortuosity, bumpstroke, wall defects) |
| Blood viscosity increase | Systemic disorders of the clotting system( thrombophilia) Severe general diseases( oncological processes, dehydration in the presence of infections and poisonings) Adverse effects of drugs( contraceptives, tamoxifen, etc.) |
| Vessel trauma | Immediatedamage to all wall elements in case of trauma or operation Complications of invasive diagnostic procedures Inflammatory changes in blood vessels( vasculitis, thrombangum) Germination wall tumor |
embodiment Arterial thrombotic events associated with other causes:
- atherosclerotic lesions of the vascular system;
- all variants of tachyarrhythmias, especially atrial fibrillation;
- infectious process on the inner shell of the heart;
- congenital and acquired disorders of the structure of the heart valves;
- aneurysms of cardiac cavities and aorta.
Manifestations of the venous form
Symptoms of venous thrombosis and severity of the condition depend on the localization of the process. Patients with thrombophlebitis and a block of jugular veins feel relatively satisfactory and can perform the usual actions. The remaining forms quickly lead to disability.
Sinuses of the brain
- Increasing, diffuse headache with a gradual decrease in the effect of pain medications.
- Increased pain in the prone position and with physical exertion.
- Increased body temperature above 38 degrees.
- Nausea.
- Convulsive seizures.
- Weakness.
- Change of consciousness.
- Insult-like symptoms.
portal portal
- Increased spleen and liver.
- Accumulation in the abdomen of fluid.
- Decreased liver function.
- Jaundice staining of the skin and eye proteins.
- Increased esophageal veins with bleeding from them.
- Pain syndrome throughout the abdomen.
- Bloating and stool disorder.
Renal vein
- Pain syndrome in the lower third of the back from both sides.
- Progressive decrease in the amount of urine released.
- Blood when you urinate.
- Accumulation of general intoxication of the body.
Jugular vein
- Redness of the skin above the vessel.
- Pain in the affected area.
- Thickening and expansion of the vein.
Badd-Chiari syndrome( hepatic veins)
- Severe pain in the projection of the liver.
- Accumulation of fluid in the abdomen, chest.
- Severe nausea.
- Abundant vomiting, in later stages - with blood.
- Network of enlarged, convoluted veins under the skin on the abdomen and chest.
- Mild icteric staining of the skin and mucous membranes.
- Increased liver size, spleen.
- Increasing swelling of the legs.
- Weakness.
- Depression of consciousness.
Paget-Shreter syndrome( shoulder and subclavian vein)
- Suddenly developed swelling of the hand.
- Increasing, throbbing pain.
- Blue staining of the skin.
- Increased sweating.
- Impaired mobility of the hand.
Mesenteric veins
Click on photo to enlarge - Growing spasms in the abdomen.
- Bloating.
- Disturbance of gases and stools.
- Severe weakness, drowsiness.
- Increased heart rate.
- Gradual decrease in pressure.
Deep veins of lower limb
- Swelling of the foot.
- Changes in skin color from pale to cyanotic.
- Increasing fatigue in the lower limbs.
With high forms at the upper third of the thigh and iliac segments:
- A rapidly increasing increase in the size of the leg.
- Violet-black skin color.
- Significant pain syndrome.
- General severe condition with impaired consciousness.
Superficial veins of the foot
- Increase in the size and appearance of the tortuosity of the veins.
- Skin over them red, painful, with seals.
- Pain syndrome in the course of a pathologically altered vessel.
- Heaviness in the shin and foot in the standing and loading position.
Pulmonary artery
- Severe pain in the thorax.
- Difficult, frequent breathing. Cough with bloody sputum.
- Frequent, small pulse.
- Significant decrease in blood pressure.
- Severe weakness.
Arterial manifestations of
Symptoms of arterial thrombosis depend on the area of blood flow disturbance. Pathology is distinguished by a more severe course than with venous forms of occlusion of the lumen of the vessel. Patients for a short time lose the ability to perform any action and in most cases require bed rest.
Brain( stroke)
The combination of clinical symptoms depends on the zone where the blood flow is disturbed. The severity of the flow is due to the number of bypass arteries and the initial state of their walls.
- Loss of entire volume of movements and sensations in a part of the body or its half.
- Swaying of facial muscles.
- Impossibility to talk and swallow.
- Vision and hearing impairments of varying severity until complete loss.
- Tremor of the body or of individual limbs( tremor).
- Unsteady gait.
- Memory impairment, including complete loss of it( amnesia).
- Problems with urination and defecation( delay, incontinence).
- Mental disorders( aggression, negation of disease, depression).
Heart( infarction)
Manifestations depend on the size of the affected vessel - the larger, the faster the symptoms and their severity develop.
- Severe pain in the left side of the thorax and( or) behind the sternum.
- Reflection of pain in the arm, neck, jaw, or abdomen.
- Frequent palpitations in the beginning, with deterioration - a decrease in the pulse.
- High pressure, and later replaced by low.
- Cooling of the skin.
- Perspiration.
- Feeling of fear.
- Feeling of air shortage.
Mesentery vessels( mesenteric)
- Sharp pain syndrome throughout the abdomen.
- Rapidly increasing bloating.
- No stool and no gases.
- Severe nausea.
- Abundant vomiting with odor of feces.
- Pale.
- Dryness of the skin.
- High figures of heart rate.
- Significant pressure drop.
- General deterioration of well-being.
- A growing sense of impotence.
Arteries of the extremities
Hand vessel damage is rare.
| Infringement of blood flow to the leg may be disturbed at different levels, and the severity of the | depends on it. If there is no timely assistance, |
|---|---|
| Sharp pain in the area with a blood flow disorder | Edema of the affected part |
| Marble pallor of the skin | Darkening of the skin |
| Violation of all sensations in thislimb parts | Intestinal necrosis of tissues( necrosis) |
| Numbness | Sinus tachyarrhythmia |
| Frequent heartbeat | General body poisoning |
| Pressure increase | |
| Growing loss of volume of active and then passive movements |
Diagnosis
| Method | What allows to evaluate |
|---|---|
| Collection of information on complaints and examination | Clinical manifestations of the disease in most cases allow already at this stage to establish a presumptive diagnosis of During the research on the systems, the doctor conducts certain teststo determine the localization of the process( flexion of limbs, check of reflexes and sensitivity, palpation) |
| X-ray studies | Used forstudies of pulmonary tissue and abdominal organs Assess the nature of the vascular pattern in the lungs, their airiness The presence of a large amount of fluid and gases in the inflated intestine is detected in the abdomen, a violation of the |
| content advancement. Laboratory blood samples | Informative for the damage of the heart and lung vessels( specific infarction andthromboembolism) Other cases no specific changes |
| Sonography of vessels in different modes( US) | Highly informative method for detecting procurementlumen clearance, extent of lesion, and treatment options Not used in cerebral and intestinal lesions |
| Magnetic and computed tomography with the | vascular program The most reliable and accurate diagnostic method for Identify any kinds of thrombi, clearly localizing the affected area and the degree of blood flow disturbance Not always available in wide practice. |
| Angiography of | In arterial forms of thrombosis has a therapeutic and diagnostic purpose It is indicated for venous formsah with lesions of large vascular trunks Not performed in case of pathology of surface vessels Invasive procedure using high doses of contrast agent |
Treatment of
The possibility of complete cure for the disease depends on:
- from the diameter of the affected vessel;
- time since the disturbance of blood flow;
- adequacy of treatment;
- general condition of the patient;
- of the course of the course of concomitant pathology.
In each case there is a risk of fatal outcome or disability, especially with arterial forms of blood flow disorders. Thrombosis of superficial vessels or small branches of internal ones proceeds more favorably.
Treatment of thrombosis includes two areas: drug and surgical. In most cases, use a combination of these.
In the pathology of the sinuses of the brain, the defeat of superficial veins, blockage of small venous branches, only conservative therapy is performed.
Medicinal ways
| purpose of | correction Preparations |
|---|---|
| blood thinners | Aspirin Warfarin Fraksiparin Heparin |
| Meltdown thrombus | streptokinase Fibrinolizin |
| expansion of small vessels | Pentoksifillin Trental Reopoligljukin |
| Strengthening of the vascular wall and increase its elasticity | Troxevasin Detraleks Vazoket |
| Anti-inflammatory drugs | Ketorolac Nimesulide Diclofenac |
Operationale
methods Use a variety of techniques, depending on the location of the clot:
- intravascular or endovascular removal( brain, lungs, heart).
- open operations with dissection of the vessel wall in the projection of the clot with subsequent suturing of the defect( abdominal cavity, limbs).
- Removal of tissue, part of an organ or limb in cases of irreversible stages of necrosis( intestines, limbs).
- Installation of clotting devices in the lumen of the inferior vena cava( small pelvis, abdominal cavity, limbs).
Forecast
| The high risk of developing severe, including fatal, consequences characterizes the vessel block of the following locations of | Relatively favorable course, with full therapy, it distinguishes blood flow disorders in diseases |
|---|---|
| Brain | Surface veins of the shin and neck |
| Heart | Sinus of the brain |
| Lungs | Deep Vein Shin |
| Intestine | Shoulder Vein |
| Liver | |
| Lower Hollow Vienna | |
| High Unit of Lower Limb Vessel |
With any form of eIt is the risk of death and subsequent disability.
Risk factors are:
- the age of the patient;
- concomitant cardiovascular pathology;
- time for seeking help;
- the amount of treatment performed.
