What disease can be affected by the venous system of a person? Why does this problem arise, 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. Such a disease is allocated in a separate form, since it is characterized by a rather severe course and an increased risk of developing severe pulmonary artery thromboembolism.
Features of the disease
Ileofemoral thrombosis can develop not only in adulthood, but also in childhood. In this case, such a disease proceeds favorably, and the treatment is quite successful. Among most children, the development of pulmonary embolism or retrombosis was not observed.
As for adult patients, for them this disease carries quite serious complications. Therefore, it is very important to identify it in time.
Main symptoms
Thrombosis that develops in the femoral or iliac veins is accompanied by symptoms such as:
- small brown dots protruding on the legs and not disappearing when pressed;
- fever;
- severe swelling, which can be observed on both lower limbs or on one of them;
- crimson or cyanotic skin color;
- gradually intensifying pain in one limb or in both legs, as well as 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. Let's consider them in more detail:
- Prodromal stage. At this stage of the disease, the patient has pains of various localization. They can be felt in the lumbosacral region, lower abdomen, as well as in the lesion in the lower limb. The pain syndrome is aching and dull in nature. Also, the patient 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 calf muscle, inguinal region and the anteromedial surface of the thigh. The nature of the pain is intense and diffuse. As for edema, it captures the entire area and spreads from the groin to the foot. Sometimes swelling is observed on the gluteus 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 leg ischemia develops, which manifests itself in sharp pains, lack of sensitivity and pulsation of the artery.
As mentioned above, one of the symptoms of the disease in question is a discoloration of the skin. They may have a pale or cyanotic color. White color occurs due to spasm of the associated arteries. A similar condition is accompanied by severe pain syndromes. Blue color or 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. Moreover, 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 onset of any serious complication.
Development reasons
The human venous system can undergo various changes. Often, patients have deep vein thrombosis. Such a disease occurs due to the slow flow of blood and a violation of its coagulability, 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 starting points that contribute to the onset of this disease:
- getting injured;
- long bed rest;
- DIC;
- infections of a bacterial origin;
- postpartum period;
- the use of contraceptives;
- pregnancy;
- malignant and benign tumors in the pelvis;
- aneurysms of the iliac and femoral arteries, as well as the abdominal aorta;
- popliteal cysts;
- retroperitoneal fibrosis;
- iatrogenic deep vein damage.
The 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.
Diagnostics
How is lower extremity thrombosis diagnosed ? Symptoms of this disease are quite pronounced. But in addition to the external examination of the patient, doctors often resort to other diagnostic research methods, which are presented in the form:
- scanning with fibrinogen;
- duplex scanning;
- radionuclide phlebography, which is carried out 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 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 methods that help dissolve the thrombus can be used to treat it.
If there is a threat of thromboembolism, then its prevention is carried out. Such a procedure is performed by ligation of the femoral vein, installation of a cava filter or plication of the inferior vena cava.
If the patient has acute ileofemoral thrombosis, then they are transported to a hospital. In this case, the patient should be in a prone position. Before the examination, he is assigned to bed rest, after which they do ultrasound scanning and venography.
In the event that there are no conditions for the examination of the patient, then under the supervision of specialists he is prescribed anticoagulants, which should be taken for ten days.
According to experts, acute venous thrombosis must 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;
- pentasaccharide fondaparinux.
With the development of thrombolysis, which requires the use of streptokinase or urokinase, the mortality of patients significantly increases due to an increase in the frequency of bleeding. In this regard, this method is used only in extreme cases, for example, if common thrombosis developed recently, that is, no more than a week ago.
Thrombolytic treatment for thrombosis of the ileofemoral species is carried out after the cava filter is installed. This is due to the fact that such therapy promotes the transition of a blood clot into the pulmonary artery, which can lead to the development of thromboembolism.
Surgical intervention
With ileofemoral thrombosis, a surgical option is possible. It is carried out according to vital signs and depends on the risk of developing pulmonary embolism.
It should also be noted that the operation is often performed if 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 hole, which is done 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 experts, the operation to remove blood clots in no case should be carried out with an adhesive process occurring in the lumen of the vein, as well as in the presence of intravascular septa.
Complications
With an untimely visit to the doctor, as well as with 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 with suspicions of 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 healthy life is moderate activity and proper nutrition.
To completely avoid the development of thrombosis, the patient must carefully monitor his lifestyle. All bad habits should be excluded and regularly observed by a doctor.
In the event that a 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 mode of activity, as well as correctly selected anticoagulant and disaggregant therapy.
According to experts, ileofemoral thrombosis is a rather serious disease that can cause significant damage to human health. However, it should be noted that this disease is treatable, including if it was started on time. The main thing is not to despair and not give up, but to follow all the recommendations of an experienced doctor.