Popliteal vein thrombosis: symptoms and treatment. Phlebologist's advice

Thrombosis of the popliteal vein: symptoms

Standard symptoms of popliteal vein thrombosis appear only in half of the cases, so sometimes the disease is difficult to diagnose. The main symptoms of the pathology include acute, prolonged pain in the lower leg area, which can intensify in the evening and at night.

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Statistics on the localization of thrombotic lesions

Also, popliteal thrombosis may be accompanied by the following changes:

• when playing sports and physical activity, the leg begins to hurt sharply;
• if you try to bend your foot towards you, you feel pain in your lower leg;
• the limb swells, turns blue, the skin begins to shine;
• there is a feeling of heaviness and distension in the limb.

The person may feel weak and have trouble moving.

Physical examination for thrombophlebitis

In most cases, thrombophlebitis of the saphenous veins can be diagnosed based on complaints and external examination. On the other hand, symptoms such as pain, skin hyperemia and swelling occur in many other diseases. Impaired patency of the deep veins, as a rule, is accompanied by varying degrees of swelling of the lower extremities. At the same time, swelling of the lower extremities can be associated with diseases of the liver, kidneys, cardiac pathology, previous trauma, infection and lymphedema.

With varicose veins, the saphenous veins are dilated, deformed, and have a tortuous course. Darkening of the skin, the development of skin sclerosis, the presence of trophic ulcers on the legs or scars indicate severe chronic venous insufficiency. On palpation, a painful cord is determined, with inflammation of the skin and pain in the projection of the thrombosed vein.

Thrombosis of the popliteal vein: causes

The exact cause of blood clots in the vessels has not yet been identified. But several factors are known that provoke thrombosis of the femoral-popliteal segment. These include:

• Age. Most often, the disease affects women after 40 years of age. Older people are more likely to get sick than younger people. After age 50, the risk doubles every ten years.
• Surgical operations. During operations, tissues are injured, blood circulation in them is disrupted, and as a result of anesthesia, blood clotting may increase.
• Limb fractures. The disease manifests itself in more than half of cases after a broken leg. Such injuries disrupt blood flow, and as a result of prolonged immobility of the limbs, the muscles weaken and the blood stagnates in them. As a result, a blood clot appears in the lumen of the vein.
• Phlebeurysm.
• Oncological diseases also often lead to the appearance of blood clots. In many cases, the disease manifests itself in patients who have had tumors surgically removed.
• Sedentary lifestyle, long forced bed rest or sedentary work.
• Thrombosis of the popliteal vein occurs during pregnancy and childbirth due to the high pressure of the uterus with the fetus on the pelvic organs and lower limbs.
• Prolonged static load, injury or compression of a vein, which impairs blood circulation.
• Using hormonal medications (such as birth control) that contain estrogen. Such drugs increase blood clotting, which leads to the formation of blood clots.
• Insufficient fluid intake.
• Heart disease, inflammation, infectious diseases.
• Hypothermia of the limb.
• Long journeys during which a person is forced to sit for a long time.
• Systematic overeating, unhealthy diet and obesity.
• Smoking and alcohol.

Clinical picture of thrombophlebitis

Medical history

The first symptoms of thrombophlebitis are often local thickening, soreness and redness of the skin in the projection of the thrombosed saphenous vein.

Patients with thrombophlebitis may have the following conditions associated with the occurrence of thrombophlebitis:

• Injury
• Varicose veins
• Long journey
• Use of hormones
• Smoking
• Family history of thrombotic events
• Venous stagnation

Popliteal vein thrombosis: diagnosis

To determine the exact signs of thrombosis, duplex ultrasound scanning (USDS) is used. The method helps to find a blood clot, measure it, determine its exact location, and recognize whether it is floating in the vessel. The method also helps to examine the condition of the veins. In addition, during the examination, doctors receive information at what speed the blood moves.

Diagnosis of popliteal vein thrombosis

Doppler ultrasound is also used in diagnosis. This method is used to determine the patency of the veins and find the place where the thrombus is located.

Popliteal vein thrombosis: treatment

If we talk about the dangers of popliteal vein thrombosis, then first of all it is worth mentioning its complications. More than 10% of patients die from them. If the disease is not treated, blood clots can break off and travel through the vessels. When they enter the lungs, they completely block the lumen of the pulmonary artery. This leads to death in most cases.

It is the danger of complications that is taken into account when choosing a treatment method. Most patients are recommended to be treated in a hospital. If their risk of thromboembolism is high, treatment will take longer. In the first days of treatment (from 3 to 10 days), the patient must remain in bed. In this case, the affected limb should be elevated at all times. This is especially important if doctors are unable to conduct a complete examination.

The ratio of venous and arterial thrombosis

If conservative treatment of thrombosis does not have an effect, doctors recommend that the patient undergo surgery.

Many patients are given medication to treat thrombosis in combination with the use of elastic compression bandages, which help protect the valves and increase blood flow. To increase the effectiveness of treatment, local topical preparations are used. Such products (creams, ointments, venotonic tonics) are recommended to be used regularly after exacerbations, as a preventive measure.

Treatment is also accompanied by internal medication. The patient is prescribed anticoagulants to slow blood clotting and protect against blood clots. For severe pain, analgesics are also prescribed. To increase blood flow from the legs, phlebotonics are used.

Expert opinion

Angioprotectors are widely used in the treatment of this disease. These are special preparations with complex action. They suppress the inflammatory process, restore vascular walls, improve blood composition and accelerate microcirculation. Also, such products help fight swelling. .

Vascular surgeon, phlebologist

Osipova Ekaterina Yakovlevna

In some cases, antibiotics are also used in treatment. The doctor develops suitable therapy in each case individually.

To reduce the manifestations of popliteal vein thrombosis, the use of Normaven® products is recommended as an additional measure. Testing of the Foot Cream proves that its use for 3 months can reduce the feeling of heaviness and fatigue in the lower extremities, minimize cramps and swelling, and also reduce the severity of the vascular pattern. The product was developed by specialists from the pharmaceutical company VERTEX and has the necessary documents and certificates.

Treatment of thrombosis with folk remedies

History of the study of phlebothrombosis

The study of deep vein phlebothrombosis dates back more than 400 years.

Occlusion of the great veins as a cause of gangrene was first described by F. Hildanus in 1593. The first mention of ileofemoral phlebothrombosis appeared in the medical literature 300 years ago, it was made by Mauriceau.

The concept of “thrombophlebitis” was first introduced into medicine by the English surgeon John Hunter (1728-1793), who performed many operations on gunshot and other wounds and noted the frequency of inflammatory processes combined with the formation of blood clots in the veins.

Interest in deep vein phlebothrombosis increased significantly after the creation of the theory of venous thromboembolism by the outstanding German pathologist R. Virchow. While autopsying the corpse of a young man in 1844 who had suddenly died after developing pain in his thigh, Virchow discovered a blood clot in the right femoral vein and a twisted blood clot in the pulmonary artery. After that, he introduced the concepts of “thrombus” and “embolus” into medical terminology. In 1845, having discovered venous thrombi in 18 cases from 76 autopsies, and in 11 cases revealing the presence of thromboembolism in the pulmonary artery, he came to the conclusion that blood clots form in the veins and are transported by the bloodstream to the pulmonary artery. He also formulated the classical triad, which is still the most complete reflection of the links in the pathogenesis of local vascular thrombus formation.

The first Russian-language monograph devoted to this problem was the work of I.F. Klein "On thrombosis, embolism and ichorremia", published in 1863.

Despite the fact that acute deep phlebothrombosis in various variants of localization and clinical course differ significantly from each other, they are united by the commonality of basic etiopathogenetic processes. The concept of phlebothrombosis as a nosological group is based on the classical Virchow triad.

More than 150 years ago, Rudolf Virchow described the basic mechanisms of intravascular thrombus formation. Its classic triad includes hypercoagulability, vessel wall damage, and slowing of blood flow. Sometimes, for this pathology to occur, a pathological change in only one of these factors is sufficient.

Despite the fact that the thrombotic process can develop at any level of the main veins, in more than half of the cases the starting point of its development in the centripetal direction is the veins of the leg. In the vast majority of cases, thrombosis is primarily localized in the veins of the leg, and subsequently grows proximally into the popliteal, femoral and iliac veins.

It is this type of development that is very often embologenic, since the growth of a thrombus occurs in the direction of veins with an increasing internal diameter, where thrombus masses are not always fixed along the entire perimeter of the vein. Such blood clots are called floating.

One of the main reasons for slow blood flow is immobilization. Under normal conditions, the outflow of blood from the lower extremities is carried out by contraction of the calf muscles, which act as a peripheral pump, pushing blood in a proximal direction, facilitated by the function of the valves. Limiting physical activity significantly disrupts this mechanism. In this case, blood is retained in the venous sinuses of the leg.

The question of the importance of risk factors and trigger factors for thrombosis has been studied in sufficient detail:

• Congenital thrombophilias (deficiencies of various factors of the hemostatic system or their pathological changes)
• Activation of coagulation factors and fibrinolysis disorders (trauma, surgery, neoplasms, pregnancy, childbirth, etc.).
• Pathology of platelets.
• Slowing and/or disruption of blood flow (age over 40 - 45 years, immobilization, pathology of central circulatory mechanisms, obesity, etc.).
• Changes in the rheological properties of blood.
• Damage to the endothelium and vascular wall (contrast agents, intravascular devices, venous catheters, dilatation of veins, etc.).
• Drug therapy (anaesthetics, muscle relaxants, chemotherapy, contraceptives, contrast agents). For example, the incidence of postoperative thrombosis after various surgical interventions can reach 20-59%.

Thrombosis of the popliteal vein: treatment with folk remedies

At the first pain and symptoms of thrombosis, immediately consult a doctor. It is important to remember that untimely treatment or its absence leads to the fact that normal blood circulation in this area can be lost irretrievably, without restoration.

Some people choose traditional medicine to combat blood clots. Indeed, selected recipes passed down from generation to generation gave in some cases positive results. It is not recommended to experience the power of ancestral knowledge without consulting a doctor. Traditional recipes can act as a counterweight to traditional medicine and interfere with the main treatment. We talk about the methods that are considered the most popular among the people.

You can try verbena infusion. Brew a spoonful of verbena in a glass of boiling water, then strain and drink in small sips all day long.

Baths with marsh dried dried herbs can relieve pain. To do this, pour 200 g of the plant into a bucket of boiling water and infuse. Take a warm bath for sore feet for 30 minutes. Regular procedures are distracting.

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Combine such procedures with the main treatment, after consulting with your doctor.

Instead of swampy cucumber, you can use regular cucumber. Preparation for the procedure is the same, only you need to keep your feet in the infusion for no more than 20 minutes.

A popular traditional medicine in the treatment of popliteal vein thrombi are compresses based on a decoction of thistle. They relieve pain and have a healing effect.

Doctor's comment

Are you worried about pain along the vein, a dense cord appears on your leg, swelling has become noticeable, perhaps the sensitivity of the skin of the limb has changed or a feeling of “pins and needles” has appeared? The most reasonable thing in this situation is to contact a phlebologist. These manifestations may indicate such a serious disease as thrombosis. If treatment is not timely, there is a high risk of complications that pose a very serious danger to both health and life. Our Vascular Surgery Center is equipped to conduct a thorough assessment of venous blood flow and confirm or rule out deep vein thrombosis. In addition, our clinic uses the most modern treatment methods. A disease that was considered intractable just a few years ago is now completely treatable. Moreover, if your condition allows, conservative treatment is possible - medications, injections, compression therapy. The main thing is timely application. If the disease has reached an advanced stage, you can count on the help of experienced surgeons. Don't wait until your only choice is emergency surgery. It’s so easy to make an appointment and finally get rid of the debilitating symptoms of the disease.

Head of the Vascular Surgery Center Girsiashvili Aleko Givievich