It is bad enough if you are tied to the hospital bed. And here in addition to the actual illness threatens a great danger: the thrombosis. Even people who sit for a long time and have a high risk of thrombosis. In total, around two out of every 1, 000 people in the Western world suffer thrombosis each year. Preferably, these blood clots form in the deep leg and pelvic veins, more rarely in the arteries. An increased risk of thrombosis persists even weeks after surgery, especially in elderly patients.
Blood clots - fortunately
If the blood did not have the intriguing ability to clot, we would bleed to death at the slightest injury. The body treats internal and external injuries as fast as lightning, by first narrowing the blood vessels and then attaching the platelets, the platelets, to the edge of the vascular injury. Together with numerous coagulation factors of the blood and the tissue, they seal the wound.
However, this protective mechanism causes the opposite in certain diseases, when blood in the body, more specifically in the vascular system, clots. This can lead to a blood clot, a so-called thrombus, forming in a vessel. The thrombus can close the vessel completely tightly - there is no blood left: the dreaded thrombosis disease. But when blood stops flowing, the supply of oxygen stops. The result: tissue dies, it can even come to partial failure of certain organs.
Above all, the veins are affected
Thromboses primarily affect the veins. Veins are the part of the blood vessel system that returns the low-oxygen blood to the heart. From there it is first pumped through the lungs and then through the arteries back into the systemic circulation to re-oxygenate all organs. Unlike the arteries, the veins inside are equipped with valves that are very important for blood transport to the heart. The flap pockets of the calf veins are in most cases the starting point of thrombosis.
Everyone knows a form of blood clot: varicose veins. Varicose veins are dilated veins just below the skin. 13 percent of all Germans suffer from it, mostly women. If there is a blood clot, this is usually harmless. The symptoms of venous thrombosis are very painful swelling in the leg, usually it also feels overheated and is blue discolored. Constant congestion can lead to chronic venous disease - often with open legs - ulcus cruris .
A thrombus sometimes wanders
However, a thrombus can also be carried away by the bloodstream and become the "wanderer", the embolus. He is washed away from the place of origin and closes a vessel elsewhere - it comes to a life-threatening embolism. This is to be prevented by all means. This is where the "anticoagulants" come into play. In the body, there are various coagulation factors, which are named in the order of their discovery with Roman numerals (eg Factor II, VII).
The coagulation factors are blood proteins and are formed in the liver. Anticoagulants delay blood clotting by lowering the body's production of certain clotting proteins. The clotting time is thereby selectively prolonged and the formation of unwanted clots, which can clog a blood vessel, is prevented.
Patients with artificial heart valves, for example, must take the active ingredient coumarin. Patients who have to lie for a long time due to surgery, get the unpopular thrombosis stockings and the daily heparin injection.
Heparin and thrombosis stockings
Heparin is a drug that inhibits blood clotting and is injected directly under the skin. Patients who have to lie a lot at home, for example, because of a leg fracture, inject themselves with their medication - usually into the abdominal wall below the navel. Again and again the intake of acetylsalicylic acid is recommended, the effectiveness for the prevention of travel thrombosis is controversial, however, as it acts only on arteries, but not on the veins.
Thrombosis stockings, including compression stockings, are used preventively: They support the veins by increasing tissue pressure from the outside, which facilitates blood backflow. They are also recommended for high risk patients traveling on longer flights.
Risk factors for thrombosis and treatment
- Prolonged bed rest
- Lack of exercise, such as sitting for long distance flights or in the car
- Congenital coagulation disorders
- Increased tendency to coagulate after major surgery or childbirth
- Arteriosclerosis and varicose veins, often in old age
- Women who take the birth control pill
Treatment of thrombosis should be as fast as possible to prevent further progression of thrombosis and reduce the risk of sometimes life-threatening complications. Bed rest in thromboses from the popliteal fossa upwards, in lower leg vein thrombosis, however, activities such as moving around are among the first measures.
Until the swelling, the legs are wrapped with bandages, then a compression stocking must be worn. The restoration of blood flow can be done by a drug dissolution of the thrombus.
Large blood clots can also be surgically removed; sometimes the closed section of the vessel is bypassed by a vascular plastic called a bypass .