Thrombosis prevention

Deep vein thrombosis and pulmonary embolism prevention (thromboprophylaxis) are the measures taken in order to prevent the formation of the blood clots which occlude the blood vessels.

Overview

Venous thromboembolism is a condition characterized by a vessel obstruction with a thrombus/blood clot and includes deep vein thrombosis and pulmonary embolism. Thromboembolism is one of the most common problems not only in the elderly but also among the younger generation. Moreover, the prevalence of thrombosis among young individuals is rising due to a sedentary lifestyle and smoking. The risk of thromboembolism increases significantly after major surgeries or long periods of immobility that lead to blood stasis and promotes the formation of the blood clots. Long-lasting flights/journeys are also associated with increased thrombosis risk and, therefore, preventive measures should be taken. 

Risk factors

Doctor holds in his hand the result of an ultrasound scan of veins with thrombosis in an elderly woman, close-up, white background, phlebeurysm, thrombophlebitis, venousIf a person experienced episodes of thrombosis in the past, he/she is more like to develop it in the future as well. Addressing these factors is an essential part of thromboprophylaxis.

A variety of conditions that decreases the speed of the blood flow and change the ability of the blood to coagulate, therefore, they are associated with a higher risk of venous thrombosis:

  • Vasoconstriction, slow or turbulent blood flow;
  • Genetic predisposition;
  • Age over 60 years;
  • Overweight or obesity;
  • Sedentary lifestyle;
  • Dehydration;
  • Dysrhythmias;
  • Pregnancy and the postpartum period;
  • Varicose veins;
  • Traumas and surgeries, especially complicated surgeries that require long-term rehabilitation;         
  • Estrogen-based oral contraceptive and hormone replacement therapy;
  • Immobility (associated with long travel times and post-surgical);
  • Varicose veins;
  • Coagulopathies (blood coagulation disorders);

Lifestyle modifications

  • Healthy diet
    A healthy diet is the only way to provide your body with all the necessary supplements and control your body weight.
  • Drinking enough water
    Dehydration (too little water in the body) is associated with an increased risk of thromboembolism.
  • Regular exercise
    Regular exercises are helpful to maintain your weight and keep your body fit. Sports enhances blood circulation and prevents blood stasis. Moreover, it is recommended to try not to sit longer than for two hours, if you need to stay sitting longer – exercise your legs.
  • Avoid smoking
    Nicotine is known to constrict the blood vessels and by this, it promotes blood stasis.

Immobility and blood clots formation

Lasting immobility (following some surgeries, during the trips or due to other medical conditions) is known to induce venous stasis in the deep veins of the lower limbs. Respectively, it is recommended to start moving as soon as possible after the period of immobility. During a trip, you should move every 2 hours to prevent thrombosis.

Mechanical thrombosis prevention

Special compression (anti-embolism) stockings (that provide a pressure of 20-40 mm Hg) are available and may be used during long-distance travels and may also be recommended for patients admitted to a hospital for some surgical interventions.

Another interesting option is intermittent pneumatic compression. A pump is used to regularly inflate and deflate the plastic leggins – compress the lower limbs and promote blood circulation in the extremities. However, this device shouldn’t be used by overweight individuals as there is a risk that the leggings won’t be worn properly.

In some extreme cases implantation of vena cava filters (special devices that are placed in the major vein and trap the blood clots preventing them from moving forward) is necessary.

Medications

Blood thinners which include anticoagulants and antiplatelet drugs are prescribed to those who are at risk of developing blood clots. These medications include heparin, fondaparinux, apixaban, dabigatran, rivaroxaban, warfarin, and many others.

It should be outlined that there are special indications for using anticoagulants and such therapy cannot be started without the doctor’s recommendation.

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