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Deep vein thrombosis (DVT):

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The venous thrombosis is a pathological condition in which a blood clot (thrombus) forms inside a vein, obstructing the normal flow of blood. A thrombus can develop anywhere within the venous system, but it most commonly occurs in the veins of the lower limbs. There are twomain types of venous thrombosis :

Superficial venous thrombosis:Occurs in veins close to the surface of the skin and is usually less serious.
Deep vein thrombosis (DVT):Occurs in deeper veins, mainly in the legs, and is more dangerous because it can lead to complications such as pulmonary embolism, when a clot detaches and travels to the lungs.

What Is Deep Vein Thrombosis (DVT)?

Deep vein thrombosis is a serious medical condition that occurs when a blood clot blocks a vein located deep within the body. Blood clots are formations of coagulated blood that develop inside a vein and can obstruct normal blood circulation.

Venous clots most commonly occur in the legs, but they may also develop in other parts of the body. The most dangerous complication occurs when the clot travels toward the heart and the pulmonary arteries, causing a pulmonary embolism, which can be life-threatening.

Symptoms in the Leg

The most common symptoms of deep or superficial venous thrombosis in the leg include:

Swelling of the affected leg
Cramping and severe pain in the calf
Unexplained pain in the leg or ankle
Warmth or burning sensation in the affected area
Localized redness and tenderness, usually along the inner part of the leg or the calf

Deep vein thrombosis can also occur in the upper limbs. Symptoms may include:

Pain in the neck or collarbone area
Shoulder pain and pain along the arm
Swelling of the arm or hand
Bluish discoloration of the skin
Difficulty moving the arm

Some patients may not realize they have deep vein thrombosis until they develop symptoms of pulmonary embolism, which may include severe chest pain, rapid breathing (tachypnea), rapid heart rate (tachycardia), shortness of breath, fainting or loss of consciousness, and cardiac arrest in severe cases. Pulmonary embolism is a medical emergency and requires immediate treatment.

Causes of Deep Vein Thrombosis

Several factors may lead to the development of venous thrombosis:

Trauma: Injury to a blood vessel may narrow its lumen or block circulation, leading to clot formation.
Surgery: During or after surgical procedures, thrombosis may occur due to vascular injury or prolonged immobilization.
Immobilization: Lack of movement (sedentary lifestyle) or prolonged immobilization due to fractures, illness, or surgery may cause deep vein thrombosis.
Cancer Patients with cancer have a higher risk of thrombosis, a condition known as paraneoplastic syndrome.
Thrombophilia: Patients with inherited or acquired thrombophilia have an increased tendency to form blood clots. Screening for thrombophilia is recommended in patients under 50 years old with thrombosis, patients with unexplained thrombosis, individuals with a family history of thrombophilia, and women with multiple miscarriages.
Certain Medications: Some medications may increase the risk of thrombosis, such as hormonal therapies, particularly when combined with smoking.

Standard Treatment for Venous Thrombosis

Deep vein thrombosis is a serious condition that, if untreated, may lead to complications such as post-thrombotic syndrome, characterized by chronic leg swelling, skin discoloration, skin hardening near the ankles, and venous ulcers, as well as pulmonary embolism, which can be fatal. For this reason, patients should immediately consult a vascular surgeon or vascular specialist if venous thrombosis is suspected.

If thrombosis is confirmed, anticoagulant therapy is initiated. In superficial venous thrombosis, anticoagulant injections are usually prescribed for 30–45 days, while in deep vein thrombosis or pulmonary embolism, anticoagulant medication is typically given orally for 3–6 months. It is important to note that anticoagulants do not dissolve the clot directly. The body gradually breaks down the clot over time, while anticoagulants prevent the clot from growing or recurring.

Do I Need Compression Stockings After Deep Vein Thrombosis?

For patients at high risk of thrombosis, graduated compression stockings can help prevent its development. If deep vein thrombosis has already occurred, compression stockings may help prevent post-thrombotic syndrome. However, the decision to use them should be made after clinical evaluation by the treating physician.

Do I Need an Inferior Vena Cava (IVC) Filter?

Current international guidelines no longer recommend routine placement of inferior vena cava filters, which were previously used as a protective “umbrella” against pulmonary embolism. The use of an IVC filter is indicated only in patients who cannot receive anticoagulants due to bleeding risk or patients who develop pulmonary embolism despite anticoagulant therapy.

The Role of Endovascular Techniques in Treating Deep Vein Thrombosis and Pulmonary Embolism?

Deep vein thrombosis in the legs is usually treated conservatively with anticoagulation because modern endovascular techniques do not provide significant additional benefit in most cases. However, when thrombosis affects the pelvic or abdominal veins, symptoms are often more severe. In these cases, modern endovascular surgery allows the immediate removal of the clot. This treatment can rapidly relieve symptoms, restore venous circulation, and prevent post-thrombotic syndrome by preserving venous valve function. I. n cases of pulmonary embolism that significantly affects heart function and threatens the patient’s life, endovascular techniques allow aspiration and removal of the clot, which can be life-saving.

Are Minimally Invasive Thrombectomy Techniques Available in Greece?

Specialized thrombus aspiration devices are available in Greece, including at the Athens Medical Center, which hosts the country’s only specialized PERT team (Pulmonary Embolism Response Team) for the management of deep vein thrombosis and pulmonary embolism. Our expertise in endovascular vascular surgery, combined with state-of-the-art equipment and an advanced hybrid operating room, ensures safe and effective treatment of deep vein thrombosis and pulmonary embolism.