Acute venous disorders

Acute manifestations of venous disorders such as pulmonary embolism or deep vein thrombosis usually occur without pre-existing conditions, but they can also be triggered by chronic venous disorders. In any case, medical treatment is immediately required.

Description of disease mechanism with venous disorders

Superficial thrombophlebitis (ST)

Superficial thrombophlebitis (ST) is a relatively common inflammatory process associated with a blood clot (thrombus) that affects the superficial veins (veins that are close to the surface of the body). Symptoms and signs include local pain, itching, tenderness, reddening of the skin, and hardening of the surrounding tissue.

Treatment and care of ST 

  • Appropriate anti-inflammatory and anticoagulant medication as prescribed by the treating physician
  • Surgical interventions (thrombectomy, ligation)
  • Non-invasive care with Sigvaris compression solutions 

Deep vein thrombosis (DVT)

Deep vein thrombosis (DVT) is a blood clot that usually forms in the deep vein system, mainly of the lower leg and which can block the venous return. The blood clot inside the vein can hold onto the vein wall, or it can be floating inside the vein.

DVT is caused by a combination of various pathophysiological factors, to  including vein wall damage, stasis, and hypercoagulability. Risk factors for the development of DVT include, amongst others, pregnancy, contraceptive medication, cancer, surgery, injuries, CVI, and travel.  

Some DVT cases have no recognized symptoms. For those who do show symptoms, they can include:

  • Pain
  • Warmth
  • Redness
  • Swelling

Complications of DVT include

  • Pulmonary embolism: If the clot breaks loose and travels through the vessel to the arteries located in the lungs, it significantly blocks blood flow through the lungs, which is a potentially fatal condition.
  • Post-thrombotic syndrome: Up to one half of patients with DVT develop a long-term complication known as post-thrombotic syndrome (PTS). This condition can show up as chronic pain, swelling, heaviness, edema, and skin changes in the affected limb. In severe cases, venous ulcers may develop.

Diagnosis of DVT

When symptoms described above occur, the patient must see a doctor quickly to confirm the diagnosis which can be made with a simple ultrasound scan. Early diagnosis and treatment can greatly reduce your risk of serious complications. 

Treatment and care of DVT

  • DVT treatment consists in taking anticoagulant drugs and wearing medical compression stockings to improve the venous blood return and to prevent PTS. 
  • It can also include thrombectomy to remove the clot. 

Important to know: Treatment should eliminate the symptoms rapidly and durably, but also allow to stay mobile and pursue every day activities.

Illustration deep vein thrombisis

The symptoms of DVT can go unrecognized.

Pulmonary embolism

Pulmonary embolism occurs when a blood clot, or part of it (emboli), detaches itself and migrates to the lung arteries. Pulmonary embolism is one of the most serious consequences of DVT because it may be fatal. The signs of embolism are non-specific and can include difficult breathing, chest pain, cough, fever, or blood expectorations.

Because these symptoms are also common with other medical conditions, pulmonary embolism may not be recognized right away. Only specific tests will enable a correct diagnosis such as lung scan (computer tomography). In case of such symptoms, emergency medical assistance must be sought at once.

Treatment and care of pulmonary embolism

Treatment can include

Post-thrombotic syndrome

Up to one half of patients with DVT develop a long-term complication known as post-thrombotic syndrome (PTS).

This condition can show up as chronic pain, swelling, heaviness, edema, and skin changes in the affected limb. In severe cases, venous ulcers may develop.

Treatment and care of PTS

Treatment can include

  • anticoagulant medication
  • thrombolysis and medical compression

Guidance for the prevention and treatment of the post-thrombotic syndrome 

One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): randomised controlled trial 

Scientific evidence shows (OCTAVIA one-pager) that, ideally, compression therapy should be continued for a minimum of two years after DVT onset to reduce the risk of developing PTS.

Variceal bleeding

Variceal bleeding is defined as bleeding from varicose veins. It is associated with a traumatized superficial varicosity, but significant bleeding can also happen from an area of ulceration. The resulting blood loss may be profound and even life threatening.

Treatment and care of variceal bleeding

  • To stop the bleeding, the leg should be elevated, and a constant pressure should be exerted on the wound.
  • Medical advice should be sought at once to receive the appropriate treatment.

Further reading

What is compression therapy
Chronic venous disorders (CVD)
Constant standing or sitting impedes the flow of blood towards the heart. Under certain circumstances, this can lead to venous insufficiency, which is characterized by improperly functioning vein valves that interfere with venous return and cause the blood to pool in the veins. If left untreated, venous insufficiency can result in the formation of serious disorders, including phlebitis, pulmonary embolism, or ulcers.
Read more
Factors that impede leg health
These factors influence leg health
Many factors can unfavorably influence leg health. These can include lifestyle factors, such as reduced activity, obesity, and/or smoking. Other factors such as advanced age, gender, hormonal changes, and a family history of venous disorders are also influential. In these cases, compression wear may help to support leg health. Factors such as surgery and long-distance traveling bear an increased risk for the development of deep vein thrombosis (DVT). Wearing compression might prevent DVT to develop.
Read more