A deep venous thrombosis or phlebitis is an accident that could have a serious complication: pulmonary embolism. These 2 diseases together are called venous thromboembolic disease.

What is DVT?
This obstruction of a deep vein by a blood clot or thrombus.

Phlebitis

His training is not a coincidence but a consequence of the 3 following phenomena:

  • Alteration of the vein wall,
  • Stagnation of blood in the vessels (or venous stasis),
  • Abnormal coagulation system of the body.



How does it occur?
In most cases, the clot forms in an area already affected in the vein wall. This training is facilitated by a situation explaining that the blood flows more slowly or not enough fluid.
If the clot remains in place and obstructing the vein, it is phlebitis (or venous thrombosis). Most often this occurs phlebitis in deep veins of the lower limb.
The calf reddens, swells, becomes hard and painful to palpation and walking. These signs are sometimes accompanied by a slight fever and a faster heart rate.

Sometimes the clot detaches from the wall of the vein and “journey” in the vascular system, eventually resulting in the pulmonary artery, blocking it or any of its branches. This pulmonary embolism. Suggestive signs: chest pain type in the side, feeling of stuffiness, cough (with bloody sputum), fever, tachycardia ..

What are the situations that favor this phenomenon?
All situations which explain that the blood flows more slowly or is no longer enough fluid:

  • Aging of the vascular system related to age,
  • of personal or family history of thrombosis,
  • pregnancy and childbirth,
  • obesity,
  • chronic venous insufficiency,
  • system dysfunction natural clotting (or coagulation abnormality),
  • some diseases (cancers, respiratory and heart failure, myocardial infarction, stroke, cardiac arrhythmia, etc..)
  • prolonged immobilization (long flight or bus, bed rest following a transaction, plus a cast prohibiting walking, etc..)
  • hormone treatments, including the contraceptive pill.

How can we be sure of the diagnosis?
Symptoms and circumstances that may make you think of phlebitis should be confirmed by an examination called venous doppler ultrasonography. This review quick, easy and painless can view all the veins and locate the clot.
In cases of suspected embolism, 2 exams must be made in emergency hospital: a lung scan and angio-CT. These 2 tests are painless and allow to confirm the diagnosis in most cases.

How to treat a venous thrombosis?
The treatment of phlebitis is an emergency because of the risk of pulmonary embolism. However, it is feasible on an outpatient basis without hospitalization, subject to medical and biological very regular. It combines:

  • anticoagulation (blood thinning medication), first administered by subcutaneous injection and tablets,
  • restraint venous stockings or pantyhose.

Depending on the severity of phlebitis, treatment can last from 6 weeks to 6 months.
Pulmonary embolism is treated as anticoagulants and restraint. Nevertheless, the potential severity cons-indicates an immediate return to the home and requires monitoring in hospital the 1st day, sometimes putting resuscitation with oxygen.
If embolism recent very serious, other drugs are used: fibrinolytics.
Anticoagulant therapy should be followed from 3 to 6 months, even if life is a question promotes persistent (as an anomaly of hemostasis).

Is there a preventive treatment of phlebitis?
There are 2 kinds:
Taking anticoagulants:

  • A short time when bed rest or immobilization transitional (illness, surgery, plaster)
  • Lifetime if bleeding disorder or heart disease.

Wearing compression stockings:

  • In certain circumstances (air travel for example) if predisposing conditions,
  • To life, a history major predisposing.

Finally, attention to the syndrome of economy class: during a long flight, when even mild venous insufficiency, it is advisable to wear stockings, get up and walk the aisles every 2 hours to stretch their legs, drink lots of water and avoid alcohol.
For some people at risk, the preventive administration of an anticoagulant injection can be justified.

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