These blood clots cause two problems
All the time, our blood is in balance. As you read this article, your blood forms clots, and yourking down clots. The balance results in no clot forming.
Three things tip the scale towards forming clots:
Many clots below the knee do not have symptoms and are missed. Clots above the knee and certainly above the groin are larger and more likely to cause symptoms.
The symptoms range from mild to very severe. In order, they are:
Leg ischaemia – some people develop such harmful clots because not enough blood can get back to the heart, the pressure in the veins of the legs gets so high that the arteries can no longer force blood with oxygen into the leg, and the leg isn’t receiving enough blood. This begins with some nerve sensory changes in the toes, progresses to a lack of movement of the limb and can eventually cause death to the tissue of the toes and foot. This is extremely rare and is a medical emergency.
The treatment recommended depends on where the blood clots are.
When blood clots form in veins below the groin, the management is always blood thinners, and most specialists recommend compression stockings, as there is reasonable quality evidence it reduces the chance of someone developing post-thrombotic syndrome or damage to the veins and scarring years down the track.
Blood clots that occur above the groin (iliofemoral segment) are considered for surgical intervention, depending on a series of factors, such as how old the patient is, what other medical issues they have and how severe their blockage and symptoms are.
A young patient with a large clot in their iliofemoral veins will likely have difficulty walking more than 100 metres immediately after the clot forms, but this generally goes away over the next six weeks as the other veins, which are still draining, get larger to accommodate for the blockages in the more significant, named vessels. The issue arises around two years later when the damage to the veins leads to problems with the skin and can cause chronic leg pain. Eventually, some patients develop venous ulcers (refer to venous ulcer section)
The surgeries that are done are minimally invasive keyhole operations.
There are three approaches to removing deep vein clots from the larger vessels in the limb and pelvis:
1. Medicine is used to dissolve the clot. This is called ‘lytic’
2. The clot can be sucked out with a small vacuum cleaner inserted through a small puncture in the skin
3. Finally, newer technologies have large baskets that are moved up past the clot and then dragged down to collect all the clots and delivered out of the body through a small hole in the made vein.
Each patient requires a different approach, depending on their anatomy, their age and the clot severity.
Often, patients will need a stent in their left common iliac vein to improve the flow after the clot Is removed and widen the capacity for blood to flow up the left leg.
Consulting locations
WOLLONGONG
Artery and Vein Clinic
402 Crown St
Wollongong
NSW 2500
GREGORY HILLS
Artery and Vein Clinic
Soma Centre
Suite 8/7, Gregory Hills drive
Gregory hills
NSW 2557
Orange
Artery and Vein Clinic
117 Molder st
Orange
NSW 2800
Contact Info
Wollongong
Phone: (02) 4226 9333
Fax: (02) 4229 4006
Gregory Hills
Phone: (02) 4601 1055
Fax: (02) 4601 1058
Orange
Phone: (02) 4601 1055
Fax: (02) 4601 1058
Healthlink EDI: wgvascul
Office Hours
9am – 4:30pm Monday to Friday
Phone Hours
7am – 6pm Monday to Friday
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