9 Common Doubts About Deep Vein Thrombosis
Thrombus, a term that gives rise to deep venous thrombosis (DVT), is the name of the blood clot that forms inside the veins of lower limbs, such as the legs, blocking blood circulation . In more severe cases, the clot may migrate to the pulmonary arteries, causing a picture of pulmonary embolism. Despite the complicated name, thrombosis, as it is popularly called, is more common than imagined, especially from the age of 50 and in patients with reduced mobility who have undergone some surgery, for example. About 180,000 new cases of thrombosis occur every year in Brazil.
The diagnosis need not be alarming, however, with the early discovery of the disease and the therapy with safer drugs, the treatment of thrombosis becomes more practical it is efficient. Dabigatran, produced by Boehringer Ingelheim, one of the world's leading pharmacists, is an anticoagulant drug used to treat thrombosis, ³. It prevents and treats thrombosis by reducing the chance of the clot migrating to other parts of the body, and can also be used to prevent stroke in people with a type of arrhythmia called atrial fibrillation, ³.
As drugs with anticoagulant action affect the blood's ability to coagulate, there is a fear that patients will not be able to overcome significant bleeding in the event of accidents or emergency surgeries. But it is now possible to reverse the anticoagulant effect in a few minutes with reversal agent administration as if it were an "antidote." Idarucizumab exerts this function in patients who use Dabigatran®.
In specific and emergency cases, the agent is used to revert the anticoagulant effect of the drug within a matter of minutes, without affecting other stages of blood clotting. In this way, it is possible to perform surgeries and other medical interventions with even greater patient safety, without waiting and with less risk of bleeding, ⁵.
But can thrombosis affect anyone? What are the most common symptoms of the disease? Ask your questions about deep vein thrombosis below:
What is deep vein thrombosis?
"Venous thrombosis is the formation of blood clots within deeper veins, which are those that are at the same level as the muscles. , thrombosis usually occurs more frequently in the lower limbs, such as the legs, blocking the circulation of the veins, "explains Vascular Surgeon Ivan B. Casella of the Hospital das Clínicas of the University of São Paulo Medical School (FMUSP).
The clot occurs when the blood leaves the liquid state and passes into a semisolid state, close to a gelatinous consistency. This clot blocks blood flow and can cause swelling and local pain. If it breaks loose and moves in the bloodstream, it may move into the pulmonary blood vessels. This condition is called a pulmonary embolism, which, when accompanied by thrombosis, is called venous thromboembolism (VTE).
What are the main causes of thrombosis?
Thrombosis occurs due to multiple factors. Having undergone surgery, especially if the patient needs to stay in bed or has limited mobility for any reason, is a major risk factor. In addition, people with genetic alterations called thrombophilia have a greater tendency for blood clotting, which can also lead to thrombosis. "Another important risk is the use of the contraceptive pill by women who already have a tendency to develop the disease, there is a history in the family.Cancer is one more example because it significantly changes the blood's coagulability, that is, it increases the tendency of blood clotting, "says vascular surgeon Ivan Casella.Can this disease strike anyone? Yes, thrombosis affects the whole population, both men and women. But the risks intensify very much with age. After the age of 50, cases of thrombosis increase significantly.
What are the main symptoms?
"In some cases, thrombosis may go unrecognized, with few symptoms. In severe cases, the member affected by thrombosis may become purplish and there may also be a sudden loss of air when the clot migrates to the lung, "says Ivan Casella Is there a habit or attitude that prevents venous thrombosis (DVT)?
"It is not a matter of habit but rather to understand the risk factors and avoid them.For example, if a patient has a tendency to develop the thrombosis and will undergo surgery, it is necessary to start prevention.In general, maintaining a healthier lifestyle also helps.Pos obesity is a slight risk factor, but is still a risk for the occurrence of thrombosis " , the doctor notes.
What is the most serious complication of the disease?
Pulmonary embolism is the most severe acute complication of deep vein thrombosis. It occurs when the clot detaches from the vein and is taken to the lung, blocking the pulmonary blood flow.
It may be asymptomatic, when it is a small embolus, and not be perceived or diagnosed. But a severe embolism in a fragile patient can lead to sudden death¹. "Therefore, it is very important to make an early diagnosis of thrombosis and to begin treatment as soon as possible," Ivan Casella adds.
What is the best treatment for thrombosis?
"The treatment for deep vein thrombosis is made by means of the anticoagulant medicine, which should be taken correctly every day for a time defined by the physician.The function of this medication is not to remove the clots but to create favorable conditions so that they do not spread through the bloodstream and can be removed "
He continues:" Treatment can therefore begin with one of the direct oral anticoagulants, a class of medicines that has emerged for less than a decade. safety, and practicality than previous treatments. In the past, you had to have constant laboratory control to see if the medicine was working New drugs do not need this control. In addition, the risks of bleeding are much lower. "
Is anticoagulant treatment safe? And how does the reversing agent work?
" In general, new anticoagulants are safer and have fewer risks. It is an advantage of these medicines. The reversing agent, in turn, is indicated in cases of severe bleeding or when the patient has to undergo emergency surgery, with no possibility of waiting ", emphasizes Ivan Casella.
The reversing agent ceases the anticoagulant effect of the drug in in a matter of minutes, returning to the bloodstream its coagulation potential¹, ⁴, ⁵. It is important to remember that not all medicines have a specific reversible agent.
What are the benefits of this treatment?
"The greatest benefit of direct oral anticoagulants is to offer a stable, safe treatment and without the necessity of constant laboratory tests to the patients diagnosed with thrombosis. It is, in short, much more practical and safe. The drug acts directly on the mechanisms of coagulation. In old treatments, the patient spent a lot of time at doses above or below the ideal, at risk of developing a new thrombosis or having some bleeding. The new drugs, however, offer a more stable therapy, with fewer risks. "
The reversing agent protects the patients in cases of emergency, reversing the anticoagulant effect in a matter of minutes. Previously, it was necessary to wait more than a day to stop the anticoagulant effect of the medications or to make a partial reversal, running the risk of bleeding during the surgical procedure¹, ⁴, ⁵. The patient, therefore, gained safety in the treatment of deep venous thrombosis with the arrival of the specific reversor for one of these new anticoagulants.
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