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.

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.

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

hemodynamic and respiratory support
anticoagulant medication
thrombolytic treatment
surgical embolectomy
catheter-directed treatment
Sigvaris compression solutions

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.