How to treat thrombosis

If the suspicion of thrombosis is confirmed, treatment must be given as soon as possible. Because if the blood clot detaches from the vessel wall (embolism), it can travel with the bloodstream to the right side of the heart and from there to the pulmonary circulation. If a pulmonary artery is blocked there, a pulmonary embolism occurs, which, in the worst case, can be fatal. In addition, thrombosis can cause venous insufficiency as a late consequence.

Thrombosis therapy: anticoagulation and thrombolysis

Most commonly, thrombosis is treated with anticoagulant drugs (anticoagulants). Heparin, which is either injected under the skin or into a vein, is usually used. This prevents the blood clot from growing and spreading and significantly reduces the risk of developing a pulmonary embolism.

Less frequently, a so-called thrombolysis is performed. The blood clot is dissolved with the help of active ingredients such as streptokinase or urokinase, thereby reopening the vein. However, with this method, the risk of internal bleeding is higher than with treatment with anticoagulant drugs.

Risks and benefits are therefore carefully weighed up before thrombolysis. It is mainly used when a pelvic vein or several veins are affected simultaneously (multilevel thrombosis), and the thrombosis is not over seven days.

With both methods, a longer-term anticoagulant treatment with so-called vitamin K antagonists such as Marcumar® is started after a few days to reduce the risk of another thrombosis (recurrence).

 

Surgery is rarely necessary for thrombosis.

Surgical removal of the blood clot using a catheter is only rarely necessary. An operation is only performed if a thrombosis has formed in the vena cava or the thrombosis narrows the arteries of the affected arm or leg.

Surgery can also be considered if thrombolysis is necessary but cannot be performed due to contraindications such as previous injuries or bleeding.

Movement as an additional measure

Contrary to previous opinions, bed rest is not necessary during the treatment of thrombosis. According to recent findings, exercise does not increase the risk of pulmonary embolism and is even recommended to support therapy.

However, it is vital to avoid applying heat in the area of ​​the thrombosis, as heat dilates the vessels and can lead to clot detachment. Straining when you have a bowel movement can also increase the risk of an embolism. Therefore, the use of stool-regulating agents may be helpful.

 

Supplement treatment with compression

In most cases, compression treatment with elastic bandages or thrombosis stockings is carried out in addition to drug therapy. On the one hand, this improves the return flow of blood and lymph and, on the other hand, reduces the risk of the clot becoming detached. Compression should be continued consistently for a few months to years to prevent a recurrence.