World Thrombosis Day is held annually on October 13th to raise awareness about thrombosis, including causes, risk factors, signs, symptoms, prevention, and treatment. Thrombosis may occur in veins (venous thrombosis), in arteries (arterial thrombosis), or lymphatic vasculature (lymphatic thrombosis). Thrombosis is a growing health problem often underestimated and misunderstood which can lead to serious complications.
Venous and arterial thrombosis are blood clots in the affected part of the body leading to damage. A venous thrombus (embolus) can break off, travel through the circulation, and lodge somewhere else as an embolism (thromboembolism). Complications can arise when a venous thromboembolism lodges in the lung (pulmonary embolism).
In blood vessels, the clotting mechanism is protective for preventing excessive blood loss while maintaining blood flow. However, in the lymphatic vasculature, coagulation is a pathological phenomenon closely related to but quite different from blood clotting. Any source of lymphatic vessel occlusion, such as internal obliteration, external compression, or increased lymphatic pressure, might predispose to localized lymphatic thrombosis.
CHRONIC VENOUS DISEASE AND THROMBOSIS
Chronic Venous Disease (CVD) is prevalent and unavoidable in many people due to persistent or unalterable risk factors. It encompasses a range of venous disorders. The spectrum of chronic venous disease signs and symptoms shows variable severity, ranging from mild to moderate (pain and varicose veins) to severe (venous ulcers).
The pathophysiology of Chronic Venous Disease (CVD) is multifactorial and characterized by venous hypertension, which triggers endothelial dysfunction and inflammation leading to microcirculatory and tissue damage, and eventually to Varicose Veins (Vvs) with dysfunctional valves and venous reflux. If not adequately treated, VVs could progress to Chronic Venous Insufficiency (CVI), leading to Venous Leg Ulcer (VLU). Studies state that endothelial dysfunction may be the central player in the link between varicose veins and Deep Vein Thrombosis (DVT). DVT is the most common cause of CVI, as the blood clot damages the leg vein valve.
Venous insufficiency is a complex multifactorial process reflecting both systemic abnormalities of connective tissue synthesis and cellular inflammatory reaction. The development of varicose veins results from a complex interplay of multiple factors, including gender, age, heredity, obesity, lifestyle, and employment. CVI is one of the most common disorders of the vascular system, affecting approximately 50% of adults.
If Chronic Venous Insufficiency is left untreated, it can lead to several complications including Venous Thrombosis, likewise, one of the common risk factors of CVI occurs when the valves of the deep veins are damaged as a result of Deep Venous Thrombosis (DVT). Due to the inevitability factor of CVD, medical treatment is required to alleviate symptoms and slow disease progression. Depending on VVs severity, management usually includes compression stockings, venoactive drugs, sclerotherapy, and surgical removal.
Venoactive Drugs (VADs), also called phlebotonics, have been promoted to be a favorable conservative treatment option for the treatment of all stages of chronic venous disease, and for the prevention of disease progression to vascular disorders such as thrombosis. International guidelines for managing venous disease support the strong recommendation of MPFF (micronized purified flavonoid fraction) and Sulodexide, which have shown benefits in CVD, CVI, and VLU.
REFERENCES:
- Primaryvenous insufficiency increases risk of deep vein thrombosis
- Riskfactors for venous and arterial thrombosis
- Varicoseveins of lower extremities, hemodynamics, and treatment methods
- AStudy of Risk Factors of Chronic Venous Insufficiency and itsAssociation with Features Suggestive of Preceding or Present DeepVenous Thrombosis
- TheRole of Endothelial Dysfunction and Inflammation in Chronic VenousDisease
- Changesof the serum properties and its effect on the endothelial cellsrestoration in patients with chronic venous disease treated withsulodexide
- Mechanismsof Lower Extremity Vein Dysfunction in Chronic Venous Disease andImplications in Management of Varicose Veins
- Current Diagnostic and Therapeutic Challenges inSuperficial Venous Thrombosis
- Sulodexidein the treatment of chronic venous disease
- MicronizedPurified Flavonoid Fraction (MPFF) for Patients Suffering fromChronic Venous Disease: A Review of New Evidence
- Coagulation in Lymphatic System
- Management of People With Lymphoedema in thePresence of Deep Vein Thrombosis
