Disorders of the Venous Systems The venous system of the lower extremities is composed of several veins that are superficial and deep. The sophisticated blood flow of the lower extremity consists of muscular venous pumps and bicuspid valves (Meissner, 2005). There are two major disorders of the lower venous system, chronic venous insufficiency (CVI) and deep venous thromboses (DVT). It is often assumed that disorders of the venous system are not relevant, but these disorders can, in fact, be more complex to treat than arterial diseases. The purpose of this paper is to examine the pathophysiology of CVI and DVT, diagnosis of the disorder, treatment of the disorder, comparison of both disease and risk factors that affect the incidence of …show more content…
CVI is a common problem with varicose veins that affect approximately 25 million adults in the United States suffer from CVI and are more than six million of these cases are reported to be severe cases of CVI (Eberhardt & Raffetto, 2014). When CVI occurs, there tends to be a dysfunction of the pumping system of the lower extremities. When obstruction takes place in the veins, it may limit the outflow of blood, thus causing increased in venous pressure when the muscles contract (Eberhardt & Raffetto, 2014). What causes a venous obstruction? Venous obstruction occurs from an intrinsic factor venous process, such as DVT or stenosis of the venous system (Eberhardt & Raffetto, 2014). The clinical manifestations of CVI range in variety and depend on pathogenesis: lower extremity pain, swelling, extremity tenderness, skin fibrosis, skin ulcerations and possibly skin hyperpigmentation (Eberhardt & Raffetto, …show more content…
Testing for DVT consist of serum blood testing for specific enzymes called D-Dimer which is a byproduct fibrinolysis; then it would suggest recent presence and lysis of thrombi (Douketis, 2016). Other diagnostic procedures include duplex ultrasonography of the affected limb to determine blood flow in the affected area and contrast venography. Treatment of DVT consists of anticoagulant therapy intravenously, subcutaneously flowed by oral anticoagulant therapy for maintenance, insertion of inferior vena cava filters, thrombolytic medications to dissolve the blood clot (Douketis, 2016). The last option for treatment of DVT is surgery which is rarely needed; thrombectomy is the surgical procedure where the clot is removed manually from the place of
A DVT is a blood clot that can occur anywhere in the body, but these blood clots tend to occur in the deep veins of the legs and thighs. It is critical that these clots are diagnosed and treated promptly to prevent further complications such as a pulmonary embolism, which occurs when a blood clot travels from the lower extremities
DVT can develop by lying in bed for long periods of time. Therefore, hospitalized patients have a considerably higher incidence of DVT. It varies from 20% to about 70%. (cdc.gov). Venous ulceration and venous insufficiency of a person’s lower leg, which are long term complications of DVT affect five tenth of a percent of the entire population.
DVTs usually occur within the deep veins of the lower leg. The DVTs that remain in the lower leg and calf tend to be asymptomatic and do not become clinically significant. A DVT is most likely to present symptoms when the proximal leg veins are involved and also when the DVT obstructs venous outflow resulting in inflammation of the vein wall (Bonner and Johnson, 2014). Warmth, redness, pain and swelling in the affected limb are common symptoms of a DVT. If a patient presents with these symptoms, a physical examination of the whole limb should be undertaken by a nurse or physician to observe for signs suggestive of a DVT. Suggestive symptoms of DVTs include superficial venous dilation, tenderness along the course of the vein, unilateral leg oedema, cyanosis, warmth and erythema (Bonner and Johnson, 2014). On examination of the limb, these are the symptoms that the nurse or physician should be looking out for, however, diagnosis on clinical presentation alone is extremely difficult as these symptoms are not specific to DVT and can be present in numerous other conditions. To improve accuracy when determining the probability of a DVT, nurses are advised to use the two level DVT Wells score. Each clinical feature is accompanied with a score. If a patient presents with a score that is two points or higher, it is likely that a DVT is present and
Deep vein thrombosis (DVT) happens when a blood clot forms in one or more of the deep veins in your body, it usually takes place in your legs. Deep vein thrombosis can cause swelling or leg pains, and you may not get any symptoms at all. Deep vein thrombosis can arise if you have certain medical conditions that affect how your blood clots. Deep vein thrombosis can also happen if you don't move for a long time. I can happen sitting in a car for too long, after surgery, following an accident, or when you are confined to a hospital or nursing home bed. DVT is a serious condition because blood clots in your veins can break loose, travel through your bloodstream and lodge in your lungs. It can block the blood flow and cause a pulmonary embolism.
DVT is associated with an increased risk for pulmonary embolism when above the knee (popliteal vein and above) 1
Thrombosis - This is a rare but potentially lethal blood clot in a vein. It is common in the calf muscle
Your first step in getting rid of your varicose veins is to understand why and how they pop up. The veins in your legs and feet have valves that work to move the blood from your lower extremities back up to your heart. However, since these valves have to work against gravity and push your blood "uphill", they sometimes get weak or worn out.
CVI is “inadequate venous return over a long period” (Huether & McCance, 2012, p. 586). The veins have valve that help with the flow of blood back to the heart. When these valves become damaged, the blood begins to back up and remain in the vein. When the vein walls become weakened, this can lead to sluggish venous return. The formation of deoxygenated blood will remain in the venous system without becoming useful to the body. This leads to “venous hypertension, circulatory stasis, and tissue hypoxia” (Huether &
Patients suffering from deep vein thrombosis often go for IVC filters implantation. These filters do not allow blood clot to break off in the vein, and enter into the lungs as it can lead to complications like chronic leg swelling, increased pressure, increased pigmentation, and discoloration of the skin.
Venous stasis is a very common disease of the leg. A venous stasis ulcer is a leg wound that does not heal because the veins of the legs are not pumping blood back to the heart. The blood pools in the lower leg which causes the leg to swell, the skin to open and form an ulcer. People who have a history of leg and feet
Compression stockings and brief walks to promote blood circulation can aid in resolving and also preventing DVTs. Findings from clinical trials have shown the effectiveness and safety of pharmacological prevention with low, fixed doses of anticoagulant drugs (Goldhaber). “Although approximately half of venous thrombotic events treated with traditional anticoagulant blood thinners resolve during a 3 to 6 month conventional duration, the risk of Post Thrombotic syndrome (PTS) persists, possibly due to acute valvular damage from complete venous obstruction (Greene). Anticoagulants have been recommended for at least 3 months, though duration of this therapy should be based on the risk of recurrence as well as whether the blood clot has
Deep vein thrombosis (DVT) is a disorder that occurs when a blood clot forms in a vein that is deep inside the body. It is mainly associated with veins in the legs, usually in the lower leg and thigh, but may occur in other parts of the body. About half of the people who have DVT show no symptoms, but people who sit for long periods, are over 60 and smoke are at higher risk, and should be aware of possible signs of a problem.
However, a diagnosis of MTS relies on both clinical and imaging findings because the presence of iliac vein compression alone is insufficient for a diagnosis. There are currently no standardized clinical or radiologic diagnostic protocols in place to aid in the identification of MTS. Since MTS is treated by a wide array of specialties, including interventional radiology, vascular surgery, cardiology, and vascular medicine, the need for an established diagnostic criterion is imperative in order to reduce misdiagnosis and inappropriate treatment. MTS patients generally do not respond well to conservative treatments; thus, early diagnosis and treatment is paramount in order to avoid complications such as iliofemoral DVT or venous insufficiency.[3, 4] This review will describe the clinical presentations of MTS and focus on the imaging modalities that have been used in aiding and confirming a
the years, having varicose veins are not only known for causing pains and discomfort towards an