Fields of treatment / Varicose Veins Treatment / Prevention of thromboembolic disease
Prevention of thromboembolic disease
Varicose vein disease is associated with a certain risk of developing deep vein thrombosis due to the slowing down of venous flow in the affected veins by so-called venous stasis. A blood clot, or thrombus, can also spread into a deep vein. If the thrombus is released, it most often embolizes into the pulmonary canal.
Risk factors for venous thrombosis
- Obesity according to Body Mass Index 30 or moreHor
- monal treatment including contraception
- Nicotinism
- A history of venous thrombosis or pulmonary embolism
- Proven hypercoagulable state - Leiden mutation, etc.
- Age over 65 years
- Small saphenous vein surgery
- Preoperative immobilization longer than 3 days
- History of oncological disease
- Chronic venous insufficiency
- Dehydration
- Pregnancy
- Lower extremity tourniquet for more than 60 minutes (for knee and ankle arthroscopies)
- The more risk factors present, the higher the risk of thromboembolic disease.
Prevention and perioperative thromboprophylaxis
At our workplace, we follow the guidelines of the Czech Hematology Society - Section for Thrombosis and Hemostasis, the Czech Surgical Society and the Czech Society of Anesthesiology, Resuscitation and Intensive Medicine:
- Early mini-invasive surgery for varicose veins - the best prevention to prevent the development of the so-called varicose complex (swelling, inflammation and leg ulcer), it is also suitable before major operations, such as large joint replacements, etc.
- Mini-heparinization - subcutaneous injection of low-molecular-weight heparin for 5–10 days, the first one is applied on the day of the operation, the next one is administered by the client at home after instruction
- Compression stockings or bandages of the lower limbs up to the groin and on the non-operated lower limb for 24 hours after the operation - redirect and accelerate blood flow in the deep venous system
- Exercising the muscle groups of the lower limbs - prevents blood stagnation
- Drinking regimen - "thins" the blood
- These regimen measures are suitable until the client is fully mobilized.
Note
According to the latest recommendations of professional societies, hormonal contraception should not be discontinued before varicose vein surgery.
