If suspicion of thrombosis is confirmed, therapy should be given as soon as possible. Because when the blood clot separates from the vessel wall (embolism), it can reach the bloodstream to the right half of the heart and from there to the pulmonary circulation. If it clogs a pulmonary artery there is a pulmonary embolism, which in the worst case can be fatal. In addition, thrombosis as a late consequence can cause venous insufficiency.
Therapy: anticoagulation and thrombolysis
Most commonly, thrombosis is treated with anticoagulant drugs (anticoagulants). In most cases, heparin is used, which is either injected under the skin or into a vein. This prevents the growth and spread of the blood clot and significantly reduces the risk of pulmonary embolism.
Less often, a so-called thrombolysis is performed. In the process, the blood clot is dissolved using active ingredients such as streptokinase or urokinase, thereby reopening the vein. However, with this method, the risk of internal bleeding is higher than with the treatment with anticoagulant drugs.
Therefore, the risk and benefits of thrombolysis are carefully weighed. It is mainly used when a pelvic vein or multiple veins are affected simultaneously (multi-day thrombosis) and the thrombosis is not older than seven days.
In both methods, a longer-term anticoagulation with so-called vitamin K antagonists such as Marcumar® is started after a few days in order to reduce the risk of recurrent thrombosis (relapse).
Operation in thrombosis rarely necessary
Surgical removal of the blood clot using a catheter is rarely necessary. Surgery is only performed if thrombosis has formed in the vena cava or if thrombosis narrows the arteries of the affected arm or leg.
Although thrombolysis may be necessary but can not be performed because of contraindications such as previous injuries or bleeding, surgery may be an option.
Exercise as an additional measure
Contrary to what used to be the case, bed rest is not necessary during the treatment of thrombosis. Exercise, according to recent findings, does not increase the risk of pulmonary embolism and is even recommended to support therapy.
However, it is important to avoid heat applications in the area of thrombosis, since heat can dilate the vessels and thus lead to a detachment of the clot. Strong pressure during bowel movements can increase the risk of embolism. Therefore, under certain circumstances, the use of chair-regulating funds makes sense.
Complement treatment by compression
In most cases, a compression treatment with elastic bandages or thrombosis stockings is performed in addition to the drug therapy. This improves blood and lymph reflux and reduces the risk of clot detachment. To prevent relapse, the compression should be consistently continued for several months to years.