Pulmonary embolism, a consequence of deep vein thrombosis, is already the third leading cause of death from cardiovascular disease.

This Sunday we celebrate World Thrombosis Day, a very unknown anniversary that raises public awareness of a disease that is often underestimated and misinterpreted. This poorly recognized disease, diagnosed in 54 cases per 100,000 inhabitants, can at worst cause pulmonary embolism, third cause of cardiovascular death.

Deep vein thrombosis (DVT) consists of blood clots (thrombi) in the deep veins of the lower extremities (femoral vein, popliteal vein or iliac vein), although less commonly the veins of the neck (jugular), upper extremities (axillary, subclavian or basilic veins) or abdomen or pelvis may also be affected.

According to the Spanish Society of Vascular and Interventional Radiology (Servei), the incidence of the first case of deep vein thrombosis of the lower extremities is between 50 and 100 cases per 100,000 inhabitants per year. The numbers are important, since this condition, together with pulmonary embolism, constitutes the third cause of death from cardiovascular diseases, second only tor myocardial infarction and stroke. Specifically, it is estimated that one out of every 100 patients will die from DVT. In the most severe cases, amputation or mortality rates can exceed 40%.

What kind of people could survive this?

Those at greatest risk of contracting this disease are those who have had long-term immobilizationwho have undergone surgery or suffered injury. Likewise, deep vein thrombosis also occurs more frequently in cancer patients, autoimmune diseases and some blood diseases.

In this regard, Dr. Jorge Cobos, member of Servei and specialist at the Department of Vascular and Interventional Radiology of the Ramón y Cajal University Hospital in Madrid, explains that obstruction of the veins of the lower extremities usually leads to “inflammation, pain and heat in the affected area.” Likewise, the expert notes that a blood clot can cause “massive congestion of the limb, causing gangrene, and the clots can travel and block the lungs,” which is called a pulmonary embolism.

RVI in severe cases

The standard and proven treatment that is used in all patients with deep vein thrombosis is anticoagulants —The most famous are heparin or synthrom—. They are designed to dissolve a blood clot and prevent pulmonary embolism, which is the most serious consequence of the disease.

In this sense, Dr. Cobos notes that the role of vascular and interventional radiologists is “fundamental” in the most serious cases during the acute phase of thrombosis, since they are responsible for aspirate or break up blood clots with medications, They restore blood circulation and avoid complications that harm the patient.

An example of this, as the physician and specialist clarifies, is a patient with extensive DVT in whom the iliac veins or vena cava are affected, as well as a patient who has contraindications to anticoagulants or when they are ineffective. An alternative for this group is catheter thrombolysis. That is, inserting a narrow tubular device using X-rays into a vein in the leg or arm, which is aimed exactly at the place where the blood clot is located. Once there, through a catheter, a special medicine is injected into the clot, which dissolves the clot.

Finally, the Servei member summarizes, in other cases it may also be necessary after chronic obstruction “Reopen large veins in the abdomen and pelvis using stents.” This method allows you to restore venous blood flow and improve blood circulation in the affected area.