Complications

The most feared complication is pulmonary embolism. If the blood clot (thrombus) adheres only very loosely to the vessel wall, it may come loose. The thrombus now floats with the blood flow back to the heart and then to the lungs.

The pulmonary arteries become increasingly narrow. The blood clot clogs the vessel and forms a pulmonary embolism. The part of the lung behind the blockage can no longer participate in the gas exchange.

If the thrombus is very large, large parts of the lung are no longer supplied with blood for gas exchange. When the blood flow capacity of the remaining lung is exhausted, the heart quickly becomes overloaded (right heart strain) with life-threatening complications. Often a pulmonary embolism remains undetected.

In half of all thromboses a pulmonary embolism can be detected without the patient noticing. In these cases the physician speaks of occult, i.e. hidden, pulmonary embolism. A pelvic vein thrombosis has the highest risk of a pulmonary embolism. A frequent late complication is the postthrombotic syndrome.

Thombosis prophylaxis

To prevent thrombosis before surgery, compression stumps are put on and heparin (low-molecular-weight heparin derivatives) is administered as an injection. The dose depends on the risk potential of the patient (have you already had thrombosis?) and the operation (high-risk operation such as artificial knee joint, artificial hip joint).

Furthermore, early movement is important for blood circulation. You can find more information on thrombosis prophylaxis under our topic: Thrombosis prophylaxis After a patient has overcome a thrombosis, a blood-thinning medication (Marcumar) is often given for a limited period of time (6-12 months) to prevent a new thrombosis. Many thromboses heal without consequences after timely therapy.

Especially if a thrombosis is not detected in time, the risk of permanent damage is high. If a thrombosis is not treated, scar tissue forms from the blood clot after a few days. This scar tissue usually forms a new duct, i.e. a new vessel.

However, the problems of the new vessels are that they do not have venous valves. Venous valves only allow blood to flow in one direction (towards the heart). A possible consequence of the uncontrolled blood flow as a result of the missing venous valves is an overload of the superficial venous system.

Varicose veins (varices) can develop. The full picture of the overload is called postthrombotic syndrome. The consequences are: Once a thrombosis has occurred, the risk of a new thrombosis is considerable!

Men in particular are at great risk of suffering another thrombosis. For upcoming operations, the thrombosis protection should be increased with heparin.

Water retention in tissue (edema)
The development of varicose veins (varices)
The inflammation of the skin (dermatitis) and
The formation of open ulcers (ulcus cruris).