Is it possible to dissolve a blood clot?

New approaches to treatment

Tatiana Izmailova, AIF HealthEvery year, more people die from venous thromboembolism than from AIDS, breast and prostate cancer and car accidents combined.

But recently, doctors have learned to prevent this potentially life-threatening situation.

Our experts: Academician of the Russian Academy of Medical Sciences, President of the Russian Society of Angiologists and Vascular Surgeons, Head of the Vascular Surgery Department of the A.V. Vishnevsky Institute of Surgery, Professor, Doctor of Medical Sciences Anatoly Pokrovsky and Associate Professor of the course of Cardiovascular Surgery and Surgical Phlebology of the Faculty of Advanced Doctors of the Russian State Medical University, member of the Executive Committee of the Association of Phlebologists of Russia, MD Sciences Igor Zolotukhin.

Dangerous clotLet's make a reservation right away: thrombosis is not a disease, but a condition in which a blood clot partially or completely blocks the blood flow through a deep vein.

As a rule, our limbs serve as a target for a dangerous process: the outflow of blood here is significantly worse than in other parts of the body. The situation is aggravated by a sedentary lifestyle, overweight and "bad" heredity. In some people, the tendency to increased blood clotting is genetically predetermined.

Most often, blood clots "clog" the veins of the lower leg. But the most dangerous are those that have formed in larger veins – iliac, femoral, popliteal. The larger the blood clot, the more damage it can cause.

Fortunately, not every blood clot leads to death. In order for the irreparable to happen, it must have an inhomogeneous structure and be loosely attached to the vascular walls. Doctors call such blood clots floating. The slightest push is enough – and, having broken away from its usual place, a deadly "bullet" with lightning speed reaches the target, which is most often the pulmonary artery, and its blockage (pulmonary embolism) is considered the main cause of hospital death of postoperative patients.

The sad list is headed by oncological, traumatology and orthopedic departments. Due to the longest stay on bed rest in local patients, the risk of developing deep vein thrombosis is 2-3 times higher than in general surgical patients.

Prevent troubleDoctors try to prevent a possible catastrophe, the threat of which persists for several postoperative weeks, in various ways: by tightening the patient's legs with elastic bandages, as well as shortening the bed rest periods.

According to the new surgical standards, even after a complex heart operation, the patient is tried to get back on his feet almost on the day of the operation or the next day.

The postoperative treatment of patients with anticoagulants (blood thinners) has also become a great help for doctors. Until recently, the gold standard of such therapy was injections of low molecular weight heparin, after which the patient was prescribed so-called vitamin K antagonists, which, however, had a number of drawbacks, such as the need for constant laboratory blood monitoring and dose adjustment due to the possible risk of bleeding.

Today, patients at high risk of thromboembolism have an alternative – a new generation of oral anticoagulants, which include direct thrombin inhibitors. Unlike vitamin K antagonists, this new, more effective class of drugs does not require constant monitoring of blood parameters. And most importantly, this therapy significantly reduces the risk of dangerous bleeding, which has already been appreciated in many Russian hospitals, where direct thrombin inhibitors are successfully used to prevent thromboembolic complications in patients who have undergone knee or hip replacement. Experts are convinced that the new oral anticoagulants have a great future.

By the wayIn addition to postoperative patients, the risk of venous thromboembolism is:

• elderly people;
• patients who have suffered a stroke, injury;
• obese people;
• patients with cardiac, chronic venous insufficiency, atrial fibrillation;
• pregnant women;
• representatives of "standing" (cooks, salespeople, hairdressers, surgeons, traffic police officers) and "sitting" professions (accountants, programmers, secretaries);
• passengers of long-distance flights.

Portal "Eternal youth" http://vechnayamolodost.ru13.005.2014