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Acute venous thrombosis and its complications, such as pulmonary embolism and post-thrombotic syndrome, are an increasingly common condition worldwide, which in its most severe forms can now be treated more effectively with minimally invasive techniques.

1. What is acute venous thrombosis and why does it concern us all?

Acute venous thrombosis refers to the formation of a blood clot, usually in one of the deep veins, which prevents the smooth flow of blood. In this case, there is a risk that pieces of the clot will break off and be transported through the bloodstream to the lungs, causing the so-called pulmonary embolism, an extremely life-threatening condition. For this reason, the need for effective treatment of acute venous thrombosis is imperative.

As a disease, it is not rare, on the contrary, its incidence is steadily increasing. Indicatively, it is estimated that 2.5-5% of the population, at some point in their lives, will have an episode of thrombosis. The incidence of the disease has also increased as a consequence of the COVID pandemic, as it is a key complication of infection with the virus in question.

As with any health problem, early diagnosis leads to the best results.

2. What are the causes and symptoms of acute venous thrombosis?

Clots can form in any vein of the body. However, they most often appear in the leg and pelvis. There are several factors that favor acute venous thrombosis, such as the following:

• Surgery or serious injury
• Cancer and certain types of its treatment, such as chemotherapy
• Various infections, such as COVID-19
• Prolonged lying down or sitting, such as on long flights
• Pregnancy and the first six weeks after childbirth
• Contraceptive use or hormone therapy for menopause
• A family history of thrombosis
• Inherited blood disorders, such as thrombophilia
• Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis
• Various autoimmune diseases, such as lupus erythematosus
• Extensive varicose veins in the legs
• Smoking
• Obesity and overweight
• Placement of venous catheters, pacemakers and defibrillators

It should be noted that quite often acute venous thrombosis does not show symptoms until parts of the thrombus have already been detached and a pulmonary embolism has occurred, when the patient also experiences chest pain and shortness of breath.

When the disease does give symptoms, the most common are pain and swelling with increased heat and redness in the area of ​​the thrombosis (e.g. in the leg or arm). If the clot remains for a long time, then we are now talking about chronic venous obstruction, which causes persistent swelling, pain, difficulty in movement and ulcers that are difficult to heal, the so-called post-thrombotic syndrome.

3. How is acute venous thrombosis treated?

Effective treatment of acute venous thrombosis starts with the correct diagnosis, which is often a challenge, as the symptoms of the disease are similar to those of other diseases. Once the diagnosis is made, the first line of defense is the administration of anticoagulant drugs and special elastic stockings to relieve swelling in the legs.

When the disease is more extensive and the symptoms are more intense, surgical repair may be required. Today, there are minimally invasive techniques, without requiring a surgical incision (only puncture) that allow for immediate removal of the clot. Techniques such as thrombectomy, thrombosuction and thrombolysis, offer immediate relief and prevent future thrombosis.

Similar techniques can be used in patients who have had a previous thrombosis and suffer from “post-thrombotic syndrome” (pain and swelling in the leg or skin ulcers). The blocked vein can be opened and a “stent” placed that will restore normal venous circulation in the affected limb.

I would like to focus in particular on the techniques of thromboplasty and stenting, which are widely applied in the USA, but in very few centers in Europe, as in order to have good results they require the cooperation of specialized interdisciplinary teams and specially designed hybrid surgeries.

The Athens Medical Center recently inaugurated the only one in Greece, a new certified Robotic Hybrid Surgery Center – “PROMETHEUS” (Discovery IGS 740 by GE Healthcare), becoming the benchmark for similar procedures treatments throughout Europe.

Our team has many years of expertise and experience in the USA, which we combine with the state-of-the-art biomedical equipment of the Athens Medical Center, in order to provide personalized, safe and minimally traumatic treatment for every case of acute or chronic venous thrombosis.