Blood Clots and Vein Disease – What You Need to Know

By Dr. Scott Pennington, Varicosity Vein Center

Blood clots in veins are common, and the incidence is estimated to be as high as 600,000 cases per year in the United States alone. These clots form most commonly in the legs and can involve the deep larger veins, called deep vein thrombosis (DVT), or the more superficial veins, called superficial vein thrombosis (SVT). DVT is more dangerous and can be complicated by blood clots traveling up through the venous system to the lungs (PE or pulmonary embolism), a complication that can be fatal. SVT can usually be managed with local treatment; but DVT, once it occurs, requires treatment with blood thinners to dissolve the clots.

What are the Risk Factors for DVT and Pulmonary Embolism?

It has long been known that blood clots occur more frequently when certain conditions are met: slow blood flow or stasis, injury to the vein wall or valves, and hypercoagulable states. Some of these conditions are present in patients who have vein disease like Venous Insufficiency and Varicose Veins. Other associated risk factors are post-operative patients, obesity, pregnancy, use of birth control pills, presence of malignancy, age greater than 60, and prolonged immobilization.

Venous Insufficiency and Varicose Veins

Venous insufficiency most commonly occurs in the superficial veins of lower extremities and means that the veins cannot deliver the blood effectively back to the heart. This results in stasis, increased venous pressure, dilation, valve and vein wall injury, microscopic leaks and inflammation. You may experience multiple symptoms and signs in your legs, including heaviness, leg fatigue, deep pain, cramping, swelling, itching, skin discoloration and thickening, and visible dilated veins (varicose veins, reticular veins, and spider veins).

Varicose veins are dilated, bulging veins greater than 3 mm in diameter visible beneath the skin of lower extremities. When some or all of these clinical findings are present, then the diagnosis of venous insufficiency can be confirmed by noninvasive outpatient doppler ultrasound, and DVT can be excluded at the same examination.