Venous Thromboembolism
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Venous Thromboembolism
Venous thrombosis is the blockage of a vein caused by a thrombus (blood clot). A common form of venous thrombosis is deep vein thrombosis (DVT), when a blood clot forms in the deep veins. If a thrombus breaks off ( embolizes) and flows to the lungs to lodge there, it becomes a pulmonary embolism (PE), a blood clot in the lungs. The conditions of DVT only, DVT with PE, and PE only, are all captured by the term venous thromboembolism (VTE). The initial treatment for VTE is typically either low-molecular-weight heparin (LMWH) or unfractionated heparin, or increasingly with direct acting oral anticoagulants (DOAC). Those initially treated with heparins can be switched to other anticoagulants (warfarin, DOACs), although pregnant women and some people with cancer receive ongoing heparin treatment. Superficial venous thrombosis or phlebitis affects the superficial veins of the upper or lower extremity and only require anticoagulation in specific situations, and may be treated with an ...
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Vein
Veins () are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal circulations which carry oxygenated blood to the heart. In the systemic circulation, arteries carry oxygenated blood away from the heart, and veins return deoxygenated blood to the heart, in the deep veins. There are three sizes of veins: large, medium, and small. Smaller veins are called venules, and the smallest the post-capillary venules are microscopic that make up the veins of the microcirculation. Veins are often closer to the skin than arteries. Veins have less smooth muscle and connective tissue and wider internal diameters than arteries. Because of their thinner walls and wider lumens they are able to expand and hold more blood. This greater capacity gives them the term of ''capacitance vessels''. At any time, nearly 70% o ...
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Great Saphenous Vein
The great saphenous vein (GSV; ) or long saphenous vein is a large, subcutaneous, superficial vein of the human leg, leg. It is the longest vein in the body, running along the length of the lower limb, returning blood from the foot, human leg, leg, and thigh to the deep femoral vein at the femoral triangle. Structure The great saphenous vein originates from where the dorsal vein of the Toe#Hallux, big toe (the hallux) merges with the dorsal venous arch of the foot. After passing in front of the medial malleolus (where it often can be visualized and Palpation, palpated), it runs up the medial (anatomy), medial side of the leg. At the knee, it runs over the posterior border of the medial epicondyle of the femur bone. In the proximal anterior thigh inferolateral to the pubic tubercle, the great saphenous vein dives down deep through the cribriform fascia of the saphenous opening to join the femoral vein. It forms an arch, the saphenous arch, to join the common femoral vein in the re ...
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Hepatic Vein
In human anatomy, the hepatic veins are the veins that drain venous blood from the liver into the inferior vena cava (as opposed to the hepatic portal vein which conveys blood from the gastrointestinal organs to the liver). There are usually three large upper hepatic veins draining from the left, middle, and right parts of the liver, as well as a number (6-20) of lower hepatic veins. All hepatic veins are valveless. Structure All the hepatic veins drain into the inferior vena cava. The hepatic veins are divided into an upper and a lower group. Upper group The upper group consists of three hepatic veins - the right, middle, and left hepatic veins - draining the central veins from the right, middle, and left regions of the liver and are larger than the lower group of veins. The veins of the upper group drain into the suprahepatic part of the inferior vena cava (i.e. part superior to the liver). Right hepatic vein The right hepatic vein is the longest and largest of all the he ...
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Subclavian Vein
The subclavian vein is a paired large vein, one on either side of the body, that is responsible for draining blood from the upper extremities, allowing this blood to return to the heart. The left subclavian vein plays a key role in the absorption of lipids, by allowing products that have been carried by lymph in the thoracic duct to enter the bloodstream. The diameter of the subclavian veins is approximately 1–2 cm, depending on the individual. Structure Each subclavian vein is a continuation of the axillary vein and runs from the outer border of the first rib to the medial border of anterior scalene muscle. From here it joins with the internal jugular vein to form the brachiocephalic vein (also known as "innominate vein"). The angle of union is termed the venous angle. The subclavian vein follows the subclavian artery and is separated from the subclavian artery by the insertion of anterior scalene. Thus, the subclavian vein lies anterior to the anterior scalene while ...
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Axillary Vein
In human anatomy, the axillary vein is a large blood vessel that conveys blood from the lateral aspect of the thorax, axilla (armpit) and upper limb toward the heart. There is one axillary vein on each side of the body. Structure Its origin is at the lower margin of the teres major muscle and a continuation of the brachial vein. This large vein is formed by the brachial vein and the basilic vein. At its terminal part, it is also joined by the cephalic vein. Other tributaries include the subscapular vein, circumflex humeral vein, lateral thoracic vein and thoraco-acromial vein. It terminates at the lateral margin of the first rib, at which it becomes the subclavian vein. It is accompanied along its course by a similarly named artery, the axillary artery In human anatomy, the axillary artery is a large blood vessel that conveys oxygenated blood to the lateral aspect of the thorax, the axilla (armpit) and the upper limb. Its origin is at the lateral margin of the fi ...
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Paget–Schroetter Disease
Paget–Schroetter disease (which evolved from a venous thoracic outlet syndrome) is a form of upper extremity deep vein thrombosis (DVT), a medical condition in which blood clots form in the deep veins of the arms. These DVTs typically occur in the axillary and/or subclavian veins. Signs and symptoms The condition is relatively rare. It usually presents in young and otherwise healthy patients, and also occurs more often in males than females. The syndrome also became known as "effort-induced thrombosis" in the 1960s, as it has been reported to occur after vigorous activity, though it can also occur due to anatomic abnormality such as clavicle impingement or spontaneously. It may develop as a sequela of thoracic outlet syndrome. It is differentiated from secondary causes of upper extremity thrombosis caused by intravascular catheters. Paget–Schroetter syndrome was described once for a viola player who suddenly increased practice time 10-fold, creating enough repetitive pressu ...
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Branch Retinal Vein Occlusion
Branch retinal vein occlusion is a common retinal vascular disease of the elderly. It is caused by the occlusion of one of the branches of central retinal vein. Signs and symptoms Patients with branch retinal vein occlusion usually have a sudden onset of blurred vision or a central visual field defect. The eye examination findings of acute branch retinal vein occlusion include superficial hemorrhages, retinal edema, and often cotton-wool spots in a sector of retina drained by the affected vein. The obstructed vein is dilated and tortuous. The quadrant most commonly affected is the superotemporal (63%). Retinal neovascularization occurs in 20% of cases within the first 6–12 months of occlusion and depends on the area of retinal nonperfusion. Neovascularization is more likely to occur if more than five disc diameters of nonperfusion are present and vitreous hemorrhage can ensue. Causes Diagnosis The diagnosis of branch retinal vein occlusion is made clinically by finding r ...
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Central Retinal Vein Occlusion
Central retinal vein occlusion, also CRVO, is when the central retinal vein becomes occluded, usually through thrombosis. The central retinal vein is the venous equivalent of the central retinal artery and both may become occluded. Since the central retinal artery and vein are the sole source of blood supply and drainage for the retina, such occlusion can lead to severe damage to the retina and blindness, due to ischemia (restriction in blood supply) and edema (swelling). CRVO can cause ocular ischemic syndrome. Nonischemic CRVO is the milder form of the disease. It may progress to the more severe ischemic type. CRVO can also cause glaucoma. Diagnosis Despite the role of thrombosis in the development of CRVO, a systematic review found no increased prevalence of thrombophilia (an inherent propensity to thrombosis) in patients with retinal vascular occlusion. Treatment Treatment consists of Anti-VEGF drugs like Lucentis or intravitreal steroid implant (Ozurdex) and Pan-Retinal L ...
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Cavernous Sinus Thrombosis
Cavernous sinus thrombosis (CST) is the formation of a blood clot within the cavernous sinus, a cavity at the base of the brain which drains deoxygenated blood from the brain back to the heart. This is a rare disorder and can be of two types–septic cavernous thrombosis and aseptic cavernous thrombosis. The most common form is septic cavernous sinus thrombosis. The cause is usually from a spreading infection in the nose, sinuses, ears, or teeth. ''Staphylococcus aureus'' and ''Streptococcus'' are often the associated bacteria. Cavernous sinus thrombosis symptoms include: decrease or loss of vision, chemosis, exophthalmos (bulging eyes), headaches, and paralysis of the cranial nerves which course through the cavernous sinus. This infection is life-threatening and requires immediate treatment, which usually includes antibiotics and sometimes surgical drainage. Aseptic cavernous sinus thrombosis is usually associated with trauma, dehydration, anemia, and other disorders. Signs and ...
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Cerebral Venous Sinus Thrombosis
Cerebral venous sinus thrombosis (CVST), cerebral venous and sinus thrombosis or cerebral venous thrombosis (CVT), is the presence of a blood clot in the dural venous sinuses (which drain blood from the brain), the cerebral veins, or both. Symptoms may include severe headache, visual symptoms, any of the symptoms of stroke such as weakness of the face and limbs on one side of the body, and seizures, which occur in around 40% of patients. The diagnosis is usually by computed tomography (CT scan) or magnetic resonance imaging (MRI) to demonstrate obstruction of the venous sinuses. After confirmation of the diagnosis, investigations may be performed to determine the underlying cause, especially if one is not readily apparent. Treatment is typically with anticoagulants (medications that suppress blood clotting) such as low molecular weight heparin. Rarely, thrombolysis (enzymatic destruction of the blood clot) or mechanical thrombectomy is used, although evidence for this t ...
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Embolus
An embolus (; : emboli; from the Greek ἔμβολος "wedge", "plug") is an unattached mass that travels through the circulatory system, bloodstream and is capable of creating blockages. When an embolus Vascular occlusion, occludes a blood vessel, it is called an embolism or embolic event. There are a number of different types of emboli, including blood clots, cholesterol plaque or crystals, Fat embolism syndrome, fat globules, Air embolism, gas bubbles, and foreign body, foreign bodies, which can result in different types of embolisms. The term is distinct from embolism and thromboembolism, which may be consequences of an embolus, as discussed below. The term was coined in 1848 by Rudolf Virchow as part of his foundational research into Thrombus, blood clots. Nomenclature The term embolus refers generally to any free-floating mass in the bloodstream, or such a mass once lodged at a site of blockage. A related term is embolism, which describes the phenomenon of an embolus lo ...
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