Venous Thrombosis: Most Effective Dietary Supplements

Venous thrombosis is defined as the formation of a blood clot (thrombus) within the veins, partially or completely obstructing blood flow. It can affect both deep veins and superficial veins. Deep vein thrombosis is often located in the lower limbs, but can also occur elsewhere in the body, such as in cerebral or pelvic veins​.

Pathophysiology

The pathophysiology of thrombosis relies on Virchow's triad, which describes three main factors leading to thrombus formation: • Blood stagnation: Prolonged immobility, venous insufficiency, or varicose veins slow blood flow, promoting clot formation. • Parietal lesions: Vascular traumas, surgical interventions, or catheter use can damage the endothelial layer of veins, initiating the thrombotic process. • Hypercoagulability: Hereditary or acquired disorders, such as thrombophilia, increase the blood's tendency to clot.​

Classification of Venous Thrombosis

Venous thrombosis is mainly categorized into two types: • Deep Vein Thrombosis: Primarily affects the deep veins of the lower limbs, but can also involve upper limbs or abdominal and pelvic veins​. This condition presents with localized pain, swelling, redness, and warmth in the affected limb. In severe cases, it can lead to a pulmonary embolism, a serious complication resulting in chest pain, shortness of breath, or tachycardia. • Superficial Vein Thrombosis: Affects veins close to the skin surface, such as the saphenous vein in the legs, and is often associated with varicose veins​. Symptoms include swelling, redness, a palpable painful cord under the skin, and sometimes a slight fever. Although less severe than deep vein thrombosis, it requires appropriate management to prevent potential complications.

Etiologies

The causes of thrombosis are numerous: • Hereditary factors: Some people have a genetic predisposition to thrombophilia, increasing the risk of thrombosis. • Acquired factors: Prolonged immobility (travel, hospitalization), surgery, cancer, pregnancy, oral contraceptive use, or hormone replacement therapy are common causes​. • Traumas and infections: Vascular lesions resulting from trauma or infections can also lead to thrombus formation​.

Complications

The main complications of venous thrombosis are: • Pulmonary embolism: A portion of the thrombus can dislodge and migrate to the lungs, causing obstruction of the pulmonary arteries. • Recurrence: The risk of recurrence is high, especially in patients with persistent risk factors such as thrombophilia or cancer​. • Post-thrombotic syndrome: Untreated deep vein thrombosis can lead to long-term sequelae such as chronic pain, swelling, or venous ulcers​.

Treatment

Anticoagulants play a crucial role in preventing the extension of blood clots (thrombus) and complications such as pulmonary embolism. The main types of anticoagulants used include: • Low molecular weight heparins: These anticoagulants, administered by subcutaneous injection, are widely used in the acute phase to treat deep vein thrombosis and prevent pulmonary embolism. They are particularly recommended for patients with deep vein thrombosis or severe superficial vein thrombosis and at high risk of extension. • Fondaparinux: Fondaparinux, used at a prophylactic dose, has demonstrated great efficacy in reducing the risks of thromboembolic complications. • Vitamin K antagonists: Vitamin K antagonists, such as warfarin, are less used in the acute phase but may be prescribed long-term for the prevention of recurrences. Their use requires regular monitoring of the international normalized ratio (INR) to adjust the dose. • Direct oral anticoagulants: Direct oral anticoagulants, such as rivaroxaban and apixaban, are gaining popularity as they do not require as strict biological monitoring as vitamin K antagonists. They are effective for treating deep vein thrombosis and preventing thromboembolic recurrences. • Elastic compression: The prescription of compression stockings (class 2 or 3) remains a recommended approach for patients with deep vein thrombosis or severe superficial vein thrombosis. These stockings help prevent the occurrence of complications such as post-thrombotic syndrome by reducing swelling and improving venous return. • Thrombolysis: In severe cases, particularly during massive deep vein thrombosis or life-threatening pulmonary embolism, thrombolysis may be used. This technique involves administering thrombolytic agents to dissolve the clot, but it is reserved for the most severe cases due to the high risk of bleeding. • Surgery and mechanical interventions: In cases of massive thrombosis, surgical intervention or mechanical thrombectomy may be considered. This option is generally reserved for situations where anticoagulant treatments prove ineffective or contraindicated.

Prevention of Thrombosis

Thrombosis prevention can benefit from the contribution of plants, combined with an adapted lifestyle. Venotonic plants like the red vine, horse chestnut, and butcher's broom strengthen venous walls and promote better venous return. The witch hazel and sweet clover help reduce swelling and relieve the heavy legs sensation. In addition, the OPCs, extracted from grape seeds, act as powerful antioxidants that protect blood vessels against oxidative damage.