Venous thromboses: the 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 deep veins or superficial veins. Deep vein thrombosis is often located in the lower limbs, but can also occur elsewhere in the body, such as in the cerebral or pelvic veins.

Pathophysiology

The pathophysiology of thrombosis is based on Virchow's triad, which describes three main factors leading to thrombus formation: • Venous stasis: Prolonged immobility, venous insufficiency, or varicose veins cause a slowing of blood flow, promoting clot formation. • Vessel wall injury: Vascular trauma, surgical procedures, or the use of catheters can damage the endothelium of the veins, initiating the thrombotic process. • Hypercoagulability: Hereditary or acquired disorders, such as thrombophilia, increase the tendency of the blood to clot.

Classification of venous thromboses

Venous thromboses are mainly classified into two categories: • Deep vein thrombosis: Primarily affects the deep veins of the lower limbs, but can also involve the upper limbs or the abdominal and pelvic veins. This condition presents with localized pain, swelling, redness and a feeling of warmth in the affected limb. In severe cases, it can lead to a pulmonary embolism, a serious complication manifesting as chest pain, dyspnea or tachycardia. • Superficial venous thrombosis: affects veins close to the skin surface, such as the saphenous vein in the legs, and is often associated with varicose veins. Its symptoms include swelling, redness, the presence of a painful cord palpable under the skin and sometimes a low-grade fever. Although less serious than deep vein thrombosis, it requires appropriate management to prevent potential complications.

Causes

The causes of thromboses are multiple: • Hereditary factors: Some people have a genetic predisposition to thrombophilia, increasing the risk of thrombosis. • Acquired factors: Prolonged immobility (travel, hospitalization), surgery, cancers, pregnancy, the use of oral contraceptives or hormone replacement therapy are common causes. • Trauma and infections: Vascular injuries following trauma or infections can also lead to thrombus formation.

Complications

The main complications of venous thromboses are: • Pulmonary embolism: Part of the thrombus can detach 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, edema 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 venous thrombosis at high risk of extension. • Fondaparinux: Fondaparinux, used at prophylactic doses, has demonstrated high efficacy in reducing the risk 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 to prevent 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 because they do not require as strict biological monitoring as vitamin K antagonists. They are effective in 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 superficial venous thrombosis. These stockings help prevent complications such as post-thrombotic syndrome by reducing edema and improving venous return. • Thrombolysis: In severe cases, particularly in massive deep vein thrombosis or life-threatening pulmonary embolism, thrombolysis may be used. This technique consists of 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 are ineffective or contraindicated.

Prevention of thrombosis

Prevention of thrombosis can benefit from the use of plants, combined with an appropriate lifestyle. Venotonic plants such as red vine, horse chestnut and butcher's broom strengthen the vein walls and promote better venous return. Witch hazel and melilot help reduce edema and relieve sensations of heavy legs. In addition, OPCs, grape seed extracts, act as powerful antioxidants that protect blood vessels against oxidative damage.