Blood clots are a serious complication that surgery patients can experience during and after the procedure. While a blood clot that forms in the leg is a serious condition, blood clots can quickly become life-threatening conditions if they move to the brain (embolic/ischemic stroke) or the lungs (pulmonary embolism). These complications are very serious and must be treated quickly to minimize the damage caused to the body or the brain.
What Causes Blood Clots After Surgery?
A blood clot is more likely to form during or after surgery than it is during your routine day to day life. There are multiple reasons for this, but one major cause is lying still on the operating table for an extended period of time. This inactivity makes it easier for blood to clot, because you aren't moving blood through your body as quickly or as forcefully as you typically during your procedure.
Some people are inactive after their surgery because they are in pain, very sick, or unable to walk. For these patients, the risk of clot formation is increased after the procedure has finished as well as during surgery because they continue to be inactive.
The type of surgery you are having can also increase the risk of having blood clots after the procedure. If your surgery requires your arteries or veins to be cut or repaired, the risk of a blood clot is higher because your body works to stop bleeding by forming clots. If you are having a surgery where your heart is stopped, typically a heart bypass surgery (CABG), your risk of a blood clot is also increased.
Your own personal medical and social history may also contribute to clot formation after surgery. For example, if you are a smoker you are at higher risk for the formation of blood clots than the average individual, even without having surgery.
Risk Factors For Blood Clots After Surgery
- Atrial Fibrillation: patients with an irregular heart beat have an increased risk of forming blood clots.
- Pregnancy: the chance of blood clots increase as the body makes blood clot faster in preparation for child birth.
- Cancer: some types of cancer make blood clot more easily.
- History of Blood Clots: if you have had a blood clot in the past your are more likely to have one in the future.
- Hormone Replacement Therapy (HRT): one known side effect of HRT is the increased risk of forming blood clots.
- Prolonged Immobility: this includes the time spent under anesthesia and time recovering if you are unable to walk and return to some normal activities.
- Heart Valve Issues: people with replacement heart valves or heart valve problems have a higher risk of forming clots that can then travel to the lungs or brain.
- Dehydration: water is a large component of blood and when there isn't enough the blood can clot more easily. Drinking adequate water after surgery can help prevent clots from forming.
- Genetics: If your immediate family is prone to forming clots, you may be as well.
Preventing Blood Clots After SurgeryGetting up and moving during your recovery from surgery is one of the best ways to prevent blood clots. Staying well hydrated by drinking ample amounts of water can also reduce your risk of forming clots. You should also know the signs and symptoms of a blood clot.
In addition to these simple measures, your doctor may also prescribe medication to prevent clots from forming.
Treatments For Blood Clots
The treatment for blood clots depends on the location of the blood clot. As always, prevention is better than treatment. For that reason, many people who have surgery are given heparin, a medication that is given by injection to prevent the formation of clots.
If a clot does form, there are treatments that can be done. Coumadin, or the generic warfarin, is given to help the body remove a clot from the bloodstream. Heparin may also be given to prevent additional clots from forming or to prevent clots from growing in size.
A clot that travels to the blood vessels that feed the brain can cause an ischemic stroke, also known as an embolic stroke. This type of stroke causes damage by depriving the tissue fed by the blocked blood vessel of oxygen.
This type of stroke is treated by a medication called TPA that helps dissolve the blood clot. If TPA cannot be used or is not effective, doctors may choose to attempt to remove the clot surgically. This procedure is done by threading a tiny instrument into the blood stream through a tiny incision in the groin. The device is slowly moved though the blood vessels of the body until the clot is reached in the brain, where it can be gently removed and withdrawn from the body through the groin incision. Once the clot is removed, blood can again flow to the tissues of the brain deprived of oxygen, and the patient may recover some of the function of that area of the brain.
Clots that form in the legs are called deep vein thrombosis (DVT) and are the most common type of blood clot after surgery. They typically remain in the legs, but can break free and begin to move through the blood stream. Clots can move from the legs to the lungs and cause a life-threatening condition called a pulmonary embolism. While a pulmonary embolism can be treated, there is a high mortality rate associated with this type of blood clot.
Typically, clots in the legs are treated with medication, but in cases where there is a high risk of the clot moving to the lungs, a device called an inferior vena cava filter (or Greenfield Filter) may be placed. This device acts as a tiny basket, catching clots before they can lodge in the lungs and cause damage. These filters are placed through a small incision in the groin or neck, through which the filter is threaded into place in the inferior vena cava. The filter may be placed temporarily or permanently.
Blood Clot Treatment--Stop the Clot. National Blood Clot Alliance. Accessed June, 2013. http://www.stoptheclot.org/learn_more/blood_clot_treatment.htm