Etiology of the lesion
The thrombosis of the femoral vein is one of the deep vein thromboses that make up the major grounds that result in cardiovascular deaths. The incidences of deaths resulting from the femoral thrombosis have increased in the recent years and are prevalent among the middle-age population (Manly 517). The average age of most of the patients diagnosed with femoral vein thrombosis ranges between 43-48 years. The average deaths caused by the femoral thrombosis ranges between three thousand and three hundred and fifty thousand worldwide. As a result, there is increasing concerns to increase the life expectancy as well as strategies for prevention and treatment.
Like any other Deep vein thrombosis, femoral thrombosis is caused by endothelial disruptions. Endothelial disruptions are internal mechanisms that are taking place without any injuries to the vein. There are activities that are associated with increased risk of developing femoral thrombosis including immobilization, persistent venous deficiency and pregnancy. These body mechanisms prevent the normal venous blood flow (Heit 371).
Macroscopic and microscopic findings
An evaluation of venous thrombi in a controlled study using specimen creatures after a definite time clearly indicate the macroscopic differences between sections with red together with white thrombus. Using the van Gieson (Vg) to stain the specimen, it can easily be identified through microscopic scanning the femoral thrombin. Van Gieson (Vg) stain makes it easier to identify white as well as red film with rich erythrocyte (Manly 517).
However, the stain must be given some time approximately 48 hours to attain the results. After 48-hour initiation of DVT, it can clearly be observed that there is a clear difference in the segments portraying red as well as white thrombus blot. Further, to exhibit the coatings resulting from the cells responsible for the defense mechanism of the body as well as the fluid content of the body together with the fibrin, carstairs staining (CS) is applied on the specimen. In addition, to have microscopic observations the circulation of platelets in groups, a DAPI staining is applied (Heit 370).
The microscopic and macroscopic experiments indicate that there is a correlation between the venous inflammation and femoral malfunctions. However, there exist no precise functions of the immune cells in the development of femoral thrombosis. In addition, the results from the experiments indicate that the major constitution of the cells within the femoral inflammation is mainly leukocytes. The leukocytes are distributed in layers crowded together contiguous to the integral endothelium. Further, neutrophils, which is a subdivision of leukocytes is predominantly present in the venous thrombi. Monocytes were also found to be occupying the remaining part. Another critical observation is that there is an implicit absence of lymphocytes.
Symptoms, signs, and laboratory findings caused by the lesion
The signs and symptoms that are associated with femoral thrombosis are numerous. The most specific being the situation characterized by the swelling of hands, legs as well as ankles. The sign is as result of unusual accretion of interstitial fluids that are retained in the tissues. The situation is referred to as edema (Mackman 916). The symptom is common to a large number of patients likely to show characteristics of femoral thrombosis. In addition, the patients also experience pulmonary embolism characterized by impasse through lung arteries. As a result, blood clots occur in the patient legs. Further, a number of affected patients experience pains around the area affected by thrombosis.
Moreover, there is an experience of warmth accompanied by rashes and the change of skin color to reddish due to clogging of the blood passages over the areas of femoral vein. In addition, there is a feeling of softness of the skin that is being experienced by over three quarters of the patients with femoral thrombosis (Heit 370). Additionally, physical findings comprise pain experienced on the bent foot as well as tender subcutaneous capillaries sections. Further, the retention of accumulated interstitial fluids in the body tissues causes pale looks on the leg. The patients also experience inconsistent staining of their lower edges.
Treatment and prognosis
The development of suggestions by the physicians in trying to treat the potential patients showing signs of femoral thrombosis comprise the application of legitimate regulations used in clinical forecasts (Mackman 916). For instance, the application of Wells enable the physicians in coming up with precise explanations from the results achieved in pretesting the probability venous thromboembolism. Additionally, the selecting patients with low pre-examination likelihood of femoral thrombi are critical in obtaining high sensitive D-dimer. Further, the application of ultrasonography is very significant for patients with high pretest likelihood as far as femoral thrombi are concerned.
Moreover, studies based on image diagnostics such as pulmonary angiography and ventilation-perfusion scan play a very significant role in the treatment and diagnosis of femoral thrombosis (Mackman 916). In addition, the application of multi-detector helical CT is a necessary requirement in the diagnosis of femoral thrombosis. Further, in the treatment of femoral thrombosis, laboratory experiments have advanced a number of tests such as D-dimer test. In addition, in order to assess the hypercoagulable conditions of stimulated fractional thromboplastin period together with the original time of prothrombin, coagulation experiments have been undertaken.
Several alternatives have been developed for the healing of the femoral thrombosis including the application of pharmacologic thrombolysis as well as surgical and endovascular intercessions. Moreover, physical actions including ambulation are very vital in the treatment of femoral thrombosis. In addition, the use of flexible compression stockings is also a vital option in treating femoral thrombosis. Further, treatment of thrombosis is also possible with anticoagulants such as heparins that produce unfractionated heparin as well as low-molecular weight heparin. In addition, factor Xa inhibitors that include rivaroxaban and fondaparinux are very essential in the reduction of bleeding.
In a bid to reduce the probability of thrombosis intermittent as well as diminish the harshness together with the period of lower extremity signs, a great emphasis is put on executing endovascular psychoanalysis, which is very essential (Esmon 226). As such, percutaneous transcatheter treatments that include mechanical thrombectomy, angioplasty as well as venous barrier stenting are fundamental. In addition, catheter-directed thrombolysis that gets rid of thrombus especially for patients suffering from huge iliofemoral vein thrombosis is a vital treatment mechanism of femoral thrombosis. Further, interior vena cava filter is also vital in treatment of femoral thrombosis.
Relevance to dental practice
Oral health cannot be separated from the general well being of the individuals. There are connections between the oral and other systematic diseases. Therefore, understanding the systematic diseases helps in the conceptualization of the dental care (Patton 520). In particular, understanding the treatment, signs and symptoms as well as other processes involved in femoral thrombosis are critical in the understanding of how some dental diseases could be treated. The processes in the treatment of femoral thrombosis such as surgery are also used in the treatment of some dental diseases. Therefore, understanding the processes involved in the treatment of femoral thrombosis is helpful in the dental care.
Works Cited
Esmon, Charles. “Basic mechanisms and pathogenesis of venous thrombosis.” Blood Review, 23.4 (2009): 225–229. Print.
Heit, John. “The epidemiology of venous thromboembolism in the community.” Journal of Arteriosclerosis Thrombosis and Vascular Biology, 28.6 (2008): 370–372. Print.
Mackman, Nigel. “Triggers, targets and treatments for thrombosis.” Journal of Natural Medicine, 451.11 (2008): 914–918. Print.
Manly, David. “Role of tissue factor in venous thrombosis.” Annual Review of Physiology, 73.16 (2011): 515–525. Print.
Patton, Lauren. “The Complexity of the Periodontal Disease – Atherosclerotic Vascular Disease Relationship and Opportunities for Inter-professional Collaboration.” Journal of Medical Research, 16.2 (2012): 519-556. Print.