Deep Vein Thrombosis

Deep vein thrombosis (DVT) occurs when your blood thickens in a clump that becomes solid, forming a clot. 

Nearly 300,000 first-time cases of DVT occur in the U.S. every year, usually in the leg.

Deep vein thrombosis (DVT) requires prompt attention

If you develop a clot and a piece of it breaks off, it could travel to one of your lungs and make breathing difficult, or even cause death.

Deep vein thrombosis (DVT) is medically treatable

Most commonly treated with blood thinners.

Duration

Can last from weeks to months.

How does a patient know they have a Deep vein thrombosis (DVT)?

DVT often occurs without any warning signs. There can be swelling, pain, redness or warmth along the vein that has the clot.

DVT forms when your blood flow becomes very slow.

Some specific cases of DVT include:

  • Inactivity, such as after a major operation or during a flight or a long car ride.
  • Damage to a vein can cause a clot to form - especially damage from a catheter, like those used in dialysis, or from a PICC line.
  • Cancer and certain other diseases and genetic conditions, called hypercoagulable states, that cause your blood to clot more easily.
  • Medications, especially hormones.

If a patient doesn’t have symptoms how is the DVT diagnosed?

All diagnoses begin with a history and physical exam. You will be asked questions about symptoms and medical history, including questions about family members.  Your vascular surgeon will also perform a physical exam.

The best test to confirm the diagnosis is a duplex scan in of the veins in the leg. This accurate, painless exam can visualize the blood clot and determine whether it is a recent event or happened some time ago. Occasionally a ct scan of the involved extremity is ordered to assess the cause of the patient symptoms.

Treatment strategies

Deep vein thrombosis (DVT) is usually treated with medication (anti coagulants). Blood thinners, also known as anticoagulants, are the most common medicines used for treating DVT.  They prevent blood clots from getting larger by decreasing your blood's ability to clot.  Over time, your body works with the blood thinners to decrease the size and consistency of the clot.  Blood thinners can be taken as a pill, as an injection or intravenously (through an IV).  Blood thinners can increase your chance of bleeding, so careful follow-up with your vascular surgeon is necessary.

Historically, anticoagulation therapy was initiated in the hospital setting but new medication advances have made allowed most DVTs to be treated from home with minimal interruption in patients’ lives. Typical duration of therapy is 3-6 months

Thrombolytic therapy is sometimes used to quickly dissolve a blood clot, especially if the clot is large and causing severe symptoms.  This treatment brings a much higher risk of bleeding than blood thinners, so it is not used unless truly necessary.

An adjunct to medical therapy is an IVC FILTER placed inside the inferior vena cava, one of the largest veins in the body.  The filter does not stop a blood clot from forming but can prevent a large clot from entering your lungs- a pulmonary embolism. Filters are placed when the medication is not working or there is an underlying reason why a patient cannot take a blood thinner

Content reprinted with permission from the Society for Vascular Surgery® (SVS).

 

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