Deep Vein Thrombosis and Treatment
Deep vein thrombosis (DVT) is a condition in which a blood clot forms in a deep vein in the body. DVT is a medical emergency and demands immediate treatment. The blood clot can partially or totally block blood flow in the vein. DVT most commonly occurs in the leg veins. The blood clot can break off and travel to the lungs, resulting in a pulmonary embolus which can be life-threatening. DVT can also damage the valves in the veins, causing blood to flow backward and pool in the legs. This results in increased pressure in the veins. This is known as chronic venous insufficiency or the post-phlebitic syndrome.
- Age 65 or older
- History of heart attack, stroke, congestive heart failure, or previous blood clot
- Immobilization (examples: prolonged travel in airplane, prolonged bed rest, leg paralysis, recent surgery)
- Inflammatory bowel disease
- Inherited blood clotting abnormalities or family history of blood clots
- Pregnancy, taking birth control pills or estrogen replacement therapy
- Varicose veins
The location and size of the DVT can determine the type of symptoms that may occur. About half of people who have a DVT do not have any symptoms. Symptoms may include:
- New swelling in one leg or arm
- Pain or tenderness in leg or arm
- Redness or discoloration of leg or arm
- Shortness of breath (with pulmonary embolus, a blood clot that travels to the lung)
- Warm area on leg or arm
Anticoagulation: A medication called an anticoagulant, also known as a blood thinner, is used to treat deep vein thrombosis. An anticoagulant prevents an existing blood clot from getting larger and the formation of new blood clots. They do not dissolve a blood clot that is already formed; however, the body will absorb the clot over time. Initially, treatment may include two anticoagulants at the same time (one administered intravenously or injected into the skin and one taken by mouth). Eventually, only one anticoagulant will be taken by mouth, after the oral medication becomes effective by itself. Depending on the type of anticoagulant, a blood test, called the International Normalized Ratio (INR), may be necessary to determine the proper dose of the anticoagulant.Your primary doctor will determine the dose of the medication, how often to have your INR checked if necessary and how long you will take this medication. Anticoagulants can cause side effects; bleeding is the most common side effect. It is important to discuss these side effects with your doctor or pharmacist.
Thrombolytic therapy: In certain situations, a thrombolytic medication may be used to dissolve the blood clot. This medication is injected through a catheter into the veins.
Other treatment may include:
- Compression bandages or stockings to assist blood flow back to the heart
- Your doctor will provide a prescription for compression stockings
- Elevation of leg or arm above the level of the heart
Thrombectomy: Open surgery is rarely performed to treat a blood clot. However, in severe cases, a thrombectomy may be performed to remove the blood clot from a vein.
Vena Cava Filter: When a blood thinner cannot be used or does not adequately treat a DVT, a filter may be placed in the vena cava (the large vein in the abdomen) to trap blood clots and prevent them from traveling to the lungs. The filter is inserted through a catheter placed into a leg, arm or neck vein.
Deep Vein Thrombosis Prevention
Blood thinners or intermittent compression stockings and pumps are used in high-risk patients or patients undergoing high-risk surgical procedures to prevent a blood clot. Ask your doctor about these measures if you are undergoing surgery.
When to Call the Doctor
Call the doctor if there is sudden onset of swelling of the leg or arm. Get immediate medical attention (Call 911) if you experience the following symptoms which may indicate a pulmonary embolus:
- Chest pain or discomfort
- Cough, with or without blood
- Low grade fever
- Rapid heart rate
- Shortness of breath
Ongoing clinical research trials at the Center for Vascular Disease are investigating new treatment options for venous disease to ensure that our patients continue to receive the most innovative care in the country. For more information regarding these clinical trials, please view the Clinical Trials Unit of Northwestern, send an e-mail or call 312-926-4000.
For more information regarding deep vein thrombosis and the treatments available, please contact the Bluhm Cardiovascular Institute at 1-866-662-8467. To schedule an appointment, please call 312-695-4965 or request a first time appointment online.