Dr. Paxton Jones joins us today for an in-depth discussion on DVT and various treatment options.
My mother took a blood thinner her whole life for DVT. Is there anything else for treatment?
Blood thinners do not remove the clot in your vein but prevent more clot from forming while your body slowly dissolves the clot. Unfortunately, the clot can damage the vein before your body can dissolve it and lead to what is called post-thrombotic syndrome. There is a treatment for early clot removal called catheter directed thrombolysis/thrombectomy (CDT) or "clot busting" treatment. This treatment consists of placing a catheter directly into the vein and breaking the clot up with medication and other devices. This treatment offers the potential to prevent post-thrombotic syndrome and improve quality of life.
What different devices can you use for DVT treatment?
If you cannot tolerate blood thinners, then you may be eligible for an inferior vena cava filter (IVC filter). This device can be placed into a large vein in your abdomen through a small catheter from either a neck or groin vein. The IVC filter is designed to "catch" clot that breaks from from the legs and travels to the heart and lungs.
In addition, many different devices may be used for CDT treatment. These devices go by several brand names (Angiojet, Ekos, infusion catheters, etc) and all are designed to deliver clot-busting medication directly into the clot in the vein, break it up and eventually remove it from your body.
Does DVT treatment work?
Post-thrombotic syndrome can occur in up to 50% of patients on standard treatment of blood thinners. This syndrome is characterized by multiple symptoms including chronic leg pain, swelling, skin color changes and ulcer formation. Early clot removal with CDT treatment offers potential to prevent this syndrome and improve quality of life. There are multiple studies underway to ascertain how well CDT treatment works. However, anecdotal evidence from patients is promising and many of our patients have benefited from CDT treatment.
I've heard something about May-Thurner Syndrome. Can you tell me more about this?
May-Thurner Syndrome or iliac vein compression syndrome results from compression of the left common iliac vein by the overlying right common iliac artery. This compression can result in clot formation, typically within the left leg. The syndrome is more common in young women. Treatment for May-Thurner Syndrome is CDT treatment to remove any blood clots with stent placement to relieve the vein compression and prevent recurrence.
Do I still need to be on blood thinners after CDT treatment?
If CDT treatment is performed, you will still need to take blood thinners for at least 90 days. After 90 days, you may be able to stop the blood thinners. However, if you have an inherited clotting disorder (these diseases increase your chance of forming blood clots) you could require lifelong blood thinners.