Deep Vein Thrombosis (DVT)

Deep Vein Thrombosis (DVT)

Deep Vein Thrombosis (DVT) is a serious condition that results when a blood clot forms in a deep vein of the legs or occasionally, the arms or other veins.  If DVT is left untreated, the blood clot can break loose and move through the bloodstream to the lungs, blocking circulation (also known as pulmonary embolism, PE).  DVT and PE are two parts of a life-threatening and possibly fatal condition called venous thromboembolism (VTE).

Treatment for DVT is based on two main types of DVT: acute and chronic. 

Acute DVT:

Medication:  The standard of care for the treatment of acute DVT is blood thinning medication.  Blood thinning medications work by allowing blood to flow around a trapped clot while at the same time preventing clot from travelling to the lungs.  However, these medications do not remove the existing clot from the vein.  Blood thinning medications rely on the body’s natural defenses to “dissolve” the clot which can take several months and often results in the vein being permanently damaged. 

IVC filter: If blood-thinning medications are not recommended, a small filter may be implanted in the inferior vena cava (IVC), the large vein that returns blood back to the heart.  The filter, called an IVC filter, works by allowing blood to flow around a trapped clot while preventing the clot from traveling to the lungs.  

DVT thrombolysis:  For patients with symptomatic acute DVT and large clots, a minimally-invasive procedure known as DVT thrombolysis is commonly performed to rapidly reduce symptoms and remove the clot.

DVT thrombolysis involves inserting a small catheter into the leg using ultrasound and x-ray guidance. Clot-dissolving medications as well mechanical devices may be inserted into the catheter and used to remove or reduce the clot. This technique will often uncover one or more areas of narrowing of the vein that caused the blood clot to form. We can treat this with angioplasty (widening the vein), or by inserting a mesh-like tube called a stent to keep the vein open.

While there is a small risk of bleeding from the procedure, DVT thrombolysis can speed the recovery from DVT and help to minimize future scarring of the veins from DVT. This potentially reduces the chances of developing a severe condition called Post Thrombotic Syndrome (PTS).

DVT thrombolysis can often be done as an outpatient procedure or a one to two-night hospital stay depending on the age of the clot. Patients with the best outcomes are those who have had symptoms for 10 days or less as this is when the clot is "fresh". Those with symptoms ranging from 10-30 days also do well.

Chronic DVT and Post Thrombotic Syndrome (PTS)

Chronic DVT and PTS can develop in 40-60% of patients who have suffered an acute DVT.  Symptoms include redness, swelling, heaviness, itching, cramps, ulcers and chronic leg pain.  PTS can affect your mobility and prevent you from enjoying your daily activities. 

For patients who have developed post thrombotic syndrome due to chronic DVT, VIP physicians use advanced techniques to treat individuals who have had clots for months to years, or who continue to experience symptoms after medication or other therapies. Procedures mainly consist of angioplasty and use of stents to open blocked veins. Our expertise and advanced techniques can often significantly improve the quality of life for those affected by chronic DVT when previously no other treatment options were available.

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