Deep Vein Thrombosis (Blood Clot in the Leg, DVT)
Deep Vein Thrombosis Treatment continued...
Sometimes the doctor will inject clot-dissolving drugs called thombolytics. This has a higher chance of complications than using blood-thinning drugs and is usually reserved for life-threatening conditions.
Not all DVTs require blood thinners. Because small clots located in veins below the knee have a low risk of traveling to the lung, people with them may only be watched by the doctor. Using ultrasound tests of the veins, the clot can be monitored to see whether it is growing.
If the patient can’t use anticoagulants, or has recurrent blood clots even while on them, the doctor may place a filter in the blood vessel called the vena cava. The filter catches new clots before they can travel to the lungs but does not keep new clots from forming.
Compression stockings are useful in preventing a complication of a leg blood clot called postthrombotic syndrome or postphlebitis syndrome in which the leg swells and becomes painful. These stockings may be bought over-the-counter or can be custom fitted. Your doctor can tell you how long to wear them.
A person who has had a deep vein thrombosis may need follow-up Doppler ultrasounds or other tests if the leg swelling persists or if the symptoms come back. During anticoagulant treatment, it is often advised to take the following measures:
- Take the prescribed amount of medication. Do not miss or add doses.
- Follow the doctor's instructions closely about when to get lab tests for blood coagulation.
- Ask the doctor before starting or stopping any medication, including over-the-counter medications. Many medicines increase or otherwise interfere with the effect of anticoagulants.
- Ask what foods should be monitired because some foods may change the effectiveness of blood-thinning drugs.
- Wear a Medic-alert bracelet with information about any anticoagulants that you are taking.
- Inform any other medical professionals including dentists or podiatrists that you are taking an anticoagulant before undergoing any procedure.
The key to prevention is to reverse any risk factors, for example:
- If a person is obese, lose weight.
- Avoid periods of prolonged immobility.
- Keep the legs elevated while sitting down or in bed.
- Avoid high-dose estrogen pills, unless they are deemed necessary by your doctor.
If you have had surgery recently, preventive treatment may be prescribed to avoid formation of a clot.
- You may be instructed to get out of bed several times a day during the recovery period.
- Sequential compression devices (SCDs) may be placed on the legs. Their squeezing action has been shown to reduce the probability of clot formation. You also may be given elastic stockings to wear.
- Treatments such as low-molecular-weight heparin or low-dose warfarin may be prescribed to prevent clot formation.
Many DVTs will get better without further problems. Some people will develop a condition called post-phlebitic syndrome that involves continued swelling and pain.
If a person has had one deep vein thrombosis, they are more likely than the average person to have another deep vein thrombosis. One third of all people who have DVT will have another one within 10 years.