Treatment for Deep Vein Thrombosis (DVT)
Treatment for deep vein thrombosis (DVT) -- a blood clot deep in a vein -- ranges from medication to self-care to surgery. Discuss treatment options with your doctor.
Goals of Treatment for DVT
There is more than one goal of treatment for deep vein thrombosis (DVT). The goals include:
- Preventing a clot from growing
- Preventing a clot from breaking off and traveling to the lung or another organ
- Avoiding long-lasting complications, such as leg pain and swelling
- Preventing blood clots from recurring
Blood Thinners for DVT
Blood thinners (also called anticoagulants) are the most common type of treatment for DVT. The three main types of anticoagulants used to treat DVT’s are heparin, warfarin (Coumadin), and rivaroxaban (Xarelto).
Blood thinners can:
- Keep a clot from growing or breaking off
- Prevent new clots from forming
But blood thinners cannot:
- Thin blood, despite their name
- Dissolve an existing clot
Heparin: People with DVT may receive heparin intravenously or by injection in the hospital for several days. You may also continue the injections at home, once or twice daily. Intravenous heparin requires blood testing, but subcutaneous (under the skin) injections of low molecular weight heparin do not.
Warfarin: As a DVT treatment, you take warfarin (Coumadin) by pill once a day, beginning while you're still on heparin. Treatment may continue for three to six months or more. While on warfarin, you will need regular blood tests to ensure you have the correct dosage -- too little increases your clot risk, too much increases your risk for bleeding. Warfarin can also interact with other medicines, vitamins, or certain foods rich in vitamin K -- making regular monitoring even more important. If you're pregnant, your doctor will prescribe other types of treatment, because warfarin can cause birth defects.
Unlike warfarin, Xarelto does not require monitoring with blood tests. It's also less likely than warfarin to cause serious bleeding. You also do not need to worry about interactions with foods with Xarelto. The downside is that it's much more expensive than warfarin.
DVT and Catheter-Directed Thrombolysis
If you have DVT, your body will dissolve the blood clot over time, but damage can occur inside your vein in the meantime. For this reason, your doctor may, in rare situations, recommend a clot-busting drug called a thrombolytic agent.
This DVT treatment may be necessary:
- For larger clots
- If you're at high risk for pulmonary embolism
- If you have DVT in an arm, instead of a leg
Catheter-directed thrombolysis rapidly breaks up a clot, restoring blood flow. It may also preserve valve function in the vein that contained the clot. The procedure is done in the hospital and carries a higher risk of bleeding problems and stroke than does anticoagulant therapy.
This is how a catheter-directed thrombolysis is done to treat DVT:
With imaging guidance, an interventional radiologist inserts a thin tube (catheter) into and through a vein in your leg. The radiologist then puts the tip of the catheter into the clot and infuses a clot-busting drug directly into it. If the vein appears narrowed, the radiologist may do a balloon angioplasty or stent placement to widen it and help prevent future blockages.