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.
Causes of Deep Vein Thrombosis (DVT)
Deep vein thrombosis (DVT) occurs when a blood clot forms in a vein deep inside a muscle in your body. It usually happens in the legs, but can also develop in your arms, chest, or other areas of your body. And though DVT is common, it can be dangerous. The blood clot can block your circulation or lodge in a blood vessel in your lungs, brain, heart, or other area. The clot can cause severe organ damage and even death -- within hours. The main cause of DVT is poor blood flow. When circulation...
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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 other 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 two main types of anticoagulants are heparin and warfarin (Coumadin).
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: Traditionally, people have received heparin intravenously in the hospital for about five to seven days. However, low-molecular-weight heparin is a new DVT treatment. It's effective within hours, reducing complications and hospitalizations. You can do the injections at home, once or twice daily, on an outpatient basis. And because it is more consistent and predictable, it doesn't require regular blood tests.
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. 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. If you can't take warfarin as a DVT treatment, an anticoagulant called a thrombin inhibitor may be an option. Or your doctor may recommend taking low-molecular-weight heparin for a longer period.
DVT and Catheter-Directed Thrombolysis
If you have DVT, your body will dissolve a blood clot over time, but damage can occur inside your vein in the meantime. For this reason, your doctor may 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.
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