What will treating DVT, a blood clot deep in a vein, do for you?
- It will prevent the clot from growing.
- It'll keep the clot from breaking off and traveling to your lung or another organ.
- You'll avoid long-lasting complications, such as leg pain and swelling.
- Treatment prevents future blood clots, too.
Often, medication and taking care of yourself will do the trick. But you may need surgery. Talk to your doctor about which medical treatment options are right for you.
These drugs, also called anticoagulants, are the most common treatment for DVT. They can keep a clot from growing or breaking off, and they prevent new clots from forming. But they can't thin your blood, despite their name, or dissolve an existing clot.
Blood thinners include:
- Apixaban (Eliquis)
- Dabigatran (Pradaxa)
- Edoxaban (Savaysa)
- Fondaparinux (Arixtra)
- Rivaroxaban (Xarelto)
- Warfarin (Coumadin)
In the hospital, your doctor may give you heparin at first, by a needle into your vein or as a shot. You may have to keep taking shots at home, once or twice daily. When you take heparin by IV, you'll need blood tests, too. But you won't need them when you're taking shots of low-molecular-weight heparin under your skin.
You may take warfarin (Coumadin) by pill once a day, starting while you're still on heparin, and then usually for 3 to 6 months or more. While you take it, you'll need regular blood tests to make sure you've got the right amount in your system -- too little won't prevent clots, too much makes dangerous bleeding more likely. It can also interact with other medicines, vitamins, and foods with a lot of vitamin K, which is another good reason to get your blood checked often.
Newer anti-clotting medicines, known as Xa inhibitors, work as well as warfarin for most people. You won't have to get blood tests, change your dose, or remember what foods you ate. These drugs may cause less bleeding than warfarin, but there's no medicine you can take to stop bleeding if it becomes a problem.
Apixaban, edoxaban, and rivaroxaban are all pills. Fondaparinux is a shot that people who are having hip fracture, hip replacement, knee replacement, or abdominal surgery get to prevent DVT. Your doctor might also prescribe it with warfarin to treat a serious DVT or to treat a clot that gets stuck in your lung, called a pulmonary embolism.
Dabigatran is a pill that stops a specific protein that helps your blood clot from working. That's why it's called a direct thrombin inhibitor.
Clot-Busting: Catheter-Directed Thrombolysis
Your body will dissolve the blood clot eventually, but in the meantime, it could damage the inside of your vein. Your doctor may recommend a clot-busting medicine called a thrombolytic agent if you:
- Have large clots causing pain, swelling, and problems with circulation
- Are at high risk for a pulmonary embolism
- Have DVT in your arm, rather than your leg
This procedure quickly breaks up a clot and restores blood flow. It may also save the valves in that vein. But it's riskier than taking blood thinners. You have a greater chance of bleeding problems and stroke.
You'll go to the hospital to get it done. Using an X-ray as a guide, a specialist will put a thin tube called a catheter into your vein and work the tip of it into your DVT. Then he'll use the catheter to send the drug directly into the clot.
When taking blood thinners or clot-busting isn't possible or doesn't work well, your doctor may want to try a more involved procedure.
Vena cava filter. This small metal device catches blood clots and stops them from moving to parts of your body where they can become dangerous. Blood passes through the filter normally.
It goes in the vena cava, the main vein that takes blood from your lower body back to your heart. The doctor will put the filter into a leg, neck, or arm vein and move it into the vein in your belly.
Venous thrombectomy. In very rare cases, you may need to have a deep vein clot cut out. A severe type of DVT, called phlegmasia cerulea dolens, doesn't respond well to other kinds of treatment.