Heparin and warfarin (Coumadin) are two types of blood thinners (anticoagulants) commonly used in deep vein thrombosis treatment. Though they're called blood thinners, these DVT treatments do not actually thin your blood; rather, they can keep existing blood clots from getting larger or prevent new ones from forming. They do this by preventing the production of certain proteins needed for blood to clot.
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.