Deep Vein Thrombosis: Treatment for DVT

Treatment for deep vein thrombosis -- a blood clot deep in a vein -- ranges from medication to self-care to surgery. Discuss with your doctor the deep vein thrombosis treatment options that are best for you.

Goals of Treatment for Deep Vein Thrombosis

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

Deep Vein Thrombosis Treatment: Anticoagulants

Anticoagulants (blood thinners) are the most common type of treatment for DVT. The two main types of anticoagulants are heparin and warfarin (Coumadin).

Anticoagulants can:

• Keep a clot from growing or breaking off
• Prevent new clots from forming

But they 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 deep vein thrombosis 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 about 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.

Deep Vein Thrombosis Treatment: Catheter-Directed Thrombolysis

Your body will dissolve a 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:

1. With imaging guidance, an interventional radiologist inserts a thin tube (catheter) into and through a vein in your leg.
2. The radiologist then puts the tip of the catheter into the clot and infuses a clot-busting drug directly into it.
3. If the vein appears narrowed, the radiologist may do a balloon angioplasty or stent placement to widen it and help prevent future blockages.