Treatment for Deep Vein Thrombosis (DVT)
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.
Other Types of DVT Treatment
If blood thinners or thrombolysis procedures are not possible, or don't work well, your doctor may recommend an alternative treatment for DVT. These include:
Vena cava filter. This is a small metal device that is temporarily inserted to capture blood clots and prevent them from moving to other areas of your body. The filter allows blood to pass through the vein as it normally would.
An interventional radiologist or vascular surgeon inserts the filter into the vena cava, which is the main vein going back to the heart from your lower body. To reach this vein, which is in your abdomen, the doctor inserts the filter into a leg, neck, or arm vein. Ask your doctor how long the filter needs to stay in place.
Elevation and compression. Elevating the affected leg and using a compression device may help reduce symptoms of DVT, such as swelling and pain. Your doctor may also prescribe graduated compression stockings to reduce the risk of recurrence. You wear this DVT treatment from the arch of your foot to just above or below your knee.
Venous thrombectomy. In very rare cases, surgery is required to remove a deep vein clot. This may be true if you have a severe type of DVT that does not respond well to nonsurgical DVT treatment. This is called phlegmasia cerulea dolens.