Treatment for Deep Vein Thrombosis (DVT)
Blood Thinners continued...
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.
If your vein seems narrow, he may widen it and help prevent future blockages by doing a balloon angioplasty or placing a stent.
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.