Blood thinners (anticoagulants) are the most common treatment for DVT, or deep vein thrombosis, which happens when a blood clot forms in a deep vein. But not everyone can take them. That’s because they make your blood take longer to clot. This can lead to serious problems if you have certain conditions that raise your risk of bleeding.
Your doctor likely won’t recommend blood thinners if you have:
- Stomach ulcers or other issues that up your risk for internal bleeding
- Uncontrolled high blood pressure
- Thrombocytopenia (low blood platelet count)
- Bleeding disorders (such as hemophilia)
In some cases, the benefits of taking a blood thinner may outweigh the risks. But you should not take blood thinners at all if you have:
- Bleeding in your brain
- Severe active bleeding
- Had recent surgery on your eyes, brain, or spinal cord
You shouldn’t take the blood thinner warfarin or these newer blood thinners if you’re pregnant:
They’re not safe for unborn babies. If you’ve had a blood clot in the past or get one during pregnancy, your doctor may decide to give you heparin. You may need to stop taking it close to the time you’ll deliver to lower your risk of bleeding complications in childbirth.
What Are Other Treatments for DVT?
When you can’t take a blood thinner for DVT, your doctor may suggest:
Thrombectomy. This is a nonsurgical procedure your doctor can do to physically remove a clot from your vein. This may be a good option to treat sudden DVT that’s causing issues.
A cardiologist, radiologist, or vascular surgeon injects dye into the vein where your clot is. They use X-ray to help them find it. They put a long, thin, flexible tube called a catheter into the vein. Then they guide it closer to where the clot is and pull it out through your vein. Once the clot is gone, your blood will start flowing again right away.
Inferior Vena Cava Filter (IVC Filter). This option won’t remove a clot, but it can keep it from traveling to your lungs and triggering a pulmonary embolism. The vena cava is the main vein that carries blood from your lower body to your heart. This might be a good option if you have a DVT in your legs.
Your doctor puts an IVC filter in your vena cava through a small cut in a vein in your groin or neck. The filter catches blood clots and stops them from circulating through your bloodstream. An IVC filter might be a good choice for you if you’re at a high risk of bleeding. But it can actually raise your risk of blood clots in the long term. It also can’t stop new blood clots from forming. This treatment is best if you’ve had several blood clots travel to your lungs before.
Iliocaval stenting. When a clot stays in your body for a long time, it can cause blockage in a vein in your pelvis called the iliac vein. You may also continue to have lower blood flow to the heart. For long-term relief, your doctor may do a minimally-invasive procedure called iliocaval stenting. A stent is a cylinder-shaped device your doctor puts in your vein to prop it open. Doctors often use stents to open blocked blood vessels after a heart attack.
The doctor will put a catheter into a blood vessel in your groin. They use a special X-ray called fluoroscopy to see real-time images of the vein. And they use small, flexible tools to open up the blockage with the stent.
Compression stockings. Ongoing DVT in your legs doesn’t allow blood to flow. This often causes swelling, pain, and discolored skin in your legs. Your doctor may prescribe special leg coverings called compression hose to help with these symptoms. You can also get them over the counter at medical supply stores or pharmacies.
They cover your leg from your foot to above or below the knee. They’re very tight at your ankle and get looser as they go up your leg. The pressure they put on your leg keeps your blood from collecting and causing a clot.
Experts recommend wearing these stockings during the day for at least 2 years to ease symptoms and stop other clots from forming.