Overview
Deep vein thrombosis or DVT occurs when there is a blood clot in the vein. It usually occurs in the lower extremities like the thighs and legs, but occasionally it can occur in other parts of the body like the arms.
A deep vein thrombosis is more likely to occur in people who:
- Are 60 years old or more
- Have jobs where they have to sit or stand for prolonged hours
- Has cancer
- Suffered heart failure
- Has varicose veins
- Are obese
- Smoke
- Have prolonged hospitalization or are confined to bed rest
Deep vein thrombosis can be dangerous if the clot breaks loose and travels into the bloodstream and to the lungs. It can block the blood circulation and cause pulmonary embolism (PE). Early diagnosis and proper treatment can help prevent life-threatening complications.
How is deep vein thrombosis diagnosed?
Deep vein thrombosis diagnosis is based on physical exam, medical history, symptoms, and other test results. Your healthcare provider will perform a physical exam such as examining the legs for swelling, changes in skin colour, tenderness, etc.
Diagnosis for DVT includes:
D-dimer test
It is a protein that is produced by blood clots. High levels of D-dimer indicate severe deep-vein thrombosis.
Duplex ultrasound
This imaging test uses sound waves to take pictures of the veins and blood flow. It detects the presence of clots in the veins. The technician uses a small hand-held, wand-like device (transducer) over the affected area. Slight pressure is applied to the area to check whether it is stiff indicating a blood clot.
Contrast venography
The healthcare provider injects a special dye into the deep vein. This makes the veins visible for examination in the x-ray.
Magnetic resonance imaging (MRI)
You have to lie down inside a tube-shaped machine. The MRI machine uses radio waves and magnetic fields to scan your body. The technician will sit in another room and diagnose the DVT. If you are feeling anxious during the scanning process, you can use the microphone and talk to your healthcare provider.
How is deep vein thrombosis treated?
The main aim of deep vein thrombosis treatment is to:
- Regulate the blood clots and prevent them from getting bigger
- Prevent the blood clots from breaking loose and travel to the lungs
- Reduce the chances of recurrence of DVT
Deep vein thrombosis treatments are as follows:
Compression stockings
Compression or support stockings are knee socks that prevent the blood from accumulating in the veins. Wearing them regularly provides relief from pain and swelling.
Blood thinners
Anticoagulants, also known as blood thinners reduce the chances of developing new clots and also prevent the existing clots from getting bigger.
Blood thinners are available as oral medications and injections. Follow the prescription and do not take an overdose of the medications as it has side effects. Certain blood thinners should be avoided during pregnancy.
Clot busters or thrombolytics
A thrombolytic agent is administered to treat pulmonary embolism or severe DVT. It also treats large clots that cause pain, swelling, and circulation problems.
The procedure breaks down the clot and prevents it from causing further damage to the vein. The clot-busting drug is inserted using a catheter directly into the clot of the affected vein. If the vein is narrow, a balloon angioplasty where a stent is placed is done to widen the vein and prevent blockages.
Procedures
IVC filter procedure
An IVC (inferior vena cava) filter is a device that restricts the blood clot from moving while allowing smooth flow of the bloodstream. It looks like an upside-down umbrella and is inserted into the main vein which is known as the inferior vena cava.
The doctor makes a small cut in the vein of your neck or groin and inserts a catheter. A collapsed IVC filter is then gently sent through the catheter. The doctor uses an X-ray guide to put the filter in place. After placement, the catheter is removed. The filter expands and attaches to the vein wall. The filter can be attached permanently or removed after some time.
DVT thrombolysis
A DVT thrombolysis is performed to treat acute deep vein thrombosis or to remove large clots. A small catheter is inserted into the vein to remove or reduce the blood clot. It is generally an outpatient procedure but might need hospitalization for one or two nights depending on the symptoms.
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