Deep vein thrombosis (DVT), is a condition characterized by the formation of a blood clot, called a thrombus, in one or more deep veins within the body, typically in the leg or pelvis, or, less commonly, the arm. A DVT may or may not produce obvious symptoms.
While anyone can develop a DVT, risk increases when considering factors such as age, immobility, obesity, venous injury, family history, smoking, estrogen supplementation, chronic heart or lung disease, and cancer. DVT can be quite serious, resulting in severe illness, disability or even death. However, when caught early, DVT can be treated or even prevented altogether.
The optimal approach for treating DVT depends on a person’s specific circumstances, including the location and severity of the thrombus, and any related risk factors. In this overview, we will outline treatment options for deep vein thrombosis.
ACUTE MANAGEMENT OF DEEP VEIN THROMBOSIS
● Anticoagulation Therapy – The first line of treatment is usually an oral or injectable anticoagulation medication (such as heparin or warfarin) to help prevent the extension of existing thrombi and reduce the risk of pulmonary embolism (PE) and recurrent DVT.
● Catheter-directed Thrombolysis (CDT) – In some cases, catheter-directed thrombolysis may be an option. With CDT, a catheter is placed so that a thrombolytic agent can be directed to the clot to dissolve it.
LONG-TERM DEEP VEIN THROMBOSIS MANAGEMENT AND PREVENTION
● Graduated Compression Stockings – Graduated compression stockings exert the greatest amount of compression at the ankle and ease compression incrementally up the calf to the knee, helping to push blood back up through the leg toward the heart, promoting healthy circulation. These can be especially helpful for people who sit for long periods.
● Inferior Vena Cava Filter – For patients who can’t take blood thinners or for whom anticoagulants prove insufficient, the placement of an inferior vena cava (IVC) filter may be considered as a measure to help prevent pulmonary embolism. Using live image guidance, an IVC filter is carefully inserted into the jugular or femoral vein and gently guided into the inferior vena cava, where it serves to trap clots and prevent them from moving to the lungs or heart. An IVC filter may be permanent, but for most patients, a removable filter is used and removed once the danger of more DVT episodes is considered over.
Patients for whom IVC may be the preferred method of DVT treatment include those with bleeding issues, a recent brain or spinal cord injury, hemorrhagic stroke, or an increased risk of falling.
Treating DVT involves not only addressing acute thrombosis, but also preventing future recurrences and managing any ongoing risks and symptoms. Interventional radiologists play a key role in DVT diagnosis and interventional treatments such as IVC filter placement, providing many patients with safer, less invasive alternatives to conventional surgery.
RAO FOR IVC FILTER PLACEMENT AND PE PREVENTION
For patients whose recurrent deep vein thrombosi risk can’t be sufficiently addressed through medication, RAO’s Center for Vascular Health offers minimally-invasive IVC filter placement and removal. With this straightforward procedure, your Board-certified RAO interventional radiologist makes a tiny incision in the neck or groin artery and uses a very thin, flexible catheter to guide a small, collapsed filter to the inferior vena cava, where it expands to provide a secure gateway that traps blood clots before they can reach the lungs or heart and cause serious problems, including disability and death.
If you have had a DVT, talk to your doctor about whether an IVC filter might be beneficial in reducing your risk of PE and other conditions.
