Deep Vein Thrombosis
What is deep vein thrombosis?
Deep vein thrombosis (DVT) is a blood clot in one of the deep veins of the extremities. DVT typically occurs in the pelvis, thigh, or calf, but it also can also occur in the arm, chest, or other locations. DVT is dangerous because it can cause a complication known as pulmonary embolism — which happens when a blood clot breaks free from the deep veins, travels through the bloodstream, and lodges in the lungs. A large embolism can be fatal.
DVT causes and symptoms
Poor blood flow or stagnation of blood flow in the leg veins often increases the risk of DVT. Usually this occurs when the legs are immobile for long periods of time, such as on a long plane ride or while recovering in bed after surgery or injury. As a result, when blood pools in your the, clots are more likely to form.
Catheters or IV lines inserted into your leg veins may also irritate your vein wall and cause clots to form.
About half of all DVT cases have no symptoms. Symptoms can depend on the location and size of the blood clot, and can include swelling, tenderness, leg pain that may worsen when walking or standing, a sensation of warmth, and skin that turns blue or red. As the condition progresses, additional complications can include persistent pain while walking, varicose veins, swelling, and ulcers at the ankle.
Diagnosing DVT
A physical examination and a duplex ultrasound test can diagnose DVT. Duplex ultrasound is a simple, reliable test that can be done in minutes.
Treating DVT
A vascular surgeon usually can treat DVT with medications or minimally invasive procedures. Surgery may be required in very rare instances.
The initial treatment of choice includes blood thinners. Blood thinners cannot break up a clot that you already have, but they help prevent the clot from growing larger.
The American College of Chest Physicians have issued new recommendations regarding the treatment of DVT, favoring more aggressive therapy for clot dissolution. Some patients may benefit from dissolving the clot, a procedure known as thrombolysis.
During this procedure, a vascular surgeon injects clot-dissolving drugs directly into the clot through a catheter. This will help relieve the symptoms and minimize long-term complications. UPMC’s vascular surgeons have an active thrombolysis program, and are involved in the testing and development of new techniques and devices to dissolve DVT.
If a patient is unable to take anticoagulants or blood thinners or if drugs don’t reduce the clots, a special metal vena cava (IVC) filter can protect against a pulmonary embolism. The vena cava is a large vein in the abdomen that carries blood back to the heart and lungs. Vena cava filters can trap the clots that break away from the leg veins before they reach the lungs. Although these filters do not prevent clots from forming, they do prevent pulmonary embolism, and they can be permanent or temporary.
UPMC’s vascular surgeons are experts in the placement and retrieval of vena cava filters, and are actively involved in the development and testing of new, removable filters.
A vascular surgeon will help determine which treatment option is the best for each patient.
For more information about DVT, visit the Society for Vascular Surgery’s website.