How do doctors treat blood clots in legs. What are the most common treatments for Deep Vein Thrombosis (DVT). Which medications are used to manage blood clots. What are the risks and benefits of different blood clot treatments. How long does blood clot treatment typically last. What are the potential side effects of blood thinners. Can over-the-counter medications help with blood clots.

Understanding Deep Vein Thrombosis (DVT) and Its Treatment Goals

Deep Vein Thrombosis (DVT) is a serious medical condition characterized by the formation of blood clots deep within the veins, typically in the legs. Proper treatment of DVT is crucial to prevent potentially life-threatening complications and ensure a full recovery. The primary objectives of DVT treatment include:

• Preventing the existing clot from growing larger
• Reducing the risk of long-term complications such as chronic leg pain and swelling
• Lowering the chances of developing future blood clots
• Preventing the clot from breaking off and traveling to the lungs (pulmonary embolism)

To achieve these goals, healthcare providers employ a range of treatment options, with medication being the most common approach. However, in some cases, more invasive procedures may be necessary.

Blood Thinners: The First Line of Defense Against DVT

Anticoagulants, commonly known as blood thinners, are the cornerstone of DVT treatment. These medications work by:

• Preventing existing clots from growing larger
• Reducing the risk of clots breaking off and traveling to other parts of the body
• Inhibiting the formation of new blood clots

Are blood thinners capable of dissolving existing clots? Contrary to their name, blood thinners do not actually thin the blood or dissolve existing clots. Instead, they create an environment in the body that makes it more difficult for clots to form or grow.

Types of Blood Thinners Used in DVT Treatment

There are several types of blood thinners used to treat DVT, each with its own administration method and duration of use:

1. Injectable and IV Blood Thinners:
   • Enoxaparin (Lovenox) – injectable
   • Fondaparinux (Arixtra) – injectable
   • Heparin – administered intravenously
2. Oral Blood Thinners:
   • Dabigatran (Pradaxa)
   • Warfarin (Jantoven)
   • Apixaban (Eliquis)
   • Edoxaban (Lixiana, Savaysa)
   • Rivaroxaban (Xarelto)

How long do patients typically need to take blood thinners for DVT? The duration of blood thinner treatment can vary depending on individual circumstances. In general, patients may need to take these medications for 3 months or longer. Some individuals may require indefinite treatment if they have recurring blood clots or other risk factors.

The Evolution of DVT Treatment: From Injectable to Oral Medications

In recent years, there has been a shift in the approach to DVT treatment. Many healthcare providers now prefer to start patients on oral blood thinners immediately after diagnosis, bypassing the need for initial injectable or IV medications. This change is due to several factors:

• Improved efficacy of newer oral anticoagulants
• Reduced risk of bleeding complications compared to traditional treatments
• Greater convenience for patients, eliminating the need for injections or hospital stays
• Fewer dietary restrictions and drug interactions compared to older medications like warfarin

Do oral blood thinners work as effectively as injectable ones? Studies have shown that newer oral anticoagulants, such as apixaban, edoxaban, and rivaroxaban, are just as effective as traditional injectable medications in treating DVT. Moreover, these medications often have a lower risk of bleeding complications, making them an attractive option for many patients.

Special Considerations in Blood Thinner Use for DVT

While blood thinners are highly effective in treating DVT, there are several important considerations that patients and healthcare providers must keep in mind:

Pregnancy and Blood Thinners

Can pregnant women safely take blood thinners for DVT? Certain blood thinners, such as warfarin, can cause birth defects and should be avoided during pregnancy. Pregnant women with DVT typically require alternative treatments, such as low-molecular-weight heparin injections, which are considered safer for both mother and fetus.

Monitoring and Dosage Adjustments

Patients taking warfarin require regular blood tests to ensure the medication is working effectively without increasing the risk of bleeding. The dosage may need to be adjusted based on these test results. Newer oral anticoagulants generally do not require such frequent monitoring, but regular check-ups are still important.

Potential Side Effects and Interactions

What are the most common side effects of blood thinners? The primary concern with blood thinners is an increased risk of bleeding. Patients should be aware of the following potential side effects:

• Unusual bruising or bleeding
• Blood in urine, stool, or vomit
• Severe headaches or abdominal pain
• Unusually heavy menstrual bleeding

It’s crucial for patients to inform their healthcare providers about all medications, supplements, and dietary habits, as these can interact with blood thinners and affect their efficacy or safety.

Over-the-Counter Options: The Role of Aspirin in DVT Management

While not a primary treatment for DVT, aspirin has shown promise in reducing the risk of recurrent blood clots. Some studies suggest that regular aspirin use can decrease the likelihood of DVT returning by approximately one-third without significantly increasing bleeding risk.

Is aspirin a suitable replacement for prescription blood thinners in DVT treatment? Aspirin is not considered a substitute for prescription anticoagulants in the initial treatment of DVT. However, it may be recommended as a long-term preventive measure after completing the prescribed course of blood thinners. Patients should always consult their healthcare provider before starting any aspirin regimen for DVT prevention.

Advanced Treatment Options: Clot-Busting Medications and Procedures

In certain situations, more aggressive treatments may be necessary to manage DVT effectively. These options include:

Thrombolytic Agents

Thrombolytic agents, also known as clot-busters, are powerful medications that can quickly break down blood clots. They may be considered for patients who:

• Have large clots causing severe pain, swelling, or circulation problems
• Are at high risk for pulmonary embolism
• Have DVT in the arm rather than the leg

While effective, thrombolytic agents carry a higher risk of bleeding complications compared to standard blood thinners.

Catheter-Directed Thrombolysis

This minimally invasive procedure involves inserting a catheter directly into the affected vein to deliver clot-busting medication to the site of the thrombosis. It can quickly restore blood flow and may help preserve the valves in the affected vein.

What are the risks associated with catheter-directed thrombolysis? While this procedure can be highly effective, it does carry some risks, including:

• Increased chance of bleeding complications
• Potential damage to the blood vessel
• Risk of infection at the catheter insertion site

Long-Term Management and Prevention of Recurrent DVT

Treating DVT is not just about addressing the immediate clot; it also involves long-term management to prevent recurrence and complications. Key aspects of ongoing DVT care include:

Extended Anticoagulation Therapy

Some patients may require long-term or even lifelong anticoagulation therapy, especially if they have recurring DVTs or certain risk factors. The decision to continue anticoagulation is made on an individual basis, weighing the benefits of clot prevention against the risks of long-term medication use.

Lifestyle Modifications

Patients are often advised to make certain lifestyle changes to reduce their risk of future blood clots:

• Maintaining a healthy weight
• Exercising regularly, with a focus on activities that promote leg circulation
• Avoiding prolonged periods of immobility, especially during long trips
• Quitting smoking
• Managing underlying health conditions that may contribute to clot formation

Compression Therapy

Wearing compression stockings can help improve blood flow in the legs and reduce the risk of post-thrombotic syndrome, a long-term complication of DVT characterized by chronic leg pain, swelling, and skin changes.

How long should patients wear compression stockings after DVT? The duration of compression therapy can vary, but many healthcare providers recommend wearing compression stockings for at least two years following a DVT episode to reduce the risk of long-term complications.

Emerging Treatments and Future Directions in DVT Management

As medical research advances, new approaches to DVT treatment and prevention are being explored. Some promising areas of investigation include:

Novel Anticoagulants

Researchers are continually working on developing new anticoagulants that offer improved efficacy, safety profiles, and convenience for patients. These may include medications with different mechanisms of action or formulations that require less frequent dosing.

Targeted Therapies

Future treatments may focus on targeting specific components of the clotting cascade or addressing underlying genetic factors that contribute to thrombosis risk. This personalized approach could lead to more effective and tailored treatments for individual patients.

Advanced Imaging Techniques

Improvements in imaging technology may allow for earlier detection of DVT and more precise monitoring of treatment effectiveness. This could lead to more timely interventions and better long-term outcomes for patients.

What role might artificial intelligence play in DVT management? AI-powered algorithms could potentially assist in risk assessment, treatment selection, and monitoring of patients with DVT. These tools may help healthcare providers make more informed decisions and optimize patient care.

The Importance of Individualized Treatment Plans for DVT

While there are established guidelines for DVT treatment, it’s crucial to recognize that each patient’s situation is unique. Factors that may influence the choice of treatment and its duration include:

• The size and location of the blood clot
• The patient’s overall health and medical history
• The presence of underlying risk factors for thrombosis
• The patient’s preferences and lifestyle considerations
• Potential contraindications to certain medications or procedures

Healthcare providers work closely with patients to develop personalized treatment plans that balance effectiveness, safety, and practicality. This collaborative approach ensures that patients receive the most appropriate care for their specific circumstances.

How often should patients follow up with their healthcare provider during DVT treatment? The frequency of follow-up appointments can vary depending on the treatment regimen and individual patient factors. Initially, patients may need to be seen more frequently, especially if they are on medications that require close monitoring. As treatment progresses and stabilizes, follow-up visits may become less frequent but remain an important part of ongoing care.

The Role of Patient Education in Successful DVT Management

Effective treatment of DVT relies not only on medical interventions but also on patient understanding and adherence to the prescribed treatment plan. Key aspects of patient education include:

Recognizing Signs of Complications

Patients should be taught to identify potential signs of treatment complications or worsening of their condition, such as:

• Increased pain, swelling, or warmth in the affected limb
• Sudden shortness of breath or chest pain (which could indicate a pulmonary embolism)
• Unusual bleeding or bruising

Medication Management

Proper use of prescribed medications is crucial for successful DVT treatment. Patients should be educated on:

• Correct dosing and administration of their medications
• Potential side effects and when to seek medical attention
• The importance of not skipping doses or discontinuing medication without medical advice
• Possible interactions with other medications, foods, or supplements

Lifestyle Adaptations

Patients should be guided on how to incorporate necessary lifestyle changes into their daily routines, such as:

• Proper use of compression stockings
• Safe exercise routines to promote circulation
• Strategies for avoiding prolonged immobility during travel or work

What resources are available to help patients manage their DVT treatment at home? Many healthcare providers offer educational materials, support groups, or nurse-led programs to assist patients in managing their DVT treatment. Additionally, there are reputable online resources and mobile applications that can help patients track their medication use, monitor symptoms, and access educational information about their condition.

The Economic Impact of DVT and Its Treatment

Deep Vein Thrombosis and its potential complications can have significant economic implications, both for individual patients and healthcare systems as a whole. Considerations include:

Direct Medical Costs

The treatment of DVT often involves substantial medical expenses, including:

• Costs of diagnostic tests and imaging studies
• Expenses related to hospital stays and outpatient visits
• Medication costs, which can be significant for long-term anticoagulation therapy
• Expenses associated with managing potential complications

Indirect Costs

Beyond direct medical expenses, DVT can lead to various indirect costs:

• Lost productivity due to time off work for treatment and recovery
• Long-term disability costs in cases of severe complications
• Travel expenses for medical appointments and treatments

Cost-Effectiveness of Treatment Options

As healthcare systems strive to provide optimal care while managing resources, the cost-effectiveness of various DVT treatment options is an important consideration. Factors that influence the economic impact of different treatments include:

• The initial cost of the treatment
• The likelihood of preventing costly complications
• The need for ongoing monitoring and follow-up care
• The potential for improved quality of life and reduced long-term healthcare utilization

How do newer oral anticoagulants compare to traditional treatments in terms of cost-effectiveness? While newer oral anticoagulants may have higher upfront costs compared to traditional treatments like warfarin, they often require less frequent monitoring and may lead to fewer complications. Some studies suggest that these factors can make newer medications more cost-effective in the long run, particularly for certain patient populations.

Understanding the economic aspects of DVT treatment can help healthcare providers and policymakers make informed decisions about resource allocation and treatment guidelines, ultimately leading to better patient outcomes and more efficient use of healthcare resources.

Treating Blood Clots in Legs

Written by Annie Stuart

Medically Reviewed by Jennifer Robinson, MD on February 21, 2023

• Blood Thinners
• Over-the-Counter Medication
• Clot Busting
• Medical Procedures
• Treating DVT at Home
• Ongoing Medication
• More

What will treating a DVT, a blood clot deep in a vein, do for you?

• It will keep the clot from growing.
• It lowers the risk of long-lasting complications such as leg pain and swelling.
• It can help prevent future blood clots.

Often, medication and taking care of yourself will do the trick. But you may need surgery. Talk to your doctor about which treatments are right for you.

These drugs, also called anticoagulants, are the most common treatment for DVT. They can keep a clot from growing or breaking off, and they prevent new clots from forming. But they can’t thin your blood, despite their name. And they won’t get rid of an existing clot.

Your doctor may want you to take blood thinners for 3 months or longer. If your blood clots developed after a surgery, you may be on medication for a shorter time. In some circumstances, your doctor may want you on blood thinners for more than a few months or indefinitely.

Sometimes you will start your treatment taking blood thinners by IV or injection. The most prescribed of these medications are:

• Enoxaparin (Lovenox), an injectable
• Fondaparinux (Arixtra), another injectable
• Heparin, taken by IV

After a few days, your doctor may switch you to a blood thinner in tablet or capsule form, such as:

• Dabigatran (Pradaxa)
• Warfarin (Jantoven)

Other blood thinner tablets can be prescribed and taken immediately after a DVT diagnosis, skipping the IV or injectable medications. Many doctors believe these medications, also known as IX inhibitors, can dissolve blood clots with less risk of bleeding. These blood thinners include:

• Apixaban (Eliquis)
• Edoxaban (Lixiana, Savaysa)
• Rivaroxaban (Xarelto)

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 certain protein that helps your blood clot from working. That’s why it’s called a direct thrombin inhibitor.

When you go to the hospital with a new blood clot (called acute DVT), your doctor may give you heparin at first, through an IV needle into your vein or as a shot. You may have to keep taking shots once you’re home, once or twice daily. When you get heparin by IV, you’ll need blood tests, too. But you won’t need them if you’re taking shots of low-molecular-weight heparin under your skin.

You may also take warfarin by pill once a day, starting while you’re on heparin and then usually for 3 to 6 months or more. While you take it, you’ll need regular blood tests to make sure you’ve got the right amount in your system. Too little won’t prevent clots, and too much makes dangerous bleeding more likely. It can also interact with other medicines, vitamins, and foods with a lot of vitamin K, which is another good reason to get your blood checked often.

Let your doctor know if you’re pregnant because warfarin can cause birth defects. You’ll have to take something else.

Make sure to take your blood thinners exactly as prescribed to avoid potentially serious side effects. These can include:

• Brown or red coloring in your urine, bowel movements, or vomit from internal bleeding
• Deep bruising
• Severe headaches or stomachaches
• Unusually heavy menstrual bleeding

Contact your doctor immediately if you start to have these side effects. Also remember, pregnant women shouldn’t take certain blood thinners.

Blood thinners can change the way other medications work and vice versa. Make sure your doctor knows about all the medicines you take.

Some studies show that taking aspirin regularly can cut the risk of DVT clots returning by one-third without increasing the risk of bleeding. But aspirin has the most impact when you take it regularly after you finish with prescription medication that you take after DVT surgery. And since aspirin therapy is not part of routine treatment of DVT, you should talk about it first with your doctor.

Your body will dissolve the blood clot over time. 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 higher 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, they’ll use the catheter to send the drug directly into the clot.

If your vein seems narrow, they may widen it and help prevent future blockages by doing a balloon angioplasty or placing a stent.

The most commonly used medications of this type include:

• Alteplase (Activase)
• Anistreplase (Eminase)
• Reteplase (Retavase)
• Tenecteplase (Metalyse, TNKase)

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.

Inferior vena cava (IVC) filter. An IVC filter is a small metal device that looks like an upside-down umbrella and can stop blood clots in your veins from moving. It goes in your body’s main vein, called the inferior vena cava (IVC). This vein runs through your belly. It sends blood from the lower half of your body back to your heart.

The procedure to put the filter in usually takes around an hour, and you can go home the same day. In the hospital, the doctor will put a medication that makes you feel sleepy and relaxed into a vein in your arm. You’ll also receive a shot to numb the area at the base of your neck or near your groin. This is where the doctor will make a small cut and insert a thin, flexible plastic tube called a catheter into your vein. Using an X-ray to guide them, the doctor will thread the filter into place in the vein. It will expand and attach to the walls of the vein. After the surgery, you may need pain medicine. When it’s time to go home, you’ll need a friend or family member to drive you.

An IVC filter traps blood clots before they cause a pulmonary embolism and is used only to prevent pulmonary embolisms. It doesn’t protect against DVT or treat the condition itself.

Your doctor may recommend an IVC filter if you have DVT along with one of these issues:

• Hemorrhagic, or bleeding, stroke
• Bleeding in your digestive tract. Many things can cause this, including tumors, ulcers, and inflammatory bowel disease.
• Malignant hypertension (very high blood pressure)
• Bleeding in your brain because of a fall or accident
• Recent brain, eye, or spinal cord surgery
• Pregnancy

They may also recommend IVC filters because of:

• Blood thinner failure. These drugs don’t work for some people.
• Circulation problems, which your doctor might call hemodynamic instability
• Serious injuries to your spinal cord or other organs. They can raise your risk for blood clots.
• Blood clots that move from place to place (mobile thrombus)
• DVT in your inferior vena cava and iliac veins. These are the veins that run from your heart to your lower body and pelvis.

There are two types of IVC filters. One stays in your body permanently. The other is designed to be removed. Your doctor may use a removable IVC filter if there’s a chance that your risk of a pulmonary embolism will drop. For example, you may be able to start taking blood thinners.

Venous thrombectomy. In very rare cases, you may need to have a deep vein clot cut out.

When you go home after DVT treatment, your goals are to get better and prevent another blood clot. You’ll need to:

• Take medications as directed. After a DVT, you’ll take blood thinners for at least 3 to 6 months. Your doctor will tell you exactly how long to take these medications. It might be different based on which drug you use. You may need to take oral blood thinners for a longer time if the reason for your clot is still present in your body.

It’s important to follow your doctor’s recommendations so you can shift from managing your health with blood thinners to just aspirin.

• See your doctor often. They’ll let you know if your medications are helping and make adjustments if you need them. If you’re taking warfarin, you’ll get a blood test to see how well your blood is clotting.
• Make sure you aren’t bleeding too much.  This is a side effect of blood thinner medications. Even a small cut can get serious when you’re taking blood thinners.
• Be safe. Talk to your doctor about things that can lead to bruises or cuts. Try not to bump or injure your legs. Don’t cross your legs.
• Stay active. Even if you’ve been on bed rest after surgery or for other reasons, get moving. That’s a sure way to prevent more blood clots. Don’t sit or stand still for more than an hour at a time. Change positions often, especially if you’re on a long trip.
• Wear compression stockings. The most common kinds of these special socks go from the arch of your foot to just below or above your knee. They can relieve the pain and swelling in your legs, and they help prevent more clots. Compression stockings come in different levels of pressure. You can get mild ones over the counter, but you’ll need to get fitted and a prescription for stronger ones. Your doctor will help you figure out what kind you need. You may have to wear them for 2 years or longer after you have DVT.
• Eat a healthy, low-salt diet. Extra pounds put more pressure on the veins in your pelvis and legs. Salt boosts your blood pressure. Keeping your sodium and cholesterol levels low can help you avoid another blood clot.
• Work on losing weight if you’re carrying extra pounds.
• Quit smoking. It affects blood flow and circulation, which can raise your odds of getting another clot.
• Lift up. Raise the bottom of your bed 6 inches off the ground. You can use blocks, books, or special risers you can find online or at home stores.

Some people with DVT might need to take blood thinners for the rest of their lives. Your doctor will make this decision based on how likely you are to have another blood clot. They’ll also consider your risk of bleeding when they suggest longer treatment with blood thinners.

You’re at higher risk for another clot if you:

• Have cancer
• Are going through chemotherapy
• Have had a blood clot in a vein before
• Are male
• Have a positive D-dimer test, which shows if your body has more blood clot formations

Top Picks

Treating Blood Clots in Legs

Written by Annie Stuart

Medically Reviewed by Jennifer Robinson, MD on February 21, 2023

• Blood Thinners
• Over-the-Counter Medication
• Clot Busting
• Medical Procedures
• Treating DVT at Home
• Ongoing Medication
• More

What will treating a DVT, a blood clot deep in a vein, do for you?

• It will keep the clot from growing.
• It lowers the risk of long-lasting complications such as leg pain and swelling.
• It can help prevent future blood clots.

Often, medication and taking care of yourself will do the trick. But you may need surgery. Talk to your doctor about which treatments are right for you.

These drugs, also called anticoagulants, are the most common treatment for DVT. They can keep a clot from growing or breaking off, and they prevent new clots from forming. But they can’t thin your blood, despite their name. And they won’t get rid of an existing clot.

Your doctor may want you to take blood thinners for 3 months or longer. If your blood clots developed after a surgery, you may be on medication for a shorter time. In some circumstances, your doctor may want you on blood thinners for more than a few months or indefinitely.

Sometimes you will start your treatment taking blood thinners by IV or injection. The most prescribed of these medications are:

• Enoxaparin (Lovenox), an injectable
• Fondaparinux (Arixtra), another injectable
• Heparin, taken by IV

After a few days, your doctor may switch you to a blood thinner in tablet or capsule form, such as:

• Dabigatran (Pradaxa)
• Warfarin (Jantoven)

Other blood thinner tablets can be prescribed and taken immediately after a DVT diagnosis, skipping the IV or injectable medications. Many doctors believe these medications, also known as IX inhibitors, can dissolve blood clots with less risk of bleeding. These blood thinners include:

• Apixaban (Eliquis)
• Edoxaban (Lixiana, Savaysa)
• Rivaroxaban (Xarelto)

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 certain protein that helps your blood clot from working. That’s why it’s called a direct thrombin inhibitor.

When you go to the hospital with a new blood clot (called acute DVT), your doctor may give you heparin at first, through an IV needle into your vein or as a shot. You may have to keep taking shots once you’re home, once or twice daily. When you get heparin by IV, you’ll need blood tests, too. But you won’t need them if you’re taking shots of low-molecular-weight heparin under your skin.

You may also take warfarin by pill once a day, starting while you’re on heparin and then usually for 3 to 6 months or more. While you take it, you’ll need regular blood tests to make sure you’ve got the right amount in your system. Too little won’t prevent clots, and too much makes dangerous bleeding more likely. It can also interact with other medicines, vitamins, and foods with a lot of vitamin K, which is another good reason to get your blood checked often.

Let your doctor know if you’re pregnant because warfarin can cause birth defects. You’ll have to take something else.

Make sure to take your blood thinners exactly as prescribed to avoid potentially serious side effects. These can include:

• Brown or red coloring in your urine, bowel movements, or vomit from internal bleeding
• Deep bruising
• Severe headaches or stomachaches
• Unusually heavy menstrual bleeding

Contact your doctor immediately if you start to have these side effects. Also remember, pregnant women shouldn’t take certain blood thinners.

Blood thinners can change the way other medications work and vice versa. Make sure your doctor knows about all the medicines you take.

Some studies show that taking aspirin regularly can cut the risk of DVT clots returning by one-third without increasing the risk of bleeding. But aspirin has the most impact when you take it regularly after you finish with prescription medication that you take after DVT surgery. And since aspirin therapy is not part of routine treatment of DVT, you should talk about it first with your doctor.

Your body will dissolve the blood clot over time. 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 higher 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, they’ll use the catheter to send the drug directly into the clot.

If your vein seems narrow, they may widen it and help prevent future blockages by doing a balloon angioplasty or placing a stent.

The most commonly used medications of this type include:

• Alteplase (Activase)
• Anistreplase (Eminase)
• Reteplase (Retavase)
• Tenecteplase (Metalyse, TNKase)

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.

Inferior vena cava (IVC) filter. An IVC filter is a small metal device that looks like an upside-down umbrella and can stop blood clots in your veins from moving. It goes in your body’s main vein, called the inferior vena cava (IVC). This vein runs through your belly. It sends blood from the lower half of your body back to your heart.

The procedure to put the filter in usually takes around an hour, and you can go home the same day. In the hospital, the doctor will put a medication that makes you feel sleepy and relaxed into a vein in your arm. You’ll also receive a shot to numb the area at the base of your neck or near your groin. This is where the doctor will make a small cut and insert a thin, flexible plastic tube called a catheter into your vein. Using an X-ray to guide them, the doctor will thread the filter into place in the vein. It will expand and attach to the walls of the vein. After the surgery, you may need pain medicine. When it’s time to go home, you’ll need a friend or family member to drive you.

An IVC filter traps blood clots before they cause a pulmonary embolism and is used only to prevent pulmonary embolisms. It doesn’t protect against DVT or treat the condition itself.

Your doctor may recommend an IVC filter if you have DVT along with one of these issues:

• Hemorrhagic, or bleeding, stroke
• Bleeding in your digestive tract. Many things can cause this, including tumors, ulcers, and inflammatory bowel disease.
• Malignant hypertension (very high blood pressure)
• Bleeding in your brain because of a fall or accident
• Recent brain, eye, or spinal cord surgery
• Pregnancy

They may also recommend IVC filters because of:

• Blood thinner failure. These drugs don’t work for some people.
• Circulation problems, which your doctor might call hemodynamic instability
• Serious injuries to your spinal cord or other organs. They can raise your risk for blood clots.
• Blood clots that move from place to place (mobile thrombus)
• DVT in your inferior vena cava and iliac veins. These are the veins that run from your heart to your lower body and pelvis.

There are two types of IVC filters. One stays in your body permanently. The other is designed to be removed. Your doctor may use a removable IVC filter if there’s a chance that your risk of a pulmonary embolism will drop. For example, you may be able to start taking blood thinners.

Venous thrombectomy. In very rare cases, you may need to have a deep vein clot cut out.

When you go home after DVT treatment, your goals are to get better and prevent another blood clot. You’ll need to:

• Take medications as directed. After a DVT, you’ll take blood thinners for at least 3 to 6 months. Your doctor will tell you exactly how long to take these medications. It might be different based on which drug you use. You may need to take oral blood thinners for a longer time if the reason for your clot is still present in your body.

It’s important to follow your doctor’s recommendations so you can shift from managing your health with blood thinners to just aspirin.

• See your doctor often.  They’ll let you know if your medications are helping and make adjustments if you need them. If you’re taking warfarin, you’ll get a blood test to see how well your blood is clotting.
• Make sure you aren’t bleeding too much. This is a side effect of blood thinner medications. Even a small cut can get serious when you’re taking blood thinners.
• Be safe. Talk to your doctor about things that can lead to bruises or cuts. Try not to bump or injure your legs. Don’t cross your legs.
• Stay active. Even if you’ve been on bed rest after surgery or for other reasons, get moving. That’s a sure way to prevent more blood clots. Don’t sit or stand still for more than an hour at a time. Change positions often, especially if you’re on a long trip.
• Wear compression stockings. The most common kinds of these special socks go from the arch of your foot to just below or above your knee. They can relieve the pain and swelling in your legs, and they help prevent more clots. Compression stockings come in different levels of pressure. You can get mild ones over the counter, but you’ll need to get fitted and a prescription for stronger ones. Your doctor will help you figure out what kind you need. You may have to wear them for 2 years or longer after you have DVT.
• Eat a healthy, low-salt diet. Extra pounds put more pressure on the veins in your pelvis and legs. Salt boosts your blood pressure. Keeping your sodium and cholesterol levels low can help you avoid another blood clot.
• Work on losing weight if you’re carrying extra pounds.
• Quit smoking. It affects blood flow and circulation, which can raise your odds of getting another clot.
• Lift up. Raise the bottom of your bed 6 inches off the ground. You can use blocks, books, or special risers you can find online or at home stores.

Some people with DVT might need to take blood thinners for the rest of their lives. Your doctor will make this decision based on how likely you are to have another blood clot. They’ll also consider your risk of bleeding when they suggest longer treatment with blood thinners.

You’re at higher risk for another clot if you:

• Have cancer
• Are going through chemotherapy
• Have had a blood clot in a vein before
• Are male
• Have a positive D-dimer test, which shows if your body has more blood clot formations

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Treatment of thrombosis and thrombophlebitis of the veins of the lower extremities in Zhytomyr

The lifestyle of a modern average person is significantly different from the life of people who lived just a hundred years ago. Technological progress has led to significant savings in free time and physical costs. Of course, this is a big plus for a person, but how does this affect the state of health?

In the 21st century, we are increasingly faced with the diseases of our time: obesity, diabetes, neurogenic disorders, cardiovascular pathologies, venous diseases. A classic example is thrombophlebitis and thrombosis of the veins of the lower extremities.

Thrombophlebitis is an inflammatory lesion of the inner wall of the veins with a high tendency to thrombosis. Thrombosis is a condition in which already formed blood clots prevent adequate blood flow.

Causes of thrombosis and thrombophlebitis

Diseases develop due to the interaction of the following mechanisms:

• systematic damage to the inner wall of the veins by toxins, allergic and inflammatory diseases, autoimmune pathologies;
• violation of the rheological properties of blood – increased blood density;
• acceleration of blood coagulation;
• slowing blood flow.

The factors mentioned above lead to this, such as excess weight, decreased physical activity. It is worth noting that smoking has a significant effect on the inner wall of the vessel, because nicotine causes inflammatory changes in the intima of the vessels.

A thrombus forms on the affected vessel wall. Thrombi may be single or multiple. When detached, the thrombus moves with the blood flow until the diameter of the thrombus is greater than the diameter of the vessel – a blockage of the vessel develops. The detachment of a blood clot is facilitated by hormonal medications, surgical interventions, and uncontrolled physical activity.

Symptoms of thrombosis and thrombophlebitis

What symptoms indicate thrombophlebitis? Among them, doctors distinguish pain in the legs, tension and weakness, frequent leg cramps, swelling, blue skin over the affected area, impaired sensitivity. Thrombophlebitis develops gradually and is characterized by an increase in symptoms. With thrombosis, symptoms occur abruptly.

Thrombosis is characterized by a sudden onset of pain with a tendency to increase, a sharp increase in body temperature up to 38.5-39° C, a sharp blue leg, swelling, manifestations of a network of visible saphenous veins on the leg (approximately on the second day).

Why is thrombosis dangerous? Thrombosis of the limb can lead to acute ischemia and subsequent dystrophy of the tissues of the leg. It is worth noting that thrombosis is the root cause of PE – pulmonary embolism, in a matter of minutes it will become fatal for the patient.

Principles of diagnosis and treatment of thrombophlebitis, thrombosis

Modern medicine provides physicians with a wide range of opportunities for rapid and high-quality diagnosis of thrombophlebitis and thrombosis. Based on his own experience and professional skills, the doctor can, thanks to the data of the examination and the collection of anamnesis, determine a preliminary diagnosis, which is fixed by the data of ultrasound scanning of the vessels of the legs and laboratory tests.

Depending on the stage, location of the thrombus and the presence of complications, doctors may choose between medical and surgical treatment. Drug treatment consists in the conservative dissolution of the thrombus through the use of anticoagulants, fibrinolytic agents and further prophylaxis with the use of antiplatelet agents.

Surgical treatment consists in the surgical removal of a blood clot and is used in the presence of large blood clots or in case of ineffective medical treatment. The course is formed individually for each patient.

For more information on treatment, please contact your vascular surgeon.

PHLEBOLOGIST CONSULTATION + ULTRASOUND OF LOWER LIMB VEINS 500 UAH UNTIL 05/31/2023

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Venous thrombosis – MOSITALMED

Venous thrombosis is an acute pathological condition that If left untreated, it can lead to a fatal complication. At the initial stages of development, the disease is not accompanied by specific symptoms, therefore, most often the disease is diagnosed late, when treatment is possible only by surgery.

At the Mositalmed clinic, thanks to the high professionalism of doctors and the use of modern technologies, vein thrombosis and its pre-existing diseases are detected even at an early stage.

Pathogenesis and etiology of venous thrombosis

The development of phlebothrombosis is based on the Virchow triad, which includes increased coagulability, violation of the integrity of the vascular wall and blood stasis. At the same time, thrombosis can occur only with a combination of all three factors. Blockage of the vessel occurs in the superficial or deep venous network, the vessels of the lower extremities, namely, the legs, are more often affected.

The risk of developing venous thrombosis increases with:

• Overweight;
• Injuries;
• Postponed surgical interventions;
• Smoking;
• Varicose veins;
• Blood clotting;
• Sedentary lifestyle;
• Pregnancy and childbirth;
• Thrombophlebitis;
• Long-term use of oral contraceptives;
• Open fractures;
• Sedentary lifestyle

Symptoms of venous thrombosis

Blockage of a vein by a thrombus may occur in the superficial or deep venous network. Deep vein thrombosis of the lower leg is considered the most dangerous, since in this case a detached blood clot can cause pulmonary embolism. PE is accompanied by acute cardiovascular failure and requires emergency treatment.

Vein thrombosis can be suspected if the following symptoms appear:

• Acute, burning pain along the vein;
• Heaviness in the legs;
• Numbness;
• Puffiness in the bridge of the lesion;
• Redness or blueness;
• General weakness;
• Local temperature increase

Diagnosis of vein thrombosis

A phlebologist deals with the diagnosis and treatment of vein thrombosis. To make a diagnosis, the specialist collects an anamnesis, conducts an examination and prescribes an additional examination.

Doppler ultrasound is a specific examination method. It allows you to determine with high accuracy the direction of blood flow, the condition of the vein valves and their valves, the presence and level of blockage of a blood clot.