What Is Deep Vein Thrombosis?
This is a condition in which blood clots in the deep veins of the legs and causes leg swelling, pain, and redness. This clot can also break off and travel up the veins and lodge in the lungs causing a pulmonary embolism.
What Are the Symptoms of DVT?
- Sudden onset of pain
- Swelling and redness of the feet are commonly seen with DVT
- Some syndromes like hypercoagulable states and peculiar vein anatomy can predispose a person for DVT
How Is This Diagnosed?
- A venous Doppler ultrasound of the leg veins would be able to identify DVT and also tell which veins are affected.
- DVT affecting the femoral and iliac veins needs to be actively treated.
How Is DVT Treated?
- Iliofemoral DVT needs to be treated to prevent a pulmonary embolism. We treat DVT by first placing an IVC filter in the inferior vena cava. This is a filter, like a sieve that is positioned in the infrarenal IVC to catch any free floating clots from traveling up and blocking the pulmonary veins.
- After this, a needle puncture is made in the popliteal vein (the deep vein behind the knee) and a special catheter is used to suck out clots from the deep veins.
- The next step is to place a perfusion catheter in the thrombosed venous segment and an infusion of a thrombolytic agent (Clot busting-medicine) like TPA or Urokinase is started.
- Check venograms are done every 12 hourly to monitor clot resolution and also to reposition the perfusion catheter. Typically a fresh thrombus would be lysed within 24 hours of thrombolysis.
Can DVT be Treated Without Thrombolysis and Through Medicines?
Yes, blood thinning medicine like Heparin can be given intravenously to help recanalize the occluded veins, this can be done in patients who are poor candidates for thrombolysis.
How Can DVT be Prevented?
- Regular exercise
- Preventing prolonged immobilization like sitting for a long duration for a long haul flight would prevent DVT.