What is DVT?

Deep vein thrombosis, also known as DVT, is a blood clot (thrombus) in one of your deep veins. Blood clots occur most commonly in your leg, the thigh or calf, but it can occur in other locations of the body. Caring for deep vein thrombosis is one of many offerings for vascular care at Ohio State.

Blood clots from deep vein thrombosis can break free to travel through your bloodstream. Known as an embolus, a floating blood clot can embed in an artery in your lung and block blood flow. This serious condition, called pulmonary embolism, can cause severe damage to your lung and may be life-threatening. DVT can be treated, but symptoms are sometimes difficult to recognize.

DVT causes

If your veins become damaged from an injury, surgery or even an immune response, they are likely to cause blood clots. Blood flow can slow down when you are inactive for long periods of time, such as when you are traveling long distances or when you are bed-ridden due to illness. Your blood can also become thicker due to some genetic medical conditions and also as a result of birth control therapy.

Risk factors that contribute to deep vein thrombosis are:

• Age older than 60
• Birth control pills or hormone therapy
• Cancer
• Disorders that make your blood more likely to clot
• History of DVT
• Injury to a deep vein
• Insertion of a central venous catheter (tube placed in vein to provide access for medical therapy)
• Overweight or obesity
• Pregnancy and the first six weeks following birth
• Sedentary lifestyle

Having more than one risk factor at a time increases your risk of developing deep vein thrombosis (DVT), but there are things you can do to reduce your risk:

• Control your blood pressure
• Exercise and stretch frequently
• Lose weight
• Move around as much as possible after a procedure or after having been ill for a long period of time
• Quit smoking
• Take medication as prescribed by your doctor to prevent clots

If you are at risk for deep vein thrombosis and are having surgery, certain precautions can be taken by your surgical team to reduce your risk. Your doctor can prescribe medication before or after surgery. You may also be requested to stop taking certain medications prior to your surgery. If you have some of the risk factors mentioned above, talk to your doctor.

DVT symptoms

• Pain and tenderness
• Swelling
• Warmth
• Discoloration of the skin

If any of these symptoms occur, call your doctor. Only about 50 percent of people with deep vein thrombosis actually have symptoms.

Diagnosing DVT

Deep vein thrombosis can sometimes be hard to diagnose, especially if you are not having symptoms. Tests can be done to determine if you have deep vein thrombosis or if you are at increased risk for developing it. The diagnostic test we use is the duplex ultrasound, which is a noninvasive diagnostic test that uses high-frequency sound waves to determine the speed and direction of blood flow. It is helpful in indicating the presence of a clot in a vein.

DVT treatment

Nonsurgical

The focus for treatment of deep vein thrombosis is to stop the blood clot from enlarging, prevent the clot from breaking off and prevent any new blood clots from forming. Anticoagulants are standard treatment to prevent these complications. Administered as an injection or a pill, anticoagulants work by thinning your blood to prevent clots from forming.

Compression stockings can help reduce swelling and pain by applying gentle pressure to the affected area. Compression stockings are prescribed by your doctor.

Procedures

If blood thinners are ineffective or unsafe, an inferior vena cava filter may be placed. The vena cava is the main vein that connects to your heart from your lower body. An inferior vena cava filter catches clots before they reach your lungs in patients who cannot be treated with blood thinners.

Thrombolysis is a minimally invasive treatment that is used to dissolve blood clots in certain special situations. Using X-ray guidance, a catheter is inserted through a small opening in the skin to the area of the blood clot. A contrast dye is injected and several X-rays are taken to identify the exact location of the clot. If your doctor decides to dissolve the clot with medication, the catheter will remain in place and the medication will be delivered through a machine over several hours or several days.