Treating Deep Vein Thrombosis

Doctors treat deep vein thrombosis (DVT) with medicines and other devices and therapies. The main goals of treating DVT are to:

  • Stop the blood clot from getting bigger
  • Prevent the blood clot from breaking off and moving to your lungs
  • Reduce your chance of having another blood clot

Medicines

Your doctor may prescribe medicines to prevent or treat DVT.

Anticoagulants

Anticoagulants (AN-te-ko-AG-u-lants) are the most common medicines for treating DVT. They're also known as blood thinners.

These medicines decrease your blood's ability to clot. They also stop existing blood clots from getting bigger. However, blood thinners can't break up blood clots that have already formed. (The body dissolves most blood clots with time.)

Blood thinners can be taken as a pill, an injection under the skin, or through a needle or tube inserted into a vein (called intravenous, or IV, injection).

Warfarin and heparin are two blood thinners used to treat DVT. Warfarin is given in pill form. (Coumadin® is a common brand name for warfarin.) Heparin is given as an injection or through an IV tube. There are different types of heparin. Your doctor will discuss the options with you.

Your doctor may treat you with both heparin and warfarin at the same time. Heparin acts quickly. Warfarin takes 2 to 3 days before it starts to work. Once the warfarin starts to work, the heparin is stopped.

Pregnant women usually are treated with just heparin because warfarin is dangerous during pregnancy.

Treatment for DVT using blood thinners usually lasts for 6 months. The following situations may change the length of treatment:

  • If your blood clot occurred after a short-term risk (for example, surgery), your treatment time may be shorter.
  • If you've had blood clots before, your treatment time may be longer.
  • If you have certain other illnesses, such as cancer, you may need to take blood thinners for as long as you have the illness.

The most common side effect of blood thinners is bleeding. Bleeding can happen if the medicine thins your blood too much. This side effect can be life threatening.

Sometimes the bleeding is internal (inside your body). People treated with blood thinners usually have regular blood tests to measure their blood's ability to clot. These tests are called PT and PTT tests.

These tests also help your doctor make sure you're taking the right amount of medicine. Call your doctor right away if you have easy bruising or bleeding. These may be signs that your medicines have thinned your blood too much.

Thrombin Inhibitors

These medicines interfere with the blood clotting process. They're used to treat blood clots in patients who can't take heparin.

Thrombolytics

Doctors prescribe these medicines to quickly dissolve large blood clots that cause severe symptoms. Because thrombolytics can cause sudden bleeding, they're used only in life-threatening situations.

Other Types of Treatment

Vena Cava Filter

If you can't take blood thinners or they're not working well, your doctor may recommend a vena cava filter.

The filter is inserted inside a large vein called the vena cava. The filter catches blood clots before they travel to the lungs, which prevents pulmonary embolism. However, the filter doesn't stop new blood clots from forming.

Graduated Compression Stockings

Graduated compression stockings can reduce leg swelling caused by a blood clot. These stockings are worn on the legs from the arch of the foot to just above or below the knee.

Compression stockings are tight at the ankle and become looser as they go up the leg. This creates gentle pressure up the leg. The pressure keeps blood from pooling and clotting.

There are three types of compression stockings. One type is support pantyhose, which offer the least amount of pressure.

The second type is over-the-counter compression hose. These stockings give a little more pressure than support pantyhose. Over-the-counter compression hose are sold in medical supply stores and pharmacies.

Prescription-strength compression hose offer the greatest amount of pressure. They also are sold in medical supply stores and pharmacies. However, a specially trained person needs to fit you for these stockings.

Talk with your doctor about how long you should wear compression stockings.

 

 

Source: National Heart, Lung, and Blood Institute, National Institutes of Health.