Doctors & Physicians- What is the treatment for deep venous thrombosis???

Question

Doctors & Physicians- What is the treatment for deep venous thrombosis???

Answer 1

The most common treatment is blood thinners, like heparin.

The goals of deep vein thrombosis treatment are to stop your blood clot from getting any bigger, to prevent the clot from breaking loose and causing a pulmonary embolism, and to prevent deep vein thrombosis from happening again.

Deep vein thrombosis treatment options include:

    *

      Blood thinners. Medications used to treat deep vein thrombosis include the use of anticoagulants, also sometimes called blood thinners, whenever possible. These are drugs that decrease your blood's ability to clot. While they don't break up existing blood clots, they can prevent clots from getting bigger or reduce your risk of developing additional clots.

      Typically, you'll first be given an injection of the anticoagulant heparin for a few days. There are two main forms of heparin, low-molecular-weight heparin and unfractionated heparin. Recent guidelines suggest low-molecular-weight heparin is usually the best treatment option. After heparin injections, your treatment may be followed by another anticoagulant in pill form, likely warfarin. You may need to take anticoagulants for three months or longer.

      The use of heparin and warfarin must be closely monitored because both can have side effects, such as an increased risk of bleeding. On the other hand, if your dose is too low, you're at increased risk of additional blood clots. To monitor the effects of blood thinners, you will need periodic blood tests to check how long it takes your blood to clot. Pregnant women should not take warfarin.

    * Clotbusters. If you have a more serious type of deep vein thrombosis or pulmonary embolism, or if other medications aren't working, your doctor may try other medications. One group of medications is known as thrombolytics. These drugs, such as tissue plasminogen activator (tPA), are given intravenously to break up blood clots. These drugs can cause serious bleeding and are typically used only in life-threatening situations.

    * Filters. If you can't take medicines to thin your blood, a filter may be inserted into a large vein — the vena cava — in your abdomen. This filter prevents clots that break loose from lodging in your lungs. The filters are sometimes referred to as "umbrellas" because they look like the wire spokes of an umbrella.

    * Compression stockings. These help prevent swelling associated with deep vein thrombosis. These stockings are worn on the leg from your foot to about the level of your knee. This pressure helps reduce the chances that your blood will pool and clot. You should wear these stockings for at least a year if possible.

Answer 2

The first poster has a great answer. In addition, I would like to mention that plenty of movement can be important as prophylaxis. It seems simplistic but it is often suggested that on long flights, one gets up and moves about the cabin regularly to prevent formation of clots. My father developed a DVT that caused his death. He had been slowly rehabilitating after a large spinal surgery and was not able to take blood thinners due to other complicated health issues. He wore compression stockings (another recommended approach as both prophylaxis and treatment) but not for the weeks before his PE while he was in the hospital.

Then there are surgical methods of extracting or treating clots. IV anticoagulants can be administered or, if the patient cannot take that route, a procedure called a thrombectomy can be performed. A small incision is made and the clot is extracted surgically, though it's not the ideal procedure (and was not an option for my father). Ironically, he would have been the physician to perform the angioplasty or stenting, had he not been the patient instead.

Answer 3

Usually blood thinners for several months - then repeat ultrasound to ensure the clot is gone.  If there are no increased risk factors, usually daily aspirin.  If the clots persist or if there are additional risk factors, likely a daily anti-coagulant (i.e. coumadin) would be prescribled.

Answer 4

It depends on where the DVT is and what it's doing.  A DVT in the thigh or pelvis is at high risk for causing a pulmonary embolus. It's typically treated with warfarin, perhaps along with elevation and warm compresses. Since it takes some time for warfarin to take effect, heparin (either unfractionated or a low-molecular weight type) is normally used initially.

A DVT in other areas may be at lower risk for PE than the risk of bleeding from the anticoagulant, and it may be approached with symptomatic treatment and watchful waiting. In this case, a DVT in the calf, for instance, might on serial exam be seen to extend towards and above the knee, in which case it may be judged to need the anticoagulant.