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Deep Vein Thrombosis
- Topic Overview
-
Health Tools
- Cause
- Symptoms
- What Happens
- What Increases Your Risk
- When To Call a Doctor
- Exams and Tests
- Treatment Overview
- Prevention
- Home Treatment
- Medications
- Surgery
- Other Treatment
- Other Places To Get Help
- References
- Credits
The main goals of treatment for deep vein thrombosis are:
- To prevent the blood clot from becoming larger.
- To prevent the blood clot from traveling to the lungs (pulmonary embolism).
- To prevent postthrombotic syndrome, a condition that can cause pain, sores, and swelling of the affected leg.
- To prevent the recurrence of blood clots.
Initial treatment
If you have symptoms of deep vein thrombosis, testing will begin immediately to find out whether you have a blood clot in your leg. Or, if a blood clot is discovered in your lung (pulmonary embolism), your doctor may test you for deep vein thrombosis.
When you are diagnosed with deep vein thrombosis, treatment begins immediately to reduce the risk that the blood clot will grow or that a piece of the clot might break loose and flow to the lungs (pulmonary embolism). Early treatment also reduces the risk of postthrombotic syndrome.
Deep vein thrombosis is usually treated with anticoagulant medicines: heparin and warfarin (such as Coumadin). Heparin is given through a vein (intravenously, or IV) or as an injection, and it acts immediately. Warfarin is given by mouth, and it takes several days to become effective. Often both medicines are started at the same time, then heparin is discontinued after warfarin becomes effective. Some people may take low-molecular-weight heparin (LMWH) long term instead of warfarin.
If your doctor thinks a clot needs to be dissolved right away, you might get thrombolytic therapy. Your doctor will inject a medicine into the clot using a needle or a tube called a catheter.
Heparin. Two types of heparin are available for treatment of deep vein thrombosis. Unfractionated heparin (UH) is given in the hospital, whereas low-molecular-weight heparin (LMWH) can be self-injected at home, which usually is more convenient. Low-molecular-weight heparin usually does not require periodic blood tests to monitor its effects.
Warfarin. If you have a blood clot in your upper (proximal) leg vein, you will likely need to take warfarin for at least 3 months. After 3 months and depending on your risk factors, your doctor may recommend that you continue on lower doses of warfarin on an ongoing basis to prevent deep vein clots from recurring.
Typically, if you have a blood clot in the lower (distal) deep leg veins (in your calf), you will need to take medicine to prevent more blood clots (anticoagulant medicine) for at least 3 months. The length of time will vary based on your own health. Sometimes your doctor won't start this medicine right away. He or she may wait 24 to 48 hours to see if your blood clot is growing. For symptom relief, your doctor may recommend a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen.
Your doctor may also recommend that you elevate your leg when possible, take walks, and wear compression stockings. These measures may help reduce the pain and swelling that can occur with deep vein thrombosis.
If you are not able to take anticoagulants, you may need a vena cava filter or different medicines.
Ongoing treatment
For deep vein thrombosis in the upper leg, you will probably need to take warfarin for at least 3 months after initial treatment. Some people may take low-molecular-weight heparin (LMWH) long term instead of warfarin.
After 3 months, your doctor may recommend that you continue anticoagulants to prevent deep vein clots from recurring. When you take anticoagulants, you need to take extra steps to avoid bleeding problems.
Heparin. If you take heparin:
Warfarin. If you take warfarin:
- Get regular blood tests.
- Prevent falls and injuries.
- Eat a steady diet, and pay attention to foods that contain vitamin K.
- Tell your doctors about all other medicines and vitamins that you take.
For more information, see:
Treatment if the condition gets worse
If your clot continues to grow or if you develop pulmonary embolism while on anticoagulation medicines, a vena cava filter may be inserted into a vein. This rarely occurs.
What To Think About
Although medical experts do not agree on the usefulness of compression stockings, these stockings are sometimes recommended to help relieve swelling and pain. Compression stockings can lower your chance of developing postthrombotic syndrome.
Pregnant women are generally not given oral anticoagulants—warfarin—because they can cause birth defects. But anticoagulants given through an IV (unfractionated heparin) or that are injected (low-molecular-weight heparin) usually can be given throughout the pregnancy. Oral anticoagulants can be started immediately after the baby is born.
| By: | Healthwise Staff | Last Revised: January 5, 2010 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine Jeffrey S. Ginsberg, MD - Hematology | |
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