Treatment of Deep Vein Thrombosis

Treatment for deep vein thrombosis (DVT), a blood clot deep in a vein, ranges from medication to self-care to surgery. Discuss treatment options with your doctor.

There is more than one reason to treat deep vein thrombosis (DVT):

  • Preventing a clot from growing
  • Preventing a clot from breaking off and traveling to the lung or other organ (embolus)
  • Avoiding long-lasting complications, such as leg pain and swelling
  • Preventing blood clots from recurring
Blood Thinners for DVT

Blood thinners (also called anticoagulants) are the most common type of treatment for DVT. The two main types of anticoagulants are heparin and warfarin (Coumadin).

Blood thinners can:

  • Keep a clot from growing or breaking off
  • Prevent new clots from forming

But blood thinners cannot thin the blood (despite their name), or dissolve an existing clot.

Heparin: Traditionally, people have received heparin intravenously in the hospital for about five to seven days. However, low-molecular-weight heparin is a new DVT treatment. It’s effective within hours, reducing complications and hospitalizations. You can do the injections at home, once or twice daily, on an outpatient basis. And because it is more consistent and predictable, it doesn’t require regular blood tests.

Warfarin: As a DVT treatment, you take warfarin (Coumadin) by pill once a day, beginning while you’re still on heparin. Treatment may continue for three to six months. While on warfarin, you will need regular blood tests to ensure you have the correct dosage, too little increases your clot risk, too much increases your risk for bleeding. Warfarin can also interact with other medicines, vitamins, or certain foods rich in vitamin K, making regular monitoring even more important.

If you’re pregnant, your doctor will prescribe other types of treatment because warfarin can cause birth defects. If you can’t take warfarin as a DVT treatment, an anticoagulant called a thrombin inhibitor may be an option. Or your doctor may recommend taking low-molecular-weight heparin for a longer period.

DVT and Catheter-Directed Thrombolysis

If you have a DVT, your body will dissolve a blood clot over time, but damage can occur inside your vein in the meantime. For this reason, your doctor may recommend a clot-busting drug called a thrombolytic agent.

This DVT treatment may be necessary:

  • For larger clots
  • If you’re at high risk for pulmonary embolism
  • If you have DVT in an arm, instead of a leg

Catheter-directed thrombolysis rapidly breaks up a clot, restoring blood flow. It may also preserve valve function in the vein that contained the clot. The procedure is done in the hospital and carries a higher risk of bleeding problems and stroke than does anticoagulant therapy.

This is how a catheter-directed thrombolysis is done to treat DVT:

With imaging guidance, the physician inserts a thin tube (catheter) into and through a vein in your leg. They will then put the tip of the catheter into the clot and infuses a clot-busting drug directly into it. If the vein appears narrowed, the physician may do a balloon angioplasty or stent placement to widen it and help prevent future blockages.

Other Types of DVT Treatment

If blood thinners or thrombolysis procedures are not possible, or don’t work well, your doctor may recommend an alternative treatment for DVT.

These include:

Inferior Vena Cava filter: This is a small metal device that is temporarily inserted to capture blood clots and prevent them from moving to other areas of your body. The filter allows blood to pass through the vein as it normally would.

A physician inserts the filter into the vena cava, which is the main vein going back to the heart from your lower body. To reach this vein, which is in your abdomen, the doctor inserts the filter into a leg, neck, or arm vein. Ask your doctor how long the filter needs to stay in place.

Elevation and compression: Elevating the affected leg and using a compression device may help reduce symptoms of DVT, such as swelling and pain. Your doctor may also prescribe graduated compression stockings to reduce the risk of recurrence. You wear this DVT treatment from the arch of your foot to just above or below your knee.

Venous thrombectomy: In very rare cases, surgery is required to remove a deep vein clot. This may be true if you have a severe type of DVT that does not respond well to nonsurgical DVT treatment. This is called phlegmasia cerulea dolens.