What are the treatment options for Deep Vein Thrombosis (DVT)?
The main stay of treatment of deep vein thrombosis is anticoagulation (blood thinner medication). New, fast acting medicines (Xarelto, Eliquis, and others) have made a paradigm shift in the treatment of DVT. Rarely is hospitalization necessary for the treatment of DVT or PE. The new medications are much easier to manage that the older medications (Coumadin, Warfarin), which are rarely used today to treat DVT and PE.
Blood thinners (anticoagulation medicine) does not dissolve the clot. Rather, it prevents new fresh clot from forming on the existing DVT. The body has a natural enzyme in the blood called plasminogen that functions to break up clot. Clot that is not dissolved turns to scar tissue in the vein over time.
The length of time a patient is on blood thinners can vary depending on the situation. Times can range from 3 months to a year. In some cases of recurrent DVT or PE, lifetime anticoagulation is recommended.
Occasionally, other treatment modalities are indicated in certain situations. For patients with extensive thrombosis of the larger iliac and femoral veins causing obstruction of blood flow out of the leg, sometimes a procedure is done to try to open up the vein by a combination of removing or breaking up the clot and inserting a stent in the vein to keep it open. This procedure used in less than 1% of DVTs.
In some cases, when anticoagulation is not possible, such as active bleeding, recent or pending major surgery, a procedure is performed where a filter is placed in the inferior vena cava to stop a potential pulmonary embolus from reaching the lungs. This is called an IVC filter. It is only done in specific situations and is not part of the routine treatment of DVT or PE.
The goals of DVT treatment are to:
- Prevent the blood clot from increasing in size and breaking free to form a pulmonary embolism.
- Prevent deep vein thrombosis from occurring again.
- Help control side effects, such as swelling