Deep vein thrombosis, or more commonly DVT, is described by medical professionals as a thrombosis, or blood clot, that develops within the deep veins of the extremities, usually in the legs or arms. A DVT is considered a medical emergency due to the risk of embolization, which can occur if a piece of a blood clot breaks free and off and travels through the circulation system to the heart, and becomes lodged in one of the pulmonary arteries. If essential flow is blocked in the lungs, a life-threatening pulmonary embolism can occur.
There are several risk factors for the development of a DVT, including immobility due to:
- Prolonged travel
- Obesity
- Pregnancy
- Surgery
- Hospitalization
- Casting of the arm or leg
In addition, DVT can form in patients who smoke, take an estro-oral contraceptives (i.e., Yaz), or have a genetic history of blood clotting.
If a doctor suspects a DVT, a physical exam will likely check the suspect area for tenderness, heat, pain, inflammation, and redness. Further diagnosis of a blood clot often entails a D-dimer blood test to examine for high levels of D-dimer (an indication of a DVT) in the blood, and an ultrasound for visual confirmation of a DVT deep within an arm, leg, chest, or pelvis. If a DVT is confirmed the following treatments may take place:
1. Anticoagulation therapy
Several different types of anticoagulation medications have been approved by the American College of Chest Physicians, but most common are novel oral anticoagulants (or NOACs), which are considered the first and foremost DVT treatment. NOACs are a type of oral anticoagulant medication that aim to thin the blood immediately to lower the risk of a pulmonary embolism or stroke from occurring. NOACs are typically marketed under names such as Savaysa, Eliquis, Xarelto, and Pradaxa in patients with no active cancers. For patients who are unable to take blood thinners due to another health issue (i.e., cancer or a bleeding disorder), low molecular weight heparin injections (i.e., Enoxaparin) are typically used in combination with a vitamin K antagonist (i.e., Warfarin) to block the blood from clotting. Patients using anticoagulation medications should always be closely supervised for bleeding by a healthcare professional.
2. Surgery for DVT
Although surgery for DVT is only recommended in rare instances, patients who have reoccurring blood clots and are unable to take blood thinners have very few other options. DVT surgery typically entails the insertion of a stent in a vein or a filter in the inferior vena cava (IVC), which is the large vein that transports deoxygenated blood from the lower and middle body into the right atrium of the heart). This filter works to prevent any future blood clots from developing in the lung.
