Frequently Asked Questions (FAQs)
What is DVT?
DVT - or Deep Vein Thrombosis - causes blood to clot, creating a thrombus within a vein that is deep inside the body, usually in the lower leg or thigh.
How does thrombus associated with DVT form?
In the legs, deep veins carry the blood from the legs to the heart with the help of powerful muscles that contract to propel the blood. After these muscles contract, one-way valves (venous valves) close to prevent blood from flowing back to the feet.
Illness, injury, vessel damage, or inactivity can slow down the blood’s movement through these veins, causing blood to “pool.” This stagnating blood creates an environment for a clot to form. Also, some people have an increased tendency toward blood clotting, either due to medication or genetic factors.
Who is at risk for developing DVT?
There are several key risk factors for developing DVT. If there is a sudden, unexplained pain or swelling in your leg or arm, consider the following situations that may be adversely affecting your circulatory system:
- Prolonged inactivity, such as bed rest during or after a surgical procedure or illness (longer than three days)
- Lengthy air or car travel where you have been unable to walk or move around (longer than four hours)
- Recent severe injury, trauma, infection, or major medical procedure that has resulted in inflammation of a vein’s lining
You should also be aware of certain hereditary and medical conditions that can increase your risk for developing DVT, such as:
- Family history (parents or siblings) of problems with blood clots
- Advanced age (elderly people are especially susceptible)
- Recent fracture or break in a limb
- Obesity
- Cancers and their treatments
- Chronic, serious illnesses such as congestive heart failure, heart attack, stroke, or sepsis
- Varicose veins
- Third trimester pregnancy and immediately following delivery
- Contraceptives/estrogen therapy
- Undiagnosed clotting disorder
- Smoking
- Sedentary lifestyle
What are the symptoms of DVT?
The symptoms of DVT can mimic those of other disorders (such as edema due to congestive heart failure, stress fractures, or arthritis), making it difficult to diagnose and treat in a timely manner. Or, there may be no symptoms at all.
The most common symptoms of DVT are:
- Swelling in the leg or arm
- Limb pain or tenderness
- Pain upon touching the affected area
- Skin that is overly warm or feverish to the touch
- Significantly red skin
- Lack of a pulse in the extremities
Why is it important to get timely diagnosis and treatment of DVT?
DVT should be treated quickly to reduce the risk of serious complications such as pulmonary embolism (PE) and post-thrombotic syndrome (PTS).
PE occurs when a piece of the thrombus breaks free from the venous lining and travels to the lungs, thereby blocking the pulmonary artery or one of its branches. PE is a serious life-threatening condition, characterized by symptoms such as sudden, unexplained shortness of breath, chest pain, unexplained coughing, and painful breathing.
PTS is caused by damage to venous valves and blocked blood flow from DVT and can result in chronic pain, poor quality of life, and increased healthcare costs. Symptoms of PTS may include swelling, heaviness, pain with walking, cramps, and hard patches on the skin.
If you suspect you are having symptoms of PE or PTS, contact your healthcare provider immediately.
What are the common treatments for DVT?
Minimally invasive treatment options are preferred for managing DVT. The most common are:
Anticoagulant drugs (blood thinners). Anticoagulants can be injected, administered intravenously, or given orally to relieve symptoms and reduce the risk of a pulmonary embolism. They are effective and easy to administer but may cause bleeding complications from long-term use. In addition, anticoagulants do not eliminate the thrombus or reduce the potential for valve damage that can lead to post-thrombotic syndrome. Anticoagulant dosage must be carefully monitored for each patient.
Thrombolytic (clot-dissolving) therapy. This therapy employs injection of a clot-dissolving drug into the thrombus. Thrombolytics are effective and relatively easy to administer but generally take time for the thrombus to dissolve. Infusion may last 8-48 hours and requires multiple trips to the lab to assess progress. With thrombolytics, there is an increased risk of bleeding and a slight risk of intracranial bleeding, which may cause a stroke.
AngioJet® mechanical thrombectomy.This therapy is the only FDA-cleared option that actually removes a thrombus associated with DVT from the body. With this technology, a thin, flexible catheter is inserted into the thrombus. High-speed water jets create a vacuum to pull the thrombus into the catheter where the jets break it into tiny fragments. These fragments are then propelled back through the catheter and evacuated from the body. Mechanical thrombectomy quickly restores blood flow and resolves symptoms. It removes thrombus from the body and can potentially reduce or eliminate the amount and duration of thrombolytic (clot-dissolving) medications used. A potential complication with mechanical thrombectomy includes transient hemolysis, damage of red blood cells, which may lead to impaired kidney function.
AngioJet® mechanical thrombectomy combined with thrombolytics. This therapy, called pharmacomechanical thrombectomy, combines catheter-delivered thrombolytics and AngioJet mechanical thrombectomy. A thrombectomy catheter infuses the thrombus with a drug that softens the clot. The same catheter then employs high-speed water jets to create a vacuum for pulling the clot into the catheter. The clot is pulverized by the jets and then evacuated from the body.
Which doctor do I see if I suspect DVT? See your primary healthcare provider immediately if you suspect you have DVT. Your provider will evaluate you and your symptoms and may refer you to a specialist such as a vascular surgeon or interventional radiologist.
AngioJet is a trademark of Medrad Inc.