Deep venous thrombosis is a condition in which a blood clot forms in a vein that is deep inside the body.
Alternative Names: DVT; Blood clot in the legs; Thromboembolism
Causes, incidence, and risk factors:
Deep venous thrombosis (DVT) mainly affects the large veins in the lower leg and thigh. The clot can block blood flow. If the clot breaks off and moves through the bloodstream, it can get stuck in the brain, lungs, heart, or other area, leading to severe damage.
Risks for DVT include:
Sitting for a long time, such as on a long plane or car trip
Bedrest
Recent surgery (especially hip, knee, or female reproductive organ surgery)
For years, the standard treatment has been a medication called heparin, which stops blood clots from forming. This type of medicine is called an anticoagulant.
If heparin is given continuously through a vein (IV), you must stay in the hospital. However, newer forms of heparin that can be given by injection once or twice a day can sometimes be used. Usually, it's a drug called enoxaparin. You may not need to stay in the hospital as long, or at all, if you are prescribed this newer form of heparin.
The drug warfarin may be prescribed in combination with heparin. Warfarin is taken by mouth. It usually takes several days to fully work. Heparin is continued until the warfarin has been fully effective for at least 24 hours. People will take warfarin for about 6 months, depending on their risk for another clot.
You will need frequent lab tests when you first start taking warfarin to check the thickness of your blood, so your health care provider can properly adjust your dose.
In rare cases, surgery may be needed if medicines do not work. Surgery may involve:
Removal of a large blood clot from the vein or injection of clot-busting medicines
Placement of a screen in the body's largest vein to prevent blood clots from traveling to the lungs
Support Groups:
Expectations (prognosis):
Many DVT's disappear without a problem, but they can return. Some people may have long-term pain and swelling in the leg known as post-phlebitic syndrome. Wearing tight (compression) stockings may help relieve this problem.
Complications:
A blood clot that breaks free in the leg and travel to the lungs (pulmonary embolus ) can be life threatening. Rapid treatment of DVT helps prevent this problem.
Calling your health care provider:
Call your health care provider if you have DVT-like symptoms.
Doctors may prescribe blood thinners to help prevent DVT in high-risk people or those who are undergoing high-risk surgery.
Sometimes patients in the hospital wear special soft boots that automatically (and gently) squeeze the calves every now and then. This is called intermittent pneumatic compression. It helps keep blood moving and prevents blood clotting.
Moving your legs often during long plane trips, car trips, and other situations in which you are sitting or lying down for long periods of time can also help prevent DVT.
References: Snow V, Qaseem A, Barry P,et al. Management of venous thromboembolism: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2007 Feb 6;146(3):204-10. Epub 2007 Jan 29.
Brotman DJ, Jaffer AK. Prevention of venous thromboembolism in the geriatric patient.Cardiol Clin. 2008 May;26(2):221-34, vi.
Review Date: 6/10/2008 Reviewed By: Sean O. Stitham, MD, private practice in Internal Medicine, Seattle, Washington; and James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.