Deep Vein Thrombosis (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Deep vein thrombosis (DVT) definition and facts
- What is DVT?
- What does a blood clot in the leg look like?
- What causes DVT?
- Signs and symptoms of DVT
- Signs and symptoms of superficial blood clots
- Who is at risk?
- Which types of doctors treat DVT?
- What tests diagnose the condition?
- What are the treatment guidelines for DVT?
- What is the treatment of superficial blood clots?
- Medications to treat blood clots in the leg
- Warfarin (Coumadin, Jantoven)
- Side effects and risks of anticoagulation therapy
- Does DVT require surgery?
- What are the complications?
- How can blood clots in the legs be prevented?
- Deep Vein Thrombosis and Pulmonary Embolism FAQs
- Find a local Cardiologist in your town
Does DVT require surgery?
Surgery is a rare option in treating large deep venous thrombosis of the leg in patients who cannot take blood thinners or who have developed recurrent blood clots while on anti-coagulant medications. The surgery is usually accompanied by placing an IVC (inferior vena cava) filter to prevent future clots from embolizing to the lung.
Phlegmasia Cerulea Dolens describes a situation in which a blood clot forms in the iliac vein of the pelvis and the femoral vein of the leg, obstructing almost all blood return and compromising blood supply to the leg. In this case surgery may be considered to remove the clot, but the patient will also require anti-coagulant medications. Stents may also be required to keep a vein open and prevent clotting. May Thurner Syndrome, also known as iliac vein compression syndrome, is a cause of phlegmasia, in which the iliac vein in the pelvis is compressed and a stent is also needed.
What are the complications?
Pulmonary embolism is the major complication of deep vein thrombosis. With signs and symptoms such as chest pain and shortness of breath, it is a life-threatening condition. Most often pulmonary emboli arise from the legs.
Post-phlebitic syndrome can occur after a deep vein thrombosis. The affected leg or arm can become chronically swollen and painful with skin color changes and ulcer formation around the foot and ankle.
How can blood clots in the legs be prevented?
- Minimize risk factors for DVT, for example, quit smoking (especially if the person also is taking birth control pills or hormone therapy).
- In the hospital setting, the staff works hard to provide DVT prophylaxis to minimize the potential for clot formation in immobilized patients. Surgery patients are out of bed walking (ambulatory) earlier and low dose heparin or enoxaparin is being used for deep vein thrombosis prophylaxis (measures taken to prevent DVT).
- When traveling it is recommended that you get up and walk every couple of hours during a long trip.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.
Kearon, C. et al. "Antithrombotic Therapy for VTE disease: CHEST Guideline and Expert Panel Report." Chest. February 2016, 149:2
Madhaven, A., et al. "May Thurner Syndrome as the Cause of Phlegmasia Cerulia Dolens." Am J Emerg Med: 2015: Dec ePub
Vieg, van Hylckama. et al. The Venous Thrombotic Risk of Oral Contraceptives, Effects of Oestrogen Dose and Progestogen Type: Results of the MEGA Case-control Study. BMJ. 2009; 339:b291.
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