How Is Deep Vein Thrombosis Treated?

Goals of Treatment

The main goals of treating deep vein thrombosis (DVT) are to:

• Stop the blood clot from getting bigger
• Prevent the blood clot from breaking off and moving to your lungs
• Reduce your chance of having another blood clot

Medicines

Medicines are used to prevent and treat DVT.

Anticoagulants

Anticoagulants (AN-te-ko-AG-u-lants) are the most common medicines for treating DVT. They're also known as blood thinners.

These medicines decrease your blood's ability to clot. They also stop existing blood clots from getting bigger. However, blood thinners can't break up blood clots that have already formed. (The body dissolves most blood clots with time.)

Blood thinners can be taken as either a pill, an injection under the skin, or through a needle or tube inserted into a vein (called intravenous, or IV, injection).

Warfarin and heparin are two blood thinners used to treat DVT. Warfarin is given in pill form. (Coumadin^® is a common brand name for warfarin.) Heparin is given as an injection or through an IV tube. There are different types of heparin. Your doctor will discuss the options with you.

Your doctor may treat you with both heparin and warfarin at the same time. Heparin acts quickly. Warfarin takes 2 to 3 days before it starts to work. Once the warfarin starts to work, the heparin is stopped.

Pregnant women usually are treated with heparin only, because warfarin is dangerous during pregnancy.

Treatment for DVT with blood thinners usually lasts from 3 to 6 months. The following situations may change the length of treatment.

• If your blood clot occurred after a short-term risk (for example, surgery), your treatment time may be shorter.
• If you've had blood clots before, your treatment time may last longer.
• If you have certain other illnesses, such as cancer, you may need to take blood thinners for as long as you have the illness.

The most common side effect of blood thinners is bleeding. This happens if the medicine thins your blood too much. This side effect can be life threatening.

Sometimes, the bleeding is internal (inside your body). People treated with blood thinners usually receive regular blood tests to measure their blood's ability to clot. These blood tests are called PT and PTT tests.

These tests also help your doctor make sure you're taking the right amount of medicine. Call your doctor right away if you have easy bruising or bleeding. This may be a sign that your medicines have thinned your blood too much.

Thrombin Inhibitors

These medicines interfere with the blood clotting process. They're used to treat blood clots in patients who can't take heparin.

Thrombolytics

These medicines are given to quickly dissolve a blood clot. They're used to treat large blood clots that cause severe symptoms.

Because thrombolytics can cause sudden bleeding, they're used only in life-threatening situations.

Other Types of Treatment

Vena Cava Filter

A vena cava filter is used if you can't take blood thinners or if you're taking blood thinners and still developing blood clots.

The filter is inserted inside a large vein called the vena cava. The filter catches blood clots that break off in a vein before they move to the lungs. This prevents pulmonary embolism. However, it doesn't stop new blood clots from forming.

Graduated Compression Stockings

These stockings can reduce the swelling that may occur after a blood clot has developed in your leg. Graduated compression stockings are worn on the legs from the arch of the foot to just above or below the knee.

These stockings are tight at the ankle and become looser as they go up the leg. This creates gentle pressure up the leg. The pressure keeps blood from pooling and clotting.

These stockings should be worn for at least a year after DVT is diagnosed.