Deep vein thrombosis (DVT) is a formation of blood clots in the large veins, most often in the lower leg. Clots can block the vein or break loose sending fragments through the blood stream to the lungs. The most common medicines for treatment of DVT are anticoagulants, or blood thinners, reports the National Heart Lung and Blood Institute. These medicines work by reducing the ability for your blood to clot, and they prevent existing clots from enlarging.
Blood thinners can be taken orally, as an injection or through an IV in the vein. Warfarin, known by the common brand name Coumadin, is in pill form. Heparin is available as an IV or an injection. Warfarin has to build up in your system to be effective, so heparin may be given for immediate action until the maintenance level by warfarin can be reached.
Possible side effects and risks for taking blood thinners are the same – getting your blood too thin causing bleeding. Since this is potentially life threatening, regular PT and PTT blood checks are required for monitoring your blood to clot.
Compression stockings are recommended by some doctors for treatment of the swelling that accompanies DVT. Compression stockings, also known as support stockings, should reach almost to your knee to maintain pressure on your leg to help the blood return to your heart instead of pooling and clotting. Be sure to get the right size and compression level. The stockings should go on smoothly with no wrinkling or bunching up under the knees. Check with your doctor to determine if you should wear the thigh length or over-the-calf length. Getting the wrong length or amount of compression for your condition can increase leg pain and cause harm. Stockings should be snug, but comfortable.
Thrombolytics are a type of medication known as a clot buster – one of the more serious and aggressive treatments for large clots or those unresponsive to blood thinners. Thrombolytics, such as tissue plasminogen activator (tPA), are directed to the area of the clot through an intravenous line. Because of the high risk for bleeding, the Cleveland Clinic reports that thrombolytics should only be used in extreme situations where the blood clot is massive or has already mobilized to the lungs causing a pulmonary embolism.
Conditions that put you more at risk for serious bleeding when using thrombolytic agents include heart disease, high blood pressure, recent delivery, severe liver disease and recent surgery.
A vein filter placed in the main vain, the inferior vena cava located in your abdomen, can block the blood clots from traveling from your legs to your heart. This is an option if your blood thinning medications are inefficient in reducing and removing your blood clot. Inferior vena cava (IFC) filters can be implanted as permanent or temporary devices, reports RadiologyInfo.
The placement of an IFC filter is done as an outpatient, unless your medical condition requires admission. An image-guided catheter is inserted into a blood vessel and forwarded to the blockage site where the filter is placed. Risks associated with IFC filter placement include infection or bleeding at the insertion site, the filter breaking loose and traveling to the heart or lungs and the filter becoming too full of clots and blocking all blood flow.
National Heart Lung and Blood Institute: Deep Vein Thrombosis https://www.nhlbi.nih.gov/health/dci/Diseases/Dvt/DVT_Treatments.html
Cleveland Clinic: Deep Vein Thrombosis https://my.clevelandclinic.org/disorders/blood_clots/hic_deep_vein_thrombosis_dvt.aspx
RadiologyInfo: What is Inferior Vena Cava Filter Placement and Removal? https://www.radiologyinfo.org/en/info.cfm?pg=VenaCavaFilter