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Vein Disorders

UH Experts Diagnose and Treat Deep Vein Thrombosis (DVT)

Thrombosis is a serious medical condition in which a blood clot (thrombus) becomes lodged in a blood vessel and slows or blocks the circulation of blood in the body. Thrombosis can occur in an artery (the vessels that send blood from the heart to the rest of the body) or in a vein (the vessels that return blood to the heart to be reoxygenated). When a clot lodges in a vein, it is called venous thrombosis. If it lodges in one of the deep veins, it is called deep vein thrombosis or DVT.

Your health is important. Get expert care.

To schedule an appointment with a UH vascular specialist, call 216-844-3800 today.

Understanding DVT and the Associated Health Risks

Deep vein thrombosis (DVT) is a common type of venous thrombosis, occurring in approximately 300,000 Americans annually. Although it can occur at any age, it is most common in older adults, with one in 100 in people over the age of 70 developing a DVT.

DVT can develop in any deep vein, including the arms, but is most common in the lower leg, thigh or pelvis. Although deep vein thrombosis by itself is not necessarily life-threatening, if the blood clot or a fragment of the blood clot breaks off and flows to the lungs, it can become a pulmonary embolism (PE). PE is a very common complication of DVT, occurring in 1-2 people out of a thousand. Together, DVT and PE are referred to as venous thromboembolism, which is the third leading cause of cardiovascular disease death after heart attack and stroke.

Another complication of DVT is post-thrombotic syndrome – a lifestyle limiting disease characterized by chronic leg symptoms including severe swelling, pressure, and venous claudication – pain with exercise that resolves with rest. Post-thrombotic syndrome occurs in 20-50 percent of patients with a DVT above the knee.

Who is at Risk for Deep Vein Thrombosis?

DVT with pulmonary embolism is most common in people who have recently had hip or knee surgery and in patients with cancer who undergo abdominal surgery. These patients will usually be prescribed daily aspirin or blood thinners to prevent clots from forming and decrease the risk of PE as they recover from surgery and often for several months after their operation. Other risk factors include:

  • Physical trauma, particularly leg fractures that require cast immobilization
  • Any chronic medical illness that requires hospitalization and/or long-term bed reset
  • Having cancer and/or receiving chemotherapy
  • Taking birth control hormones
  • Age, particularly in people 70+ years of age even if otherwise healthy
  • Excess weight or obesity
  • Thrombophilia – a condition in which your blood forms clots too easily
  • Inherited genetic traits

In addition, about a third of people who develop DVT and PE will have no identified risk factors.

Recognizing the Symptoms of DVT and When to Seek Medical Help

If you are actively being monitored for any of the conditions listed above, your medical provider will be watchful for signs and symptoms of DVTs and may prescribe preventive medications.

If you are not under the care of a health professional or are between visits and experience symptoms such as swelling in your leg, deep muscle pain, cramping, redness or skin that is warm to the touch, it is important to be evaluated by a vascular specialist immediately. You may have a DVT, which if untreated could lead to a pulmonary embolism (PE), a life-threatening condition.

If you experience chest pain, shortness of breath and/or a racing heartbeat, always call 9-1-1.

Noninvasive Diagnosis of Deep Vein Thrombosis and PE

If a patient presents with any symptoms of DVT, the most common method used to confirm or rule out thrombosis is ultrasound – a completely noninvasive and painless procedure that uses sound waves to produce pictures of the body.

The ultrasound technician will first apply a special gel to the area of the leg being studied. The ultrasound wand is then moved up and down the area while pressing down to exert pressure on the area being studied. Normal veins will collapse under this pressure while blocked or congested veins will not. The technologist will flag any abnormal results and send the images to a vascular specialist for interpretation. The test takes less than one hour.

Computed tomography (CT) is the most commonly used diagnostic tool to confirm or rule out pulmonary embolism (PE). For this test, the patient is injected with a contrast dye which lights up the blood vessels on imaging so that any abnormalities or blockages in the lungs can be seen. The test itself only takes a few minutes. In some patients, a PE may be found during imaging tests for other conditions – this is known as an incidental finding.

Proven Therapies for the Treatment of DVT and PE

If a DVT or PE is identified, the first and primary treatment is usually blood thinner medications. These medications work by slowing/stopping the growth of the clot until the body’s natural anticoagulants can dissolve it. Patients will usually be prescribed blood thinners for at least three months or until the healthcare team decides the risk of additional clots forming is minimal.

Patients with idiopathic DVT (no identified cause or risk factors) may be on blood thinners for a longer period of time.

If a patient doesn’t respond to blood thinner medications, or if they have severe symptoms like extreme swelling, more invasive treatments may be used to try and break up, dissolve or remove the clot. These may include:

Reduce Your Risk of DVT with Lifestyle Modifications

Aging is one of the primary risk factors for developing blood clots and there isn’t anything we can do to stop that. However, no matter your age, there are some simple steps you can take to lower your risk of DVT and PE and greatly improve your overall health. These include:

  • Exercise regularly – walking is a great way to keep the blood moving in your legs
  • Quitting smoking
  • Losing weight
  • Managing chronic health problems like diabetes, hypertension and high cholesterol
  • If you have any type of surgery, get moving again as soon as your doctor says it is safe to do so.