Treating Deep Vein Thrombosis

A deep vein thrombosis (DVT) is a blood clot that occurs in a deep vein. If the blood clot isn’t treated, a piece may break off and go to your lungs. This causes a potentially life-threatening complication called a pulmonary embolism (PE). Over time, a DVT can also damage veins. To protect your health, a DVT must be treated right away. Both hospital and home treatment for DVT includes medicines to stop the clot from growing.

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Treating DVT at Home or in the Hospital

A DVT is treated with blood thinners called anticoagulants. These medications control and prevent more blood clots from forming. You may get your anticoagulant through a vein (intravenous), as an injection, or as a pill. A DVT is often treated at home with anticoagulants. In certain cases, your health care provider may tell you go to the hospital for treatment. You may need to do this if you have a very large DVT or a pulmonary embolism. You may also need to do this if you are at risk for bleeding complications or you have a serious illness.

Getting back on your feet soon after you find out you have an uncomplicated DVT may help ease symptoms and speed up your recovery. But in certain cases, your health care provider may tell you to limit your activity. Talk with him or her about what level of activity is right for you.

Medication

Your health care provider will prescribe an anticoagulant to treat your DVT. You may be given warfarin as a pill along with an injection or through a vein for at least 5 days. A newer treatment is a pill called rivaroxaban. This pill doesn’t need you to also have an injection or an IV.

Take your anticoagulant exactly as directed. Keep all scheduled appointments for blood testing. If you don’t, you will be at risk for bleeding complications.

If you were prescribed warfarin, you will need regular blood tests to measure its effect. These blood tests include a prothrombin time (PT) and international normalized ratio (INR). Your dose of warfarin will be changed based upon these test results. Your doctor will manage your warfarin. Or you may need to go to an anticoagulation clinic. It’s very important that you know when your next PT/INR blood test is. Your health care provider or the clinic will give you dosing instructions based upon those results.

If you were prescribed rivaroxaban, you won’t need PT/INR testing. But you should have lab tests to check kidney function.

Medication tips:

  • When you are taking warfarin, make sure your intake of vitamin K stays at about the same level. This is because vitamin K helps your blood clot. You don’t have to avoid foods with vitamin K, but keep the amount you eat about the same each day.

  • Don’t make major changes to your daily diet. Always tell your doctor before you make changes to your diet habits.

  • Follow up with your doctor as advised. Make sure your doctor knows about all of the medications you are taking, including those that are over-the-counter. Dietary supplements may interact with your anticoagulant.

  • Don’t stop or start any medications, including those that are over-the-counter, unless your doctor or pharmacist tells you to do so.

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Additional Treatment Tips

  • Your health care provider may tell you to use compression stockings. These will make the blood flow more easily in your legs. They also help prevent long-term tissue damage.

  • When you are at rest, put your legs up on a soft surface, such as a pillow. Move your ankles, toes, and knees often to help the blood flow.

  • You may need anti-inflammatory medicine to help relieve pain.

Procedures

Depending on your health and the size of your DVT and where it is, your health care provider may recommend that you have 1 or more procedures. These can be done only in certain cases. Your doctor can give you more information and answer any questions you may have.

Thrombolysis. This procedure dissolves a large clot. A thin tube (catheter) is placed into the vein where the DVT is. The doctor takes X-rays of the vein and the clot. Then, clot-dissolving medication is sent to the clot through the catheter. In some cases, a mechanical device is also used to break up the clot.

Angioplasty. This procedure widens the vein where the DVT is and makes blood flow better. Narrowing (stenosis) of the vein can block blood flow and make it more likely that a blood clot will form. A catheter with a balloon on the end is placed into the vein where the DVT is. The doctor uses X-rays to put the catheter in the right place. Once the catheter is in place, the balloon is inflated to widen the vein. In some cases, a wire mesh device (stent) may also be put in the vein to help keep it open.

Inferior vena cava filter. An inferior vena cava (IVC) filter is a small device used to trap a clot (embolus) in a leg. The IVC is the largest vein in your body. A catheter is placed in the vein. The filter is then sent through the catheter to the clot. This procedure may be done if you have a blood clot in the leg. It may also be done before surgery if you are at risk for a pulmonary embolism. Health care providers typically recommend an IVC for people who can’t take blood thinners to treat a DVT. It may also be used for people who have DVTs that form again even after taking blood thinners.

 

When to Seek Medical Attention

DVTs and their treatment have risks.

Call 911 right away if you have any of the following:

  • Sudden chest pain

  • Shortness of breath

  • Fast heartbeat

  • Sweating

  • Fainting

  • Coughing up blood

  • Pain, swelling, redness, or warmth in the calf or thigh

Otherwise, call your doctor right away if you have signs of problems with your anticoagulant, such as:

  • Cough with bloody sputum

  • Bruises

  • Heavy or uncontrolled bleeding

  • Bleeding in the urine, stool, or vomit

  • Black or tarry stools