Deep Vein Thrombosis

Deep Vein Thrombosis, DVT, is a term that refers to the development of clots within veins that directly flow towards the heart. They are most commonly diagnosed in the veins of the leg, but can be seen in the arm and pelvis too. There are many causes but can be caused basically by having particularly sticky blood, having slow or no flow within the vein, or from having and injury to a vein.

Many people who have a 'spontaneous' DVT will do so on the background of a combination of these factors. In most circumstances a cause can be found through a detailed history and appropriate investigation by a Specialist.

The usual way of managing a DVT has been to give the patient a blood thinning drug (warfarin). This is given to stop the clot from getting bigger and to enable the body to develop new channels through which blood can flow, either through the clot or through neighbouring veins unaffected by the clot. The biggest perceived risk from a DVT is that part of the clot will break off and be deposited in the arteries of the lung. This is a Pulmonary Embolism, PE, and can lead to life-threatening strain on the heart and compromised breathing.

More recently, a more active form of treatment has been recommended by Vascular Specialists called catheter directed thrombolysis. Instead of passively treating the clot, a potent clot busting drug can be given directly into a fresh clot through a catheter placed into the vein. The effect is to restore the flow through the blood vessel more rapidly, reducing the damage done to the lining of the vein from the presence of the clot. It is believed that doing this prevents the risk of PE, and the risk of developing complications from inadequate clot clearing by the bodies own mechanisms, and reduces the risk of future clots in the same area. Busting the clot, thrombolysis, does frequently mean that there is a period in hospital and a few procedures both to protect the lung with a filter and to insert the clot busting device but the overall benefit is worth the inconvenience and risks involved. Performing catheter directed thrombolysis may not be right for everyone and it may still require the patient to take blood thinner medicines in the future. A Vascular Specialist will be able to best advise you.

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