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Deep Vein Thrombosis: Aggressive clotting from a curable condition
Omar P. Haqqani, MD
Midland Daily News
January 15, 2017
Arteries and veins: Both share an equal importance in transporting blood all over the body, with the arteries taking oxygenated blood to all of the body’s major systems, and the veins returning oxygen-poor blood back to the heart.
In this system of give and take, all that’s required is for one clot to disrupt blood flow, vastly affecting the way our bodies are able to function properly.
Deep Vein Thrombosis (DVT) is among the many vascular diseases that make these tasks difficult to perform. DVT occurs when irregular blood clotting forms within one of the body’s deep vein systems, which all ultimately lead to the heart.
Some veins lie deep inside the muscle, while others just beneath the skin. However, all deep veins connect to the vena cava, the largest vein in the body.
DVT most commonly occurs in the thigh, calf or pelvis, but can also occur in the chest or an arm.
There are many risk factors that are either directly responsible for the contribution of a deep vein thrombosis, or may put someone at an increased of developing one.
Risk factors that have the potential to lead to a DVT are either a result of previous conditions, such as trauma, bone fracture, cancer, varicose veins; past experiences, such as surgery of the hip, leg or abdomen, or pregnancy; or from the use of medications or health devices, such as birth control pills, hormones taken for menopause symptoms, long term intravenous lines, use of a pacemaker or implantable cardioverter defibrillator.
As far as risk factors that put those at an increased risk of developing a deep vein thrombosis, obesity, inherited tendencies that increase the risk of blood clots, being older than 60, or being in a Type A blood group, all contribute to this possibility.
A DVT can be diagnosed through a number of different tests, or a simple physical examination.
In the case of a physical examination, a medical doctor or vascular specialist would look at the affected area, keeping an eye out for any signs of swelling, redness, warmth, tenderness, or pain that occurs when walking or standing.
Tests can also be done to confirm diagnosis of a DVT. A duplex ultrasound, for example, is able to obtain a photo of the affected area, while a venogram helps to identify the vein affected by the blood clot.
If you find yourself diagnosed with a DVT, it’s important to know that there are many different treatment options for dissolving clots found in a deep vein system, depending on the signs, symptoms and extent of the disease.
Additionally, when looking at the various medications and therapies, your doctor or vascular specialist will also take a look at your age and health as factors for treatment.
In the early stages of DVT, compression stockings are typically recommended to help prevent blood from collecting in the leg veins, as well as reduce swelling caused by previously formed clots.
When looking at medications, anticoagulant therapy, such as Warfarin (Coumadin) or newer drugs, such as Rivaroxaban, is often used to help control the size of current clots, as well as thin the blood to prevent new clots from forming. Through this method, either an anticoagulant pill or IV is administered for a given period.
When these treatments aren’t enough to work on their own, there are a few different minimally invasive procedures to help dissolve the clots.
In patients who have a high risk of developing a pulmonary embolism, a condition where a blood clot dislodges and travels to the lung or in younger patients, thrombolytics may be recommended. Through this procedure, a catheter is placed into the vein where the clot exists, and a “clot-busting” drug is then injected to help dissolve the clot over time.
In another catheter-based procedure, an Inferior Vena Cava (IVC) filter is inserted through a vein in the leg, arm, or neck. After this, a small metal filter that looks like an inverted pyramid is passed through the catheter and placed in the inferior vena cava to trap any clots that may break away from the leg veins.
Finally, in a venous thrombectomy, clots are surgically removed through a procedure. This method is typically used when all other medication therapies have proven ineffective.
DVT are common conditions, and may affect someone you know. They require aggressive treatments to avoid long term complications, such as post-thrombotic syndrome, which causes intractable swelling — and has no known cure. Preserving the function of the veins requires early intervention by a vascular surgeon.
In order to fully understand the benefits and requirements for undergoing any of these procedures, consult your doctor or vascular surgeon for more information.
A deep vein thrombosis can ultimately affect the way our bodily processes take place, putting us at risk of developing a number of serious health concerns as a result. However, the more we continue to educate ourselves about vascular disease and how we can control its effects on the body, the better.
Dr. Omar P. Haqqani is the chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.
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