Deep vein thrombosis (DVT, also called venous thrombosis) is a blood clot that develops in a vein deep in the body. The clot may partially or completely block blood flow through the vein. Most DVTs occur in the lower leg, thigh or pelvis, although they also can occur in other parts of the body including the arm, brain, intestines, liver or kidney.
Even though DVT itself is not life-threatening, the blood clot has the potential to break free and travel through the bloodstream, where it can become lodged in the blood vessels of the lung (known as a pulmonary embolism). This can be a life- threatening condition. Therefore, prompt diagnosis and treatment are necessary.
DVT can also lead to complications in the legs referred to as chronic venous insufficiency or the post-thrombotic syndrome. This condition is characterized by pooling of blood, chronic leg swelling, increased pressure, increased pigmentation or discoloration of the skin, and leg ulcers known as venous stasis ulcers.
A superficial venous thrombosis (also called phlebitis or superficial thrombophlebitis) is a blood clot that develops in a vein close to the surface of the skin. These types of blood clots do not usually travel to the lungs unless they move from the superficial system into the deep venous system first.
A DVT usually forms in one leg or one arm. Not everyone with a DVT will have symptoms, but symptoms can include:
Some people do not know they have a DVT until the clot moves from their leg or arm and travels to their lung.
It is important to call your doctor right away or go to the emergency room if you have symptoms of a pulmonary embolism or DVT. Do not wait to see if the symptoms “go away.” Get treatment right away to prevent serious complications.
The following conditions can increase your risk of a DVT:
An appointment to find out if you have a DVT includes an exam and review of your medical history. You will also need testing. Common tests to diagnose a DVT are:
A duplex venous ultrasound. This is the most common test used to diagnose a DVT. It shows the blood flow in the veins and any blood clots that exist. An ultrasound technician will apply pressure while scanning your arm or leg. If the pressure does not cause the vein to compress, it could mean there is a blood clot.
Venography. This test uses X-rays to show your deep veins. A special dye (contrast material) is injected into your veins so the X-rays show the veins and any blood clots. Any blockage in blood flow may also be seen. Venography may be used if the results of the duplex ultrasound aren’t clear.
Other tests you may have include:
If your doctor thinks you may have a genetic disorder that causes blood clots, you may need blood tests. This may be important if:
A DVT may make it harder for you to get around at first. You should slowly return to your normal activities. If your legs feel swollen or heavy, lie in bed with your heels propped up about 5 to 6 inches. This helps improve circulation and decreases swelling.
Patients with a DVT may need to be treated in the hospital. Others may be able to have outpatient treatment.
Treatments include medications, compression stockings and elevating the affected leg. If the blood clot is extensive, you may need more invasive testing and treatment. The main goals of treatment are to:
Important Information About Medications
Treatment for a DVT can include:
Anticoagulants ("blood thinners"). This type of medication makes it harder for your blood to clot. Anticoagulants also stop clots from getting bigger and prevent blood clots from moving. Anticoagulants do not destroy clots. Your body may naturally dissolve a clot, but sometimes clots do not completely disappear.
There are different types of anticoagulants. Your doctor will talk to you about the best type of medication for you.
If you need to take an anticoagulant, you may only need to take it for 3 to 6 months. But, your treatment time may be different if:
The most common side effect of anticoagulants is bleeding. You should call your doctor right away if you notice that you bruise or bleed easily while taking this medication.
You will likely need to wear graduated compression stockings to get rid of leg swelling. The swelling is often because the valves in the leg veins are damaged or the vein is blocked by the DVT.
Most compression stockings are worn just below the knee. These stockings are tight at the ankle and become more loose as they go up the leg. This causes gentle pressure (compression) on your leg.
Vena cava filters are used when you cannot take medications to thin your blood or if you have blood clots while taking this type of medication. The filter prevents blood clots from moving from the vein in your legs to the lung (pulmonary embolism). The filter is put in place during minor surgery. It is inserted through a catheter into a large vein in the groin or neck, then into the vena cava (the largest vein in the body). Once in place, the filter catches clots as they move through the body. This treatment helps prevent a pulmonary embolism, but does not prevent the formation of more clots.
After you have a DVT, you will need to reduce your risk of future clots by:
If you have never had a DVT , but have an increased risk of developing one, be sure to:
Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.
Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart and Vascular Institute Outcomes.
Choosing a doctor to treat your vascular disease depends on where you are in your diagnosis and treatment. The following Heart and Vascular Institute Sections and Departments treat patients with all types of vascular disease, including blood clotting disorders:
Section of Vascular Medicine: for evaluation, medical management or interventional procedures to treat vascular disease. In addition, the Non-Invasive Laboratory includes state-of-the art computerized imaging equipment to assist in diagnosing vascular disease, without added discomfort to the patient. Call Vascular Medicine Appointments, toll-free 800.223.2273, extension 44420 or request an appointment online.
Department of Vascular Surgery: surgery evaluation for surgical treatment of vascular disease, including aorta, peripheral artery, and venous disease. Call Vascular Surgery Appointments, toll-free 800.23.2273, extension 44508 or request an appointment online.
You may also use our MyConsult second opinion consultation using the Internet.
The Heart and Vascular Institute also has specialized centers and clinics to treat certain populations of patients:
Learn more about experts who specialize in the diagnosis and treatment of vascular and arterial disease.
If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
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