Blood Thinners (Anticoagulation)

Medication will be prescribed to you that will prevent the formation of new blood clots. This medicine must be taken every day as you doctor prescribes it. You will likely have to take the medicine for 3-6 months, but possibly longer depending on your risk factors. Antiocoagulation medications can be taken in pill form, or may require an injection. Some medications require regular blood tests to monitor its effectiveness. Your doctor will discuss the options with you.

Catheter-Directed Thrombolysis

This procedure is performed by an interventional radiologist and is best performed as soon as possible after a DVT is diagnosed. During this procedure, ultrasound and x-rays are used to guide a small catheter (tube) directly into the affected vein(s). Once the catheter is in place, a drug is administered directly into the clot which dissolves the clot. Other devices are also used which directly remove the clot from the veins. Often patients need to spend the night in the intensive care unit (ICU) while the medicine is being given. Some patients may receive a head CT before the procedure to make sure there is not an increased risk for bleeding.

By removing the clot, it is hoped there will be less damage to the vein and therefore fewer symptoms associated with a post-thrombotic syndrome. Once the clot is dissolved and/or removed, it may be possible to see if there is any narrowing within the vein. This can subsequently be treated with angioplasty or placement of a stent within the narrowed vein.

Inferior Vena Cava Filter Placement

If a patient cannot be treated with blood thinners (due to an increased risk of bleeding) and is not felt to be a candidate for catheter-directed thrombolysis, then placement of an Inferior Vena Cava Filter may be indicated. Filters can also be placed in patients who are felt to be at significantly increased risk for DVT formation who would be unable to tolerate a pulmonary embolism. A filter is a small device that is placed directly into the Inferior Vena Cava, which is the main vein draining blood from both legs. The filter stays within this vein and traps any clot that travels from the legs before it is able to reach the lungs. Filters can be a permanent device, but often they are removed when they are no longer needed. This procedure is done on an outpatient basis at one of our local hospitals.