Schedule an initial consultation at one of these locations:

Utah Vascular Clinic

801.281.0027

650 East 4500 South, Suite 100
Salt Lake City, UT 84107

Ogden Regional Medical Center

801.479.2450

5475 South 500 East
Washington Terrace, UT 84405

Services

Vascular

Pharmomechanical Thrombolysis of Deep Vein Thrombosis

What is a deep vein thrombosis (DVT)?

DVT, or "deep vein thrombosis" literally means clotting of the deep veins. Veins are the low-pressure blood vessels (as opposed to the high-pressure arteries) that return the blood from the limbs, brain and internal organs back to the heart. Clotting of the veins, or thrombosis, almost always occurs in the legs.

What are the symptoms of a DVT?

A DVT in the legs can have no symptoms at all, but if the clot is large or extensive enough it can cause pain, redness, leg swelling and pain.

What are the risk factors for DVT?

Clots can form in the veins for many reasons, usually because of a combination of risk factors. Conditions that slow the flow of blood for an extended period of time such as immobility or long car or plane rides can promote a DVT. Surgical procedures and trauma to the veins or tissues such as knee surgery or an intravenous catheter are additional risk factors. Conditions that make the blood prone to clotting such as birth control pills or certain genetic conditions can also play a role. Finally, having a previous DVT is a risk factor for developing another clot.


What is the treatment for a DVT?

Small clots in superficial veins (veins just under the skin) and clots limited to the calf muscles frequently don’t need any treatment at all. The standard treatment for deeper clots above the calves is anticoagulation. Anticoagulant medications are also known as "blood thinners". Depending upon the severity of the clot and your risk factors, anticoagulants are usually given for three to six months.

What are the side effects of a DVT?

Short term, a DVT can break off and float into the lungs, a condition called "pulmonary embolism". A pulmonary embolism is a dangerous condition that can cause chest pain, shortness of breath, or sudden death. The reason for anticoagulation medications is not only to prevent a DVT from growing, but also to prevent a fatal pulmonary embolism.

Long term, a DVT can damage the veins and their valves. Valves are tiny cusps inside the veins that prevent backflow of blood into the feet. When the valves are damaged, backflow causes increased pressure that results in pain and swelling. If the pressure is severe, long term complications such as darkening – or pigmentation – of the skin, hardening and flakiness of the skin, and skin ulceration can occur. These problems are collectively called "post-phlebitic syndrome".

What is venous thrombolysis?

Thrombolysis means to dissolve a blood clot. If your clot is large and your acute symptoms are severe, your doctor may refer you to an interventional radiologist for venous thrombolysis. Thrombolysis is a minimally invasive image guided procedure. During a thrombolysis, an interventional radiologist threads a small hollow tube into the clotted vein behind the knee using ultrasound. Thrombolytic medication is then infused to dissolve the clot. After the procedure the catheter is removed and pressure is used to seal the tiny hole in the vein. The procedure is performed awake without the need for general anesthesia or incisions. The skin behind the knee is numbed with an anesthetic before the catheter is placed and IV medications are given to prevent anxiety.

What are the benefits of thrombolysis?

Thrombolysis can result in a rapid improvement in the acute pain and swelling associated with DVT. Long term, thrombolysis has been shown to prevent or reduce the painful and disfiguring complications of DVT including post-phlebitic syndrome. Because there are occasional bleeding complications from thrombolysis, this procedure is usually reserved for patients with large clots that cause severe symptoms. To be effective, thrombolysis is optimal if offered within the first two weeks after the onset of symptoms. Thrombolysis is sometimes performed out to four weeks if symptoms are severe, but beyond four weeks the veins valves are permanently damaged and interventional treatments will usually be ineffective.


Refer to these websites for more information:

Find more information on the Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism:



Have you been diagnosed with a blood clot in your leg, also known as Deep Vein Thrombosis or DVT? If so, you may be a perfect fit to participate in the ATTRACT Study, in which national physician experts in DVT treatment are currently enrolling patients to determine the best treatment for blood clots.





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Do you know the signs & symptoms?

Deep Vein Thrombosis

Deep Vein Thrombosis (DVT) occurs when a blood clot forms in one of the deep veins of your body, usually in your legs, but sometimes in your arm.

  • Swelling, usually in one leg
    (or arm)
  • Leg pain or tenderness often described as a cramp or
    Charley horse
  • Reddish or bluish skin discoloration
  • Leg (or arm) warm to touch

Pulmonary Embolism

Clots can break off from a DVT and travel to the lung, causing a pulmonary embolism (PE), which can be fatal.

  • Sudden shortness of breath
  • Chest pain-sharp, stabbing; may get worse with deep breath
  • Rapid heart rate
  • Unexplained cough, sometimes with bloody mucus