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Deep Vein Thrombosis (DVT)

What is DVT?
Deep vein thrombosis, or DVT, is a blood clot that forms in a deep vein.  A clot is a clump of thickened blood that partially or completely blocks blood flow. Most deep vein clots occur in the lower leg or thigh and usually affect one limb. But they can occur elsewhere.

A DVT can cause two major problems.  First, if the clot breaks loose, flows through the bloodstream and lodges in the lungs, it can cause a pulmonary embolism, which can be fatal. Second, a deep vein clot can harden, scar the vein, and lead to long-term complications that are difficult to treat and often disabling.

Symptoms of DVT
Symptoms in the affected limb include:

  • Swelling or heaviness
  • Pain, cramping or tenderness
  • Skin discoloration (usually red)
  • Warm to the touch
     

Risk factors for DVT
Venous (vein) problems like DVT affect people of all ages.  The following conditions may increase your risk for developing DVT:

  • Recent surgery
  • Cancer
  • Recent leg trauma (e.g. bone fracture)
  • Pregnancy (current or recent)
  • Immobilization, such as from a medical illness
  • Hormonal-based medications including birth-control pills
  • Hereditary blood-clotting disorders
     

How DVT is diagnosed
A physical exam is conducted and a health history, including a list of medications, is obtained. Diagnostic tests may include:

  • Ultrasound – The most common imaging test for DVT. It uses sound waves to create images of blood flow.
  • Venography – Uses a “dye” that is injected into the affected limb. The dye is visible on an x-ray and indicates if and where a blockage is located in deep veins.
  • Advanced imaging – These tests provide more detailed images. They are computed tomography (CT) and/or a magnetic resonance imaging (MRI) exam. CT uses radiation; an MRI does not.
     

Treatments for DVT (medications & compression therapy)
Medications called anticoagulants (blood thinners) may be prescribed for several months or for the rest of one’s life. Anticoagulants prevent the clot from getting larger and from traveling elsewhere in the body. They also prevent other clots from forming but they don’t actively dissolve the original clot.

Compression therapy, including prescribed stockings and compression devices, can also be used to treat deep vein clots. They gently squeeze the legs to increase blood circulation.

Left untreated, the original clot or DVT can sometimes permanently damage the affected vein. This complication is known as post-thrombotic syndrome (PTS). PTS can cause chronic (daily) leg pain and swelling and, in some patients, cause hard-to-heal leg sores that damage the skin. An estimated 40% of people with a DVT will develop PTS. Patients with severe PTS can experience major life difficulties including extreme discomfort with walking or other physical activity, and inability to work.
 

Interventional Radiology procedures
Interventional radiology procedures are used to treat DVT when anticoagulants and compression therapy are not enough. These procedures are “minimally invasive” in contrast to regular open surgery, and recovery is quicker.

Interventional radiology procedures involve a catheter, which is a thin hollow tube. Using image guidance, the catheter is inserted through a tiny incision into the vein that contains the clot. The desired treatment is then initiated through the catheter and targeted to the specific area needing treatment.
 

Acute DVT therapies
Although the majority of acute DVTs can be treated with anticoagulant drugs alone, the following interventional radiology procedures may also be used in select patients:

  • Thrombolytics – Involves the use of clot-busting medicines to dissolve clot
  • Mechanical thrombectomy – Uses a device, which is inserted through the catheter, to remove or reduce the clot.

Occasionally a vena cava filter is used. This medical device is implanted in the inferior vena cava (a large blood vessel) to “catch” blood clots and prevent them from traveling. Some vena cava filters are “retrievable.”  They can be removed when no longer needed. Some are permanently implanted.
 

Chronic DVT therapies
The following interventional radiology procedures may be used to treat chronic DVT.

  • Balloon angioplasty – Uses a tiny, balloon-tipped catheter to widen the narrowed vein
  • Stent placement – Requires the insertion of a tiny scaffold-like metallic device that props narrowed veins open 
     

What is an interventional radiologist?
An interventional radiologist is a specially trained physician  who uses imaging techniques to diagnose — and treat— numerous diseases and conditions. They perform non-surgical procedures that are less invasive and pose fewer risks than traditional surgery. Recovery is generally quicker too. At Mallinckrodt Institute of Radiology (MIR), interventional radiologists who are experts in venous disease treat DVT.
 

Why Mallinckrodt Institute of Radiology (MIR) for your DVT treatment?
It’s often difficult to distinguish between a simple and a difficult venous (vein) problem. MIR has the experience and expertise to know the difference.

We have a team of nationally-recognized interventional radiologists who specialize in DVT and other vein problems. Our interventional radiologists have the most experience in the region in performing catheter-based procedures that can prevent and treat permanent leg damage associated with venous disease. And because we are associated with an academic center – Washington University School of Medicine – our patients have access to the newest treatments and clinical studies, including National Institutes of Health (NIH) trials, to address DVT and its complications.
 

Insurance information
We accept most major insurance plans. Appointments are readily available. Urgent cases are seen within 48 hours and most non-emergent cases are seen within two weeks. 
 

Related physicians
Our team of dedicated vein specialists includes:

For an appointment, call:  314-362-3371

FAQ
https://www.mir.wustl.edu/appointments-referrals/for-patients