Categories: Vascular Surgery

Deep Vein Thrombosis

A formation of the blood clot (thrombus) in one or more deep veins in the body, usual legs, is called Deep Vein Thrombosis (DVT). It causes leg pain or swelling, but at times can occur without any symptoms. DVT can develop due to certain medical conditions that impact blood clots, like if the patient is immobile after a surgery or an accident, or when they’re confined to a bed. DVT can become a serious condition if the clots break loose and travel through the bloodstream and get stuck in the lungs, obstructing the blood flow (pulmonary embolism). This can be a serious and life-threatening complication.

Causes

A blood clot can lead to DVT. The clot prevents blood from properly circulating in the body. This clotting can occur due to several reasons, which include:

  • An injury or damage to the blood vessels can narrow or block blood flow, resulting in a clot.
  • Surgery can damage blood vessels. Followed by bed rest with little to no movement post-surgery can add to the risk of developing a blood clot.
  • Immobility or inactivity, when a person sits for extended hours can lead to a slowdown of the blood flow to the legs. This can lead to the development of a clot in the legs.
  • Ingestion of certain medications also increases the chances of forming a blood clot in the veins.

Symptoms

Following are the symptoms of DVT –

  • Swelling in the affected leg or a rare swelling in both the legs.
  • A cramping pain or soreness which starts in the calf, leading to pain in the legs.
  • Red or discoloured skin on the legs.
  • A warm feeling in the affected leg.

DVT often occurs without noticeable symptoms.

Diagnosis

Post a detailed check of the symptoms and a physical examination of the areas of swelling, tenderness or discolouration of the skin, the doctors might suggest following tests which include –

  • Ultrasound. An ultrasound helps to determine where the clot is, whether it is growing or to check for a new one.
  • Blood Test. Some basic blood tests are done to determine what form of treatment would be suitable. Advanced tests are also carried out, when needed, to determine if there are any underlying blood problems that make you more prone to developing clots. Some of these tests are carried out immediately and some a while later.
  • Venography. A dye is injected into a large vein in the foot or ankle. An X-ray creates an image of the veins in the legs and feet, to look for clots. However, less invasive methods of diagnosis, such as ultrasound, can usually confirm the diagnosis. This is therefore used only as a part of a treatment strategy.
  • CT or MRI scans. These can help in providing visual images of the veins and showing the clot if it exists. Sometimes the clots are revealed when scanning for other reasons.

Treatment

DVT is usually treated with medication. The most common medication to treat DVT is Blood Thinners also known as anticoagulants. They help in decreasing the blood’s ability to clot thus preventing the blood clots from getting larger. These blood thinners can be taken as a pill, as an injection or through an IV.  The other option is Thrombolytic Therapy, which quickly helps in dissolving a blood clot if the clot is large and causing several problems. This type of treatment carries a higher risk of bleeding, so it is not used unless truly necessary. The last option is placing an IVC FILTER, inside one of the largest veins in the body. Although this does not stop the formation of a blood clot, it can definitely prevent a large clot from entering the lungs. Your doctor will always make an assessment of the risks and benefits of the various treatment options and discuss the same with you.

Prevention

The risk of having DVT can be lowered by making lifestyle changes like maintaining optimal blood pressure quit smoking and losing weight if overweight. Being mobile and walking around after sitting for too long helps to keep the blood flowing. Make sure you do not get dehydrated- drink plenty of water especially in hot weather and when travelling or having a fever. Take blood thinners on doctor’s recommendation to lower the chances of blood clot post a surgery (if having one). One can develop DVT during travel if the sitting hours are more than four hours. Keep moving around often, get out of the car and stretch at intervals during long drives. Walk in the aisles if flying, taking a train, or riding a bus. Stretch the legs and feet while sitting — this keeps the blood moving steadily in the calves. Don’t wear tight clothes that can restrict blood flow.

Dr. Robbie George | Chief of Vascular & Endovascular Surgeon | Mazumdar Shaw Medical Center, Bommasandra, Bangalore

Narayana Health

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