What is Deep Vein Thrombosis (DVT)?
Deep vein thrombosis, also commonly known as “DVT”, is a disease in which clots (thrombus) form in the large veins in the legs and lower abdomen. Although some DVTs are painless, many are painful. With careful diagnosis and treatment, most DVTs are not life-threatening. However, this cannot be said for DVTs that remain unnoticed and hidden deep in the leg. When a clot breaks away from the place where it forms in the large deep veins in the leg and abdomen and moves, it is called an embolism. When an embolus travels to the heart via the bloodstream and from there into the pulmonary vein, it is called a “Pulmonary Embolism”. If this condition is not detected early and treated, it can be extremely fatal.
What Are the Symptoms of DVT?
In about half of DVT cases, no symptoms are detected. In the other half, the most common symptoms are:
- Sudden swelling (diameter increase) in one of the legs
- Pain and tenderness
- Increased skin temperature
- Prominence of veins close to the skin
- Skin color change (blue, red or pale)
How Is DVT Diagnosed?
DVT is diagnosed with a doppler ultrasound. This simple test is painless, safe and very common. A specific blood test called “D-dimer” can be a sign of a newly formed clot. If this test is negative, it is unlikely that the patient has DVT.
What Causes DVT?
DVT usually occurs as a result of two or three of the following conditions:
- Slow blood flow in deep veins
- Patient’s blood is prone to clotting
- Irritation, damage or injury to the inner surface of the vein
Many conditions can cause blood clots to form, causing the above conditions. These include situations that require lying still for long periods of time, such as after surgery or illness, or long journeys without moving. Those who have a family history of blood clots or those who have been treated for cancer are also at risk of developing blood clots. Factors that cause irritation and injury to the veins include accidents and medical procedures.
There are also certain medical conditions that increase the risk of DVT through the 3 mechanisms above, such as heart failure, obesity, COPD, smoking, varicose veins, pregnancy, and use of birth control pills. If you think you are at risk, you should definitely consult a specialist.
How is it treated?
Both DVT and pulmonary embolism are treated with blood thinners. These drugs, called “anticoagulants,” reduce your blood’s ability to clot and prevent clots that form inside your vein from getting bigger.
Patients are also often advised to wear compression stockings, which have therapeutic properties, to reduce swelling and skin changes.
Heparin administered intravenously or low molecular weight heparin administered subcutaneously is immediately started as an anticoagulant treatment to reduce the risk of pulmonary embolism. Treatment is then continued at home with oral warfarin (Coumadin ®) or new generation anticoagulant pills.
If the clot formed in the vein is large or located in the abdomen, your doctor may recommend clot-dissolving treatment. In this treatment, clot-dissolving medication is applied directly to the clot with the help of a catheter. Sometimes, in addition to this procedure, the clot that has started to melt is suctioned with a clot-absorbing catheter. If there is also narrowing in the vein due to the clot, stent or balloon treatment can also be applied.
In cases where the clot needs to be removed but clot-dissolving medications cannot be used, surgical treatment can be performed with a small incision made in the groin.
As mentioned above, the use of clot-dissolving drugs or clot evacuation can be applied to patients with a heavy clot load, no other health problems, and active patients. This treatment largely prevents chronic leg swelling, color changes, and wound opening that may occur in the future. However, these applications pose a serious risk of bleeding in the patient.
Some Tips to Prevent DVT Formation
- Don’t sit for long periods of time
- Raise and lower your feet from time to time while sitting
- If you are on a long plane trip, get up and walk around every 4 hours and squat down and get up
- Drink plenty of fluids other than alcohol on the plane
- Drink at least 6 glasses of water every day
- Before long plane trips, consult your doctor and ask if he/she will recommend compression stockings or medication
- If you have varicose veins (especially if you are pregnant), wear protective compression stockings
- Do not choose tight pants