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Deep venous thrombosis - Treatment

Alternative Names

DVT; Blood clot in the legs; Thromboembolism

Treatment:

DVT treatment helps prevent a pulmonary embolus from forming and helps prevent another DVT.

For years, the standard treatment has been a medication called heparin to stop blood clots from forming (anticoagulant). It results in quick anticoagulation, and it prevents the clot from growing.

If heparin is given continuously through a vein (IV), it requires a hospital stay. However, newer forms of heparin known as low molecular-weight heparin can sometimes be used. These forms include:

  • Enoxaparin(Lovenox and Clexane)
  • Ardeparin (Normiflo)
  • Tinzaparin (Innohep and Logiparin)
  • Certoparin (Sandoparin)
  • Dalteparin (Fragmin)
  • Reviparin (Clivarin)
  • Nadroparin (Fraxiparin)
  • Certoparin (Sandoparin)

Heparin can be given by injection once or twice a day to shorten or avoid the need for a hospital stay.

A person with DVT also may get an oral medication called warfarin with the heparin. Warfarin usually takes several days to fully work. Heparin is continued until the warfarin has been fully effective for at least 24 hours. People will take warfarin for about 6 months. Usually warfarin is started after heparin.

Warfarin causes an increase in the time it takes blood to clot, known as prothrombin time (PT). A system called the International Normalized Ratio (INR) is used to report the ability of the blood to clot properly. Doctors will adjust warfarin to keep the INR between 2 and 3.

Rarely, surgery may be performed when medications fail:

  • Removal of a large blood clot from the vein or injection of clot-busting medicines may be used
  • Placement of a screen in the body's largest vein to prevent blood clots from traveling to the lungs

Expectations (prognosis):

Many DVT's disappear without a problem, but they can recur. Some people may have chronic pain and swelling in the leg, known as post phlebitic syndrome.

A pulmonary embolus, a blood clot that breaks free in the leg and travel to the lungs is called, can occur and can be life threatening. Rapid treatment of DVT helps prevent this problem.

Complications:

Calling your health care provider:

Call your health care provider if you have DVT-like symptoms.

Go to the emergency room or call the local emergency number (such as 911) if you have DVT and you develop chest pain, difficulty breathing, fainting, loss of consciousness, or other severe symptoms.

  • Reviewed last on: 4/7/2008
  • A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz, Kelli A. Stacy, ELS. Previously reviewed by Rita Nanda, MD, Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network (4/27/2007).
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