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Deep Vein Thrombosis

Deep vein thrombosis (DVT) is a blood clot that forms in the large veins of the arms or legs. These clots can travel through the bloodstream to the brain or heart, and can cause a stroke or pulmonary embolism (PE).

Causes

  • Trauma to the vein's inner lining. These may include surgery, serious injury, inflammation or an immune response.
  • Blood flow is sluggish or slow. This can be caused by lack of movement for long periods of time, such as sitting on an airplane or in a car for many hours, or after surgery.
  • Thicker-than-normal blood. Certain genetic conditions can increase blood's tendency to clot.

Symptoms

  • Pain, tenderness, swelling, warmth, or discoloration of the leg
  • Dilation of the superficial veins in the affected limb
  • Shortness of breath or chest pain

Post-thrombotic Syndrome

Post-thrombotic syndrome (PTS) is a late-complication that occurs in 25-33 percent of patients with DVT. It typically occurs within two years of diagnosis, despite appropriate treatment with blood thinners. PTS consists of chronic leg pain (aching or cramping), leg heaviness, itching or tingling, swelling, redness, varicose veins and leg discoloration. These symptoms are typically more pronounced upon standing or walking for long periods and relieved upon rest. PTS can lead to venous stasis ulcers in some patients.

Treatment

Treatment options for acute DVT include anticoagulation with blood thinners (like heparin or warfarin) and pharmacomechanical thrombolysis, in which clot-busting drugs are delivered through a small catheter placed inside the blocked vein, followed by mechanical removal of the clot itself.

All patients with DVT should be treated with three to six months (or longer) of anticoagulation and wear elastic compression stockings, which have been shown to reduce the incidence of PTS.

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