Treatment Options
The good news is that we can implement a treatment plan after our vascular
doctors receive the patient’s test results. DVT and PE treatment will include
minimally-invasive procedures, medications, and lifestyle changes. Three goals
in the treatment process fall under the umbrella of prevention and reduction.
The goals are to prevent blood clot growth, prevent the risk of PE, and reduce
the chances of another DVT episode.
Medications
We may prescribe blood thinners known as anticoagulants, heparin, and enoxaparin.
These three medications will block the activity of a certain enzyme that
prevents blood from clotting. As a result, they can help dissolve clots and
prevent more from forming in the body.
Heparin can usually be given through an intravenous (IV) line into the arm or
neck vein, while enoxaparin is through injection under the skin
(subcutaneously). If the patient receives heparin or enoxaparin orally, they may
be prescribed another drug called warfarin since these medications do not work
alone at preventing blood clots from forming again.
Patients receiving either an IV or injection, usually for a few weeks, will then
be prescribed warfarin, taken orally, to provide long-term protection against
future occurrences of DVTs.
Minimally-Invasive Options
Some patients may not be ideal candidates for oral medications. If this is the
case, our specialist may recommend thrombolysis, filters, or support stockings
(compressions).
Thrombolysis is a minimally-invasive procedure usually reserved for patients with
advanced DVT and PE stages. It can also help patients who do not respond to
blood thinners. Clot busters or thrombolytics are given through a catheter or IV
and connected directly to the blood clot. It is important for patients not to
perform any strenuous activity up to 24 hours after this procedure.
Inferior vena cava (IVC) filters are inserted into the patient’s vein and are
used to prevent PE. According to the FDA, they are
meant to be used as a temporary solution and should be removed as soon as blood
clots are no longer a risk. Additionally, IVC filters may be used simultaneously
for patients with stents in place.
Lifestyle Changes
Support stockings, on the other hand, are stockings that pull up to the knee and
help prevent pooling in the patient’s legs and reduce swelling. Our doctor may
suggest that the patient wear the stockings during the day (or when most active)
for an unspecified amount of time. The timeframe depends on the severity of the
patient’s case; for some, they may need to wear the stockings for months to
years.