Deep Vein Thrombosis

Nuffield Vascular and Interventional Radiology offers exceptional care for the urgency and complexity of Deep Vein Thrombosis (DVT). With innovative therapies and interventions, Dr Suresh Babu provides personalised treatment plans to help you recover and reclaim your active lifestyle.

Table of Contents

Understanding Deep Vein Thrombosis

Blood circulation in the legs is broadly divided into two systems. The arterial system carries oxygenated blood from the heart to the legs, while the venous system transports deoxygenated blood from the legs back to the heart. The venous system has two components:

  1. The superficial venous system, located just under the skin.
  2. The deep venous system, situated near the bones and deep muscles, which is responsible for carrying the majority of blood from the legs to the heart.

 

Deep vein thrombosis (DVT) occurs when blood clots form in the deep veins of the lower limbs. Although rare, deep veins in the arms can also be affected under specific circumstances. While most cases of DVT require urgent medical attention, they are generally not life-threatening.

However, if untreated or unrecognised in time, these clots can progress toward the heart. Pieces of the clot can break off and travel to the heart and lungs, leading to a severe condition called pulmonary embolism (PE). In some cases, pulmonary embolism can result in life-threatening clots, blocking oxygen transfer and posing a significant risk of death.

What is Venous Thromboembolism (VTE)?

Venous Thromboembolism (VTE) is a medical condition that encompasses two interconnected yet distinct issues: Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). It occurs when a blood clot forms in the deep veins, typically in the legs (DVT). This clot can break free, travel through the bloodstream, and lodge in the lungs (PE), blocking the pulmonary arteries. VTE is a serious condition requiring prompt medical attention to prevent complications and improve outcomes.

In severe cases, DVT can progress to more critical conditions, including:

  • Deep Vein Thrombosis (DVT): A blood clot forming in a deep vein, usually in the legs, which can cause complications if the clot dislodges and travels to the lungs.
  • DVT with Pulmonary Embolism: When a blood clot from a DVT travels to the lungs, causing a potentially life-threatening blockage in the pulmonary arteries.
  • Pulmonary Embolism (PE): A dangerous condition where one or more pulmonary arteries are blocked by a clot, typically originating from a DVT in the legs.
  • Phlegmasia Alba Dolens: A rare and severe form of DVT, marked by painful leg swelling and whitening due to a blocked major vein.
  • Phlegmasia Cerulea Dolens: A life-threatening progression of DVT, causing intense pain, swelling, and blue discolouration in the leg due to nearly complete venous blood flow obstruction.

 

Understanding and treating VTE early is essential to prevent life-threatening complications.

Risk Factors for Venous Thromboembolism (VTE)

  • Surgical Procedures
  • Major Trauma or Lower Extremity Injuries
  • Prolonged Immobility
  • Cancer or Malignancy
  • History of DVT or PE
  • Advancing Age
  • Pregnancy and Postpartum Period
  • Use of Estrogen-Based Oral Contraceptives or Hormone Replacement Therapy
  • Underlying Medical Conditions (e.g., Acute Myocardial Infarction, Inflammatory Bowel Disease, Nephrotic Syndrome)
  • Obesity
  • Smoking
  • Varicose Veins
  • Thrombophilia (Inherited or Acquired Clotting Disorders)

 

Awareness of these risk factors is crucial for prevention and early intervention.

Symptoms of Deep Vein Thrombosis (DVT)

The symptoms of DVT can vary based on the location and severity of the clot. While some patients may experience mild discomfort, others may present with more noticeable signs.

  • Mild Symptoms:
    • Mild swelling, aching, or cramps in the calf or leg.
    • Discomfort that may be easy to overlook.
  • Common Symptoms:
    • Swollen and tender legs, starting in the calf and potentially extending to the thigh and groin.
    • Redness and visible, prominent blue veins under the skin.
  • Other Signs:
    • Fast heartbeat (tachycardia).
    • Shortness of breath, which may occur alone or alongside limb swelling. This is a serious symptom requiring immediate medical attention, as it could indicate a pulmonary embolism (PE).

 

Recognising these symptoms early is crucial for timely treatment and prevention of complications.

Understanding Risk Factors for Deep Vein Thrombosis (DVT)

  • Prolonged Immobility:
    Extended periods of inactivity, such as during long-haul flights or lengthy travel, are among the most common risk factors for DVT.
  • Post-Surgical Recovery:
    Major surgeries involving the limbs, pelvis, or abdomen significantly increase the risk.
  • Dehydration:
    Inadequate hydration can thicken the blood, increasing the likelihood of clots.
  • Severe Trauma:
    Injuries to the arms or legs can elevate the risk of developing blood clots.
  • Genetic Predisposition:
    Inherited clotting disorders can make individuals more susceptible to DVT.
  • Abnormal Blood Vessel Anatomy:
    Conditions like May-Thurner Syndrome or Paget-Schroetter Syndrome can disrupt normal blood flow, raising the risk of clot formation.
  • Underlying Cancer:
    Certain cancers can lead to a higher tendency for blood clotting due to paraneoplastic syndromes.

 

Awareness of these risk factors is essential for prevention and early intervention.

How is Deep Vein Thrombosis (DVT) Diagnosed?

Diagnosing DVT involves a combination of clinical evaluation, medical history, and diagnostic tests:

  • Clinical Assessment: Reviewing risk factors and symptoms.
  • Blood Tests: Checking for elevated D-dimer levels, which indicate increased clotting activity.
  • Imaging Tests:
    • Duplex Ultrasound: A non-invasive test to detect clots in the deep veins.
    • CT Scans: May be used to examine leg veins or lung arteries for complications like pulmonary embolism.

 

Treatment often includes anticoagulation therapy to prevent clot progression and reduce the risk of complications.

Treatment Options for Deep Vein Thrombosis (DVT)

  1. Medical Management:
    The standard treatment for most patients involves blood-thinning medication (anticoagulation therapy) to prevent clot growth and reduce the risk of new clots forming.
  2. Minimally Invasive Pharmaco-Mechanical Treatments:
    For cases where medical therapy alone is insufficient, or if the DVT is extensive or life-threatening, catheter-based treatments may be recommended. This approach involves:
    • Using small incisions (less than a centimetre) to access the veins.
    • Removing most of the clot immediately while continuing anticoagulation therapy to prevent new clots.
    • Treating clots in the lungs simultaneously, if necessary.

 

Advantages of Minimally Invasive Interventional Treatments:

  • Effective for a select group of patients with severe or unresponsive DVT.
  • Catheter-based techniques clear clots efficiently, typically within 90 minutes, with a low complication risk of 1-2%.
  • Complements anticoagulation therapy for comprehensive care.

The choice of treatment depends on the patient’s condition and the severity of the DVT. These innovative techniques provide an effective option for managing complex cases.

Your Health, Our Priority​

I’m here to help you regain control of your health. Together, we’ll manage your symptoms and prevent future complications using personalised care and innovative technology. – Dr Suresh Babu

Schedule Your Consultation Today