DVT Treatment

Deep vein thrombosis (DVT) is a serious medical condition characterised by the formation of blood clots within the deep veins of the body, typically in the legs.

If left untreated, DVT can lead to complications such as pulmonary embolism, post-thrombotic syndrome, and chronic venous insufficiency. Fortunately, there are several treatment options available to manage DVT effectively, each with its indications, risks, and outcomes.

Anticoagulant therapy for deep vein thrombosis

Anticoagulant therapy is the most common form of DVT treatment and involves the use of blood-thinning medications to prevent the formation of new blood clots and the extension of existing clots. Commonly prescribed anticoagulants include heparin, warfarin, and direct oral anticoagulants (DOACs).

Direct oral anticoagulants (DOACs) are a convenient and effective alternative to traditional anticoagulant therapy for the treatment of DVT. These medications have a rapid onset of action, predictable pharmacokinetics, and fewer drug interactions compared to warfarin. However, they are not suitable for all patients, and careful consideration of individual factors is necessary when selecting the appropriate anticoagulant therapy.

While effective, anticoagulant therapy carries the risk of bleeding, and regular monitoring of blood clotting parameters is necessary to ensure safety and efficacy.

Thrombolytic therapy is reserved for cases of acute DVT with severe symptoms or extensive clot burden. This treatment involves administering clot-dissolving medications (thrombolytics) to rapidly dissolve the clot and restore blood flow. Thrombolytic therapy is effective in quickly removing very large quantities of thrombus and it helps to reduce the complications of post-thrombotic syndrome by 50%. It is performed by specialists such as vascular surgeons and requires intervention within 2 weeks of symptom onset to have the best results.

Catheter-directed thrombolysis

Catheter-directed thrombolysis is a minimally invasive procedure that delivers thrombolytic medication directly into the clot through a catheter inserted into the affected vein. This targeted approach allows higher doses of medication to be delivered to the clot while minimising systemic exposure and reducing the risk of bleeding. Dr Ling is an expert in using catheter-directed thrombolysis to clear large DVTs and help prevent complications of DVT.

Inferior vena cava (IVC) filter placement

Inferior vena cava (IVC) filter placement may be considered in patients with DVT who are at high risk of pulmonary embolism and cannot receive anticoagulant therapy. An IVC filter is a small device inserted into the inferior vena cava to trap blood clots and prevent them from travelling to the lungs. While effective in preventing pulmonary embolism, IVC filters are associated with risks such as filter migration and thrombosis.

Surgical interventions

Surgical interventions may be considered in cases of chronic DVT or complications such as venous ulcers or severe venous insufficiency. Options include venous thrombectomy, venous bypass surgery, or minimally invasive stenting of chronically occluded veins.

Venous thrombectomy is a surgical procedure performed to remove a blood clot (thrombus) from a vein, typically in cases of severe or extensive cases. During a venous thrombectomy, the surgeon makes an incision over the affected vein and carefully dissects it down to the site of the clot. Using specialised instruments, the clot is extracted from the vein, restoring blood flow and alleviating symptoms associated with DVT. In most cases, thrombectomy may be performed using minimally invasive techniques, such as catheter-directed thrombolysis, where a catheter is inserted into the vein to deliver clot-dissolving medication directly to the site of the clot.

Venous bypass surgery, also known as venous revascularisation, is a procedure used to reroute blood flow around a blocked or damaged vein, restoring circulation and relieving symptoms. During a venous bypass procedure, the surgeon creates a new pathway for blood to flow by grafting a healthy vein or synthetic graft material onto the affected vein above and below the blockage. This bypass allows blood to bypass the obstructed segment of the vein, improving venous return and reducing the risk of complications such as post-thrombotic syndrome or venous ulcers.

Endovenous treatments such as balloon dilatation and stenting, are minimally invasive techniques that Dr Ling regularly uses to open blocked veins. This can be achieved with a small needle and sheath in the vessels, allowing rapid recovery and discharge from hospital often within 24 hours.

Surgical interventions for DVT are specialised interventions that vascular surgeons are highly trained in performing. The specific procedure chosen depends on the individual patient’s anatomy, symptoms, and underlying medical conditions. As with any surgical procedure, there are risks and potential complications – your surgeon would discuss these with you and recommend a pathway that best suits your situation.

Compression therapy

Compression therapy involves the use of compression stockings or bandages to improve blood flow in the legs and reduce swelling and discomfort associated with DVT. Compression therapy is often used as an adjunct to other treatments and can help prevent post-thrombotic syndrome.

Early mobilisation and physical therapy

Early mobilisation and physical therapy help manage DVT by promoting blood flow, preventing muscle deconditioning, and reducing the risk of recurrent clot formation. Patients are encouraged to engage in regular exercise, leg elevation, and ankle exercises to improve circulation and reduce swelling.

Long-term management

Long-term management of DVT involves regular follow-up appointments to monitor treatment response, assess for complications, and adjust therapy as needed. Patient education is essential to ensure adherence to medication regimens, recognise signs of recurrent DVT or complications, and adopt lifestyle modifications to reduce the risk of recurrence.

Dr Adrian Ling at the Vein Artery Specialist clinic in Melbourne specialises in DVT treatment, providing a range of advanced therapies to manage this condition effectively. In addition to DVT treatments, Dr Ling specialises in varicose and spider vein treatments. The Vein Artery Specialist clinic offers comprehensive care for patients with venous disorders. Consult with the experts for treatments such as sclerotherapy in Melbourne.

The management of DVT requires a comprehensive approach tailored to the individual patient’s needs and risk factors. With advancements in medical technology and a better understanding of the pathophysiology of DVT, healthcare providers can offer effective treatments to improve outcomes and reduce the burden of this potentially life-threatening condition.

If you’re seeking DVT treatment in Melbourne, Victoria, Australia, Dr Adrian Ling offers expert care tailored to your individual needs.