Medical Treatment

If the patient has a deep vein thrombosis, they will be treated with a blood-thinning medication (anticoagulant).

• These medications do not make the clot go away. They stabilize the clot and make it adhere to the vessel wall.
  
  
• The body normally breaks up (lyses) the clot on its own. This is a gradual process that may take several days or weeks.
  
  
• Anticoagulants prevent further clotting and worsening of the condition.
  
  
• They do this by preventing factors in blood from coming together and clotting too easily.

Treatment standards changed in early 2003 with the finding that lower doses of anticoagulants would prevent recurrent DVTs.

• It is considered safe to continue treating people who have had one deep vein thrombosis with clot-preventing medications for much longer than six months, which was the previous recommendation.
  
  
• Clotting is the body's natural way of preventing bleeding. These medications increase risk of bleeding from anywhere in the body. Any trauma, fall, or injury can result in uncontrolled bleeding in a person taking anticoagulant medications. The lower doses do not carry such a high bleeding risk.
  
  
• The benefits of continuing treatment outweigh the risks of bleeding.
  
  
• One can decrease the chance of having a second deep vein thrombosis without creating such a serious bleeding risk.

If the patient has a clot above the knee, they most likely will be admitted to a hospital for treatment. While in the hospital, the patient will be given an anticoagulant medication called heparin (Hep-Lock, Liquaemin). Heparin is available only as a subcutaneous injection or through an IV. It rapidly stops the blood from clotting further. It is generally used only in hospitals and is not for home use.

• Another oral anticoagulant, called warfarin (Coumadin), usually is started within one to three days. The patient will probably be discharged from the hospital once they have started taking warfarin. Warfarin can be taken as an outpatient.
  
  
• Low molecular weight heparin (Lovenox) is a newer option for treating deep vein thrombosis at home. This form of heparin is given twice daily by injecting into the skin. The pharmacy dispenses the drug in prefilled, easy-to-use syringes. The patient or a family member will be taught how to give the injections.
  
  
• After being discharged, return to a hospital emergency department or call 911 if the patient has any concerns about bleeding, especially if they have red or black bowel movements, red or brown urine, faintness, dizziness, severe headache, or any bleeding that does not stop.

In rare cases, the healthcare provider may elect to dissolve the clot with special "clot-busting" medications. This is done only when the clot is identified within the first 6-12 hours and rapidly reverses the symptoms of a deep vein thrombosis and pulmonary embolism.

• Because these medications carry a significant risk of causing bleeding, their use for deep vein thrombosis is typically not the first line of treatment.
  
  
• Examples of these medications are urokinase (Abbokinase), streptokinase (Kabikinase, Streptase), or alteplase (Activase).

Some people should not take anticoagulant medication. They include people who have had bleeding in the brain (a type of stroke), recent brain surgery, or bleeding from the gastrointestinal tract. People who also have very high blood pressure or those involved in recent trauma or who have had any recent surgery are not candidates for thrombolytic therapy.

• If the patient is one of these people, the healthcare provider may instead recommend placement of a filter in the inferior vena cava, the main vein returning to the heart.
  
  
• This prevents clots in the lower body from traveling to the heart and lungs, where they can do more damage.

Viewer Comments & Reviews

Deep Vein Thrombosis - Symptoms Experienced

The eMedicineHealth physician editors ask:

For deep vein thrombosis, what were the symptoms and signs you experienced?

Comment submissions for this question have ended.
See 27 Viewer Comments & Reviews

View Comments