Understanding DVT: A Vein Physician’s Perspective
Medically reviewed by Saina Attaran, MD, MRCS, FRCS, on November 13, 2023
Deep Vein Thrombosis (DVT) is characterized by blood clots that form within deep veins, typically in the legs or pelvis. These clots can obstruct blood flow, leading to pain, swelling, and potentially life-threatening complications if they dislodge and travel to the lungs, causing a pulmonary embolism (PE). Learn how to recognize, manage, and prevent its potentially deadly outcome from a vein specialist.
Chronic venous insufficiency, the malfunctioning of the vein valves in the leg that causes swelling, skin changes, and varicose veins, increases the risk of DVT. According to a study published by the National Library of Medicine (NIH), two-thirds of patients with DVT have pre-existent primary chronic venous disease. Further, varicose veins and a prior history of venous thromboembolism (VTE) have been found to be the top two risk factors for post-operative VTE in patients undergoing total hip or knee joint replacement surgery.
What is DVT?
DVT is an acronym for Deep Vein Thrombosis, a condition characterized by the formation of blood clots (thrombi) in the deep veins of the body, typically in the legs. These clots can obstruct the flow of blood and cause a range of health problems. Left untreated, DVT can have severe consequences, including pulmonary embolism (PE), which is a life-threatening condition. A PE is a blood clot that blocks and stops blood flow to an artery in the lung. Prompt treatment dramatically reduces the risk of death.
We spoke to a board-certified Center for Vein Restoration (CVR) vein doctor, Saina Attaran MD, MRCS, FRCS. Dr. Attaran is the lead physician at CVR’s Gilbert, Arizona, vein clinic about DVT and PE and asked what causes DVT, what signs to look for, and what an individual should do if they suspect a blood clot.
Does vein treatment increase the risk of DVT?
Dr. Attaran: “Generally, any procedure on the legs or even anywhere in the body can increase the risk of deep vein thrombosis. Treating the superficial veins in the long term should allow for a decrease in deep vein thrombosis in general. Still, during the treatment, there is a slight increase for which we will make sure that the patient is mobile and hydrating well, and sometimes, we ask them to take baby aspirin.”
What can I do to avoid DVT if I have vein issues?
Dr. Attaran: “It depends. First of all, we need to diagnose what kind of vein issues the patient has. If it is an old DVT causing post-thrombotic syndrome, or the patient might have just venous incompetence, which could be on the superficial veins or the deep veins.
So, all of them need to be diagnosed first. And for that, we will do an ultrasound to find out precisely the anatomy, the pathology before, and the current pathology of the patient. And then, based on that, we can advise them.”
What signs and symptoms of DVT should I watch out for?
Dr. Attaran: “The first is pain and tenderness. Sometimes, there's swelling and redness in the affected limb. Sometimes, this can be asymptomatic, but in general, it is important to make sure that the calf muscle is not stretching or tender. And if it is, it's always good to have DVT ruled out as soon as possible.”
What is the risk of developing PE after a DVT?
Dr. Attaran: “Again, it all depends on the size and the location of the DVT and underlying conditions. The risk is small in somebody who has the first-time DVT, only a small one in a calf muscle, but it increases as the clot is located more centrally, like in popliteal or femoral veins or in iliac veins, which are inside the abdomen.
Also, as we get older, with all the comorbidities, the risk of PE increases. If a patient has been immobile or on a flight, the risk can increase again. There is a small risk, but it varies from patient to patient.”
Are there any medications I can take to prevent and treat DVT?
Dr. Attaran: “To prevent, yes, hydration, mobilization, and exercise, all that can prevent from developing DVT. Also, sometimes, baby aspirin can help, depending on if it's the first time or not or if the patient has recurrent DVTs.
If the patient has DVT already, the treatment is again different. We have to diagnose whether it's acute or chronic. For acute DVT, yes, medications such as Eliquis or Xarelto are prescribed. If it is a recurrent DVT and the patient should be on lifetime anticoagulation, warfarin also can be an option.”
Any other advice that you can give patients about their risk of DVT?
Dr. Attaran: “Yes, be mindful of the symptoms. Try to wear your compressions when you are taking a vacation or on a long trip, on a flight, or in a car. If you're in a car, make sure you have frequent stops and walk for ten minutes.
If you're on a plane, make sure you get up and walk after every hour for a few minutes. This will prevent or at least decrease the risk of developing DVT. Make sure you’re well-hydrated. Even if you are in a sitting position, make sure you move your legs often.
If you have concerns or see any sign of DVT, make sure you go to a vein center and have an ultrasound. If you don't have a vein center available or close by, go to ER. Don't take a chance.”
Center for Vein Restoration Offers DVT Rule-Out Services
To avoid a lengthy and costly trip to the emergency room, Center for Vein Restoration offers a DVT rule-out service for individuals who suspect they have a DVT. This one-stop management approach includes a scan and treatment anticoagulation, education, and follow-up if needed. Call the DVT hotline at 877-SCAN-DVT (877-722-6388).
Risk Factors for DVT
Understanding the risk factors for DVT is crucial, as it can affect people from all walks of life. Some common risk factors include:
Prolonged immobility
Long periods of inactivity, such as sitting during long flights or car rides, can increase the risk of DVT.
Surgery or injury
Certain surgeries and injuries can lead to immobilization, making blood clots more likely.
Pregnancy
Pregnancy can increase the risk of DVT due to changes in blood circulation.
Birth control and hormone therapy
Some medications, especially those containing estrogen, can increase the risk of blood clots.
Obesity
Excess weight can place additional pressure on the veins, making clots more likely.
Age
DVT risk increases with age, especially after 40.
Family history
A family history of blood clots can elevate your risk.
Smoking
Smoking can damage blood vessels and increase the risk of clot formation.
Cancer
Certain types of cancer and cancer treatments can increase the risk of blood clots.
Inherited blood clotting disorders
Some individuals have genetic conditions that predispose them to clotting.
Symptoms of DVT
Recognizing the symptoms of DVT is essential for early diagnosis and treatment. Common symptoms of DVT include:
- Swelling: One of the most common signs is sudden swelling in one or both legs.
- Pain: You may experience persistent pain, often described as a cramp or soreness.
- Warmth: The affected area might feel warm to the touch.
- Redness: Skin discoloration, often red or discolored, can be a symptom.
- Vein prominence: The affected vein may become more visible.
However, it's important to note that some people with DVT may not exhibit any symptoms, making it a silent threat. This is why understanding the risk factors and seeking medical attention when you suspect DVT is crucial.
Diagnosis and Treatment for DVT
If you suspect DVT or have risk factors, it's essential to seek medical attention promptly. Diagnosing DVT typically involves a combination of methods, including ultrasound, blood tests, and imaging scans.
Treatment for DVT focuses on preventing the clot from getting larger and reducing the risk of complications. Common treatments include:
- Anticoagulants: These medications thin the blood and prevent new clots from forming.
- Thrombolytic therapy: In severe cases, clot-busting medications can dissolve the clot.
- Vena cava filter: In rare situations, a filter may be placed in the largest vein in your body to prevent clots from reaching your lungs.
- Compression stockings: These can help reduce swelling and improve blood flow.
- Elevation and movement: Keeping the affected leg elevated and moving it regularly can help prevent complications.
Increase Your Chances of Surviving DVT
DVT is a serious medical condition that can have life-threatening consequences if left untreated. Understanding the risk factors, recognizing the symptoms, and taking preventive measures are crucial to safeguarding your health.
If you suspect DVT or have any risk factors, do not hesitate to consult with a healthcare professional, such as CVR’s DVT hotline, at 877-SCAN-DVT (877-722-6388). Early detection and prompt treatment can make a significant difference in the health outcome.