Deep venous thrombosis

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Deep veins	Deep veins	Deep venous thrombosis, iliofemoral	Venous blood clot
Venous thrombosis - series

DVT; Blood clot in the legs

Treatment of DVT is intended to prevent the development of a pulmonary embolus and to prevent another DVT.

For years, the standard treatment has been an anticoagulant medication called heparin, which was given through the vein. This results in very quick anticoagulation and treatment of the clot. Along with heparin an oral medication called warfarin is given.

Warfarin usually takes several days to become fully effective, so heparin is continued until the warfarin has been fully effective for at least 24 hours. The warfarin is usually continued for about 6 months. In almost all circumstances, warfarin is started only after heparin has been started.

Because heparin is given as a continuous intravenous (I.V.) infusion, it requires hospitalization. However, newer forms of heparin, known as low molecular-weight heparin (usually a drug called enoxaparin) can be used in some circumstances. This heparin can be given by injection once or twice a day and thus can shorten or eliminate the need for hospitalization.

Warfarin causes an increase in the time it takes blood to clot (known as the PT). The PT is monitored to determine if the blood is sufficiently anticoagulated. A measurement known as the INR standardizes PT measurements between labs. For most patients warfarin is adjusted to keep the INR between 2 and 3.

Most DVT's disappear without difficulty, however there is a risk of recurrence. Some patients may develop some chronic pain and swelling in the leg known as post phlebitic syndrome. Pulmonary embolus is uncommon when DVT's are treated properly but can occur and can be life threatening.

• pulmonary embolus
• post-phlebitic syndrome

Call your health care provider if symptoms suggestive of DVT occur.

Go to the emergency room or call the local emergency number (such as 911) if chest pain, difficulty breathing, fainting, loss of consciousness, or other severe symptoms occur in a person with a DVT.

Review Date: 07/29/2005
Reviewed By: William Matsui, M.D., Assistant Professor of Oncology, Division of Hematologic Malignancies, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD. Review provided by VeriMed Healthcare Network.