Deep vein thrombosis (DVT) is a blood clot that develops within a deep vein in the body, usually in the leg and in the larger vein that runs through the muscles of the calf and the thigh.
Deep Vein Thrombosis can cause swelling and pain in the leg, but often occurs without giving any symptoms. A DVT may well settle completely, as the thrombosis is dissolved by the body naturally, however, if a DVT extends up the deep veins it can become dislodged from the vein, and get carried through the main veins and heart to lodge in the lungs; also known as a pulmonary embolism. Small pulmonary emboli may cause chest pain, and sometimes coughing up of blood. Multiple or larger pulmonary emboli may cause breathlessness. A large pulmonary embolus which blocks the main blood vessels to the lungs can be fatal.
The thrombosis can also cause chronic blockage in the deep veins or damage to their valves, leading to long term swelling and sometimes skin problems at the ankle.
DVT and pulmonary embolism together are known as venous thromboembolism (VTE).
Symptoms of Deep Vein Thrombosis include:
- pain, swelling and tenderness in one of your legs (usually your calf)
- a heavy ache in the affected area and warm skin over the affected area, particularly at the back of your leg below the knee. DVT usually (although not always) affects only one leg and the pain may be worse when you bend your foot upward towards your knee.
There is now evidence that wearing below knee graduated compression stockings reduces the chance of DVT for people with special risk factors, as there is no direct evidence about people being at special risk of DVT as a result of long journeys, but based on evidence about surgical operations the following factors increase the risk:
- Having had a recent major operation
- Obesity or being overweight
- The contraceptive pill or hormone replacement therapy (HRT)
- Heart disease Varicose veins
- Varicose Veins
Treatment options for DVT include:
- Medical Blood Thinners - such as aspirin or anticoagulants such as heparin injections, or warfarin by mouth may be advisable for a few people who have medical conditions with a particularly high risk of DVT. This kind of treatment will always be on the explicit advice of a doctor.
- Compression Techniques - graduated compression stockings reduce the risk of DVT. They also help to prevent the ankle swelling which many people experience on long journeys.
- Clot Removal - also known as Thrombectomy is the process of physically removing or breaking up blood clots. Surgery to remove a blood clot is rare. It's only considered if the blood clot is very large and is blocking a major blood vessel. This step is normally done as a last option, if use of clot-dissolving drugs or other treatments is not an option or has been unsuccessful.
- Deep Vein Stenting - veins have been blocked for a long time can cause scarring and narrowed veins. The use of balloons and stents to dilate up the blocked veins and keep them open can be used in cases like these. This requires careful planning, and is only suitable for certain cases.
Our Vascular (Vein) Clinic in London is led by Mr Ian Franklin, one of London's top vascular surgeons and a leading specialist in vascular and endovascular surgery.
Due to the inherent complexity of the many vascular disorders, there may be more than one way of managing a particular condition. For this reason, when planning a procedure, Mr Franklin will discuss all the treatment options in a multidisciplinary team meeting, to ensure that all perspectives are considered before recommending a course of action to a patient.
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