Description
Deep Vein Thrombosis (DVT) is a condition where blood clots form in the deep veins, typically in the legs, causing potential complications if these clots break loose and travel to the lungs. It is often linked to immobility, surgery, pregnancy, and certain medical conditions. Early diagnosis through symptoms like leg swelling and pain is crucial, as DVT can lead to pulmonary embolism. Treatment involves blood-thinning medications and preventive measures such as movement, compression stockings, and lifestyle adjustments to minimize risks.
Summary Listen
- Deep vein thrombosis (DVT) involves clot formation in deep veins, often the femoral and iliac veins, typically in the legs. Prolonged immobility, recent surgery or trauma, heart disease, cancer, inflammatory bowel diseases, severe infections, and ICU stays are predisposing factors. Hormonal factors, like increased estrogen levels during pregnancy or from oral contraceptives, and inherited blood clotting disorders also elevate DVT risk.
- Typical DVT symptoms include sudden swelling, pain, and redness in the affected limb. Diagnosis involves considering medical history, physical examination, and confirming with non-invasive ultrasound to check for vein occlusion and clot characteristics. D-dimer tests are used if ultrasound results are inconclusive, especially when pulmonary embolism is suspected.
- The primary goals of DVT treatment are to prevent clot extension, reduce pulmonary embolism risk, and prevent recurrence. Anticoagulation is the cornerstone of treatment, involving blood thinners for 3-6 months, or up to a year in some cases. Systemic thrombolytic therapy is reserved for cases with pulmonary embolism causing cardiac failure.
- Endovascular treatments, such as catheter-directed thrombolysis and pharmacomechanical thrombectomy, are increasingly used for faster and safer clot removal. IVC filters are selectively used when anticoagulation is contraindicated or ineffective. Compression therapy is recommended for at least two years to prevent post-thrombotic syndrome.
- Long-term management involves lifestyle modifications like avoiding dehydration, exercising regularly, and maintaining a healthy weight. The choice of anticoagulants depends on patient factors and physician preference, with low molecular weight heparin often followed by newer oral anticoagulants. Thrombophilia workup should be performed after initial anticoagulation therapy is completed.
- Preventive measures for DVT include maintaining an active lifestyle, moving during prolonged immobility, staying hydrated, and using compression stockings. Post-operative DVT prevention involves early mobilization, compression devices, and perioperative anticoagulation, especially after orthopedic, oncology, or gynecological surgeries.
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About the Speakers
Dr. Rahul Agarwal
Consultant Vascular and Endovascular Surgeon, Evercare Hospitals
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