Can range from asymptomatic mild swelling to an extreme form of sudden-onset swelling of one leg, with tightness and pain.
If thrombus dislodges from leg veins and reaches the lung [pulmonary embolism], patient can develop breathlessness which at times can be fatal.
Insome patients, extensive DVT can cause leg gangrene due to local ischemia.
Stasis (slow blood flow] due to immobilization after injury or medical illness.
Vascular trauma (injury or after surgery).
Hypercoagulable state (cancer, dehydration, thrombophilia].
The initial treatment of DVT is by use of injectable anticoagulants like heparin or low-molecular weight heparin [LMWH] followed by oral anticoagulation using warfarin or newer oral anticoagulants. These oral medicines are usually continued for 6-9 months. Along with this, stockings may be used to control leg swelling.
Worldwide, vascular specialists dealing with acute DVT and its acute as well as chronic problems evaluated newer methods to improve vein recanalisation and also reduce the occurrence of vein valve damage and the incidence of post-thrombotic syndrome. Catheter-directed treatment methods are now considered to be most effective in achieving these goals. This treatment is a percutaneous, minimally invasive method performed through the popliteal or femoral vein. After removal of thrombus from the vein by guiding catheter or mechanical thrombectomy devices (Angiojet, Penumbra], direct clot dissolving medicines [thrombolytics) are given for some time to clear the thrombus. If there is vein stenosis/narrowing noted in common iliac vein or IVC, angioplasty with stent placement may also be required.
In few patients who are at high risk of pulmonary embolism, an IVC filter is placed via the percutaneous route for protection.
In summary, newer management methods for DVT employ regional catheter-based techniques with the aim to achieve better early & long-term results. These methods should be increasingly considered for young, mobile patients who wish to live a better and active life ahead. Vein angioplasty and stenting may also be required in 20%-30% of these patients who have vein stenosis or compression (May Thurner syndrome].