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Deep Vein Thrombosis Surgery

When blood clots (also called thrombi) form in the deep veins of muscles, a condition called deep vein thrombosis (DVT) results. If these blood clots break loose and travel to the lungs, DVT can be life-threatening, causing pulmonary embolism. When a patient develops pulmonary embolism, (s)he has blood clots in his or her lungs that are impeding blood flow, causing strain on both the lungs and the heart. Pulmonary embolism is a medical emergency that requires immediate attention.

While blood clots can form in any vein, DVT typically occurs in the deep veins of the legs. Luckily, DVT is a preventable and treatable condition. While exercise, diet and compression stockings help prevent DVT, DVT treatment often involves taking anticoagulant medication.

Because deep vein thrombosis generally responds well to treatment, surgery is a rarely needed last resort. Simply put, surgery for leg DVT is only needed in the most extreme cases. Along with the most serious DVT cases, other instances in which DVT surgery is needed include:

when patients cannot take medications for their clots due to concerns about excessive bleeding or allergies
if an embolus (a “traveling” or loose blood clot) develops.

DVT Symptoms

Only 50 percent of individuals with DVT actually experience symptoms. Often the symptoms are very mild and include:

discomfort in the area of the clot
mild swelling of the skin above the clot
redness in the area of the clot discomfort.

If you are experiencing any DVT symptoms, see your doctor as soon as possible. Your doctor will likely need to perform a series of tests to make a proper DVT diagnosis.

Common DVT Surgeries

Here's a review of some of the more common surgeries used to treat deep vein thrombosis:

Balloon Angioplasty: The purpose of a balloon angioplasty is towiden the vein after a blood clot has been dissolved. During this procedure, a doctor inserts a catheter containing a small balloon into the narrow vein. He can then expand the balloon. The vein, in turn, will widen to accommodate the balloon. After a while, the balloon can be deflated and removed. These veins tend to have an improved blood flow.
Catheter-Directed Thrombolysis: The purpose of catheter-directed thrombolysis is to prevent pulmonary embolism by dissolving the blood clot in the lung.

Unlike anticoagulants, which help prevent clots from forming, thrombolytic agents work by dissolving existing clots. In catheter-directed thrombolysis, a doctor administers thrombolytic agents via catheter or IV. Therefore, patients receiving this treatment will have to stay in a medical facility for a few days or as long as it takes to completely dissolve the clot.
Stent Insertion: For DVT patients who have a vein that is prone to collapse, stent insertion may be necessary. In this procedure, a stent (a small mesh tube) actually prevents the vein from collapsing. The stent will expand once it is inserted and will act as a support for vein walls.
Thrombectomy: In extremely severe cases of DVT, the blood clot may need to be removed surgically from the vein. This procedure is called thrombectomy. In most cases of thrombectomy, the patient will need to take anticoagulant medication, such as heparin, during his surgery and then take warfarin (another anticoagulant) for an extended period post surgery.
Vena Cava Interruption: The purpose of vena cava interruption is to prevent pulmonary embolism from occurring.In this procedure, a doctor surgically positions a filter inside a big vein that exists between the DVT location and the heart. The filter will catch or trap emboli, ensuring that they do not reach the lungs. Blood, however, can continue to flow normally through the umbrella-like filter.

Risks of DVT Surgery

Because surgery is only recommended in most serious DVT cases, risks associated with any DVT surgery are generally considered minimal when compared to the risks of not having the surgery. Like any surgery, however, DVT surgeries do carry some associated risks. Discuss possible risks and side effects of DVT surgery with your doctor before undergoing a procedure.

Similarly, keep in mind the risks associated with anesthesia and post-surgery infection. Bleeding may also be a complication.

DVT Treatment After the Surgery

Patients will likely remain in the hospital for a few days after DVT surgery. Following the surgery, they will most often take an oral anticoagulant for a few months to prevent future clots.

Once a patient has recovered from the surgery, doctors will likely require follow-up tests and visits to monitor progress. During these post-surgical follow-ups, doctors may alter medication dosages to reduce the risk of re-developing DVT after surgery.

Resources

health-cares.net (July 18, 2005). What's the Treatment for Deep Vein Thrombosis? Retrieved July 17, 2007, from the health-cares.net Web site:
http://heart-disease.health-cares.net/deep-vein-thrombosis-treatment.php.

Merck & Co., Inc., (n.d.). Deep Vein Thrombosis. Retrieved July 17, 2007, from the Merck Web site: www.merck.com/mmhe/sec03/ch036/ch036b.html.

Sanofi-Aventis U.S., LLC, (n.d.) All About DVT Protection and Treatments. Retrieved July 17, 2007, from the DVT.net Web site:
http://www.dvt.net/allAboutDVT/protectionTreatments/
default.aspx.

VascularWeb (Jan. 26, 2006). DVT. Retrieved July 17, 2007, from the VascularWeb Web site:
http://www.vascularweb.org/_CONTRIBUTION_PAGES/
Patient_Information/NorthPoint/Deep_Vein_Thrombosis.html.

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