Everything You Need To Know About Deep Vein Thrombosis and It's Treatment

What is Deep Vein Thrombosis?

Deep vein thrombosis (DVT) is a condition that occurs due to the formation of blood clots in the deep veins that are located in the body. These clots usually develop in the lower legs, thigh or pelvis, but can also appear in other parts of the body. A condition of DVT can be very serious as blood clots in the veins can break loose, travel through the bloodstream and get stuck in the lungs, leading to a complication called pulmonary embolism which is the blocking of the blood flow.

How does it form?

Causes & Symptoms of Deep Vein Thrombosis

Causes of deep vein thrombosis can be:

• Hereditary
• Obesity
• Injury
• Prolonged sitting or standing
• Cancer
• Birth control pills
• Prolonged bed rest
• Smoking

Symptoms of deep vein thrombosis are:

• Swelling on the calf of one or both the legs
• Pain that may worsen due to prolonged standing or walking
• Red or discoloured skin on the legs followed by a warm sensation
• Veins that are swollen, red, hard and appear tender while touching
• Cramping pain in the affected leg that usually initiates in the calf
• Shoulder pain
• Neck pain
• Swelling in the arm or hand
• Blue tinted skin colour
• Pain that moves from the arm to the forearm
• Feeling of weakness in the hand
• Coughing that may bring up blood
• Sharp pain in or tightening in the chest
• Pain in the shoulder, arm, back, or jaw
• Shortness of breath or rapid breathing

Diagnosis - Deep Vein Thrombosis Treatment

Test – Deep Vein Thrombosis

• D-dimer blood test: D-dimer is a type of protein produced due to the formation of blood clots. A D-dimer test is used to measure the presence of the protein fragment that is released due to the breaking up of the blood clots. This test also helps in ruling out the possibility of a condition of pulmonary embolism.
• Duplex Ultrasound: This is a standard imaging test that helps in diagnosing a condition of DVT. During the test, the doctor or technician uses sound waves to determine the blood flow and detect the presence of any blockage or blood clots located deep in the veins with the help of a transducer.
• Magnetic resonance imaging (MRI) scan: This is an imaging test that uses radio waves and a magnetic field to provide images of the body. An MRI scan helps in diagnosing a condition of DVT in the veins of the abdomen. Generally, this test is used to diagnose the condition in patients for whom an ultrasound examination is unfeasible or inappropriate.
• Venography: This is a type of X-ray that involves the injecting of a dye into a large vein in the foot or ankle. The X-ray then creates images of the veins in the legs and feet, which helps the doctor to look for the presence of blood clots. However, since this is an invasive procedure, it is mostly replaced by a duplex ultrasonography and is only used in certain patients.

Self diagnosis – Deep Vein Thrombosis

If you are interested in evaluating a condition of DVT by yourself at home, you can perform a Homan’s sign test. In this test, you will have to actively extend the knee in the leg that you want to check. Once your knee is in position, try raising your leg to 10 degrees with someone’s assistance. You can ask the person assisting you to passively and abruptly squeeze your calf with one hand while flexing your foot with the other. If you experience any type of deep calf pain or tenderness during the process, it is possible that you might be diagnosed with a condition of deep vein thrombosis and should consider seeking medical help to prevent the condition from progressing into a severe complication.

Diagnosis by doctor

Consulting a vascular surgeon or hematologist is the right approach to diagnosing a condition of DVT. Once you consult or visit a doctor for a diagnosis of your condition, the doctor will first ask you about the symptoms, go through your medical history and carry out a physical evaluation by checking for the signs of swelling or enlargement and discoloration of the veins. Additionally, the doctor may feel for tenderness in your legs and accordingly recommend you to go for certain tests in order to confirm your diagnosis.

Severity - Deep Vein Thrombosis

Grade 1: Normal blood flow

In this stage the blood flows freely and mixes with anticoagulants present in the blood that keeps the blood cells from clotting.

Grade 2: Coagulation

Risks & Complications - Deep Vein Thrombosis Treatment

During the surgery

• Reaction to the anaesthesia
• Excessive bleeding
• Infection
• Blood clots
• Damage to blood vessels
• Stroke

After the surgery

Postphlebitic/Post-thrombotic Syndrome: This refers to the signs and symptoms of a chronic vein insufficiency that develops following a deep vein thrombosis surgery, causing chronic pain, swelling, skin discoloration, skin sores, and certain other symptoms in the leg.

If left untreated

If a condition of venous insufficiency like DVT is left untreated, it can lead to complications that can be severe and life threatening. In case you don’t seek proper treatment for DVT on time, the blood clot can travel to the lungs from other parts of the body, blocking one or more arteries or blood vessels in your lungs, resulting in a fatal complication of pulmonary embolism. A pulmonary embolism is followed by a number of signs and symptoms that include shortness of breath, chest pain while coughing or inhaling, a rapid heart rate, etc..

When to consult a doctor for Deep Vein Thrombosis Treatment?

A condition of deep vein thrombosis can lead to severe complications if the blood clots break loose and travel through your bloodstream. This blood clot can get stuck in your lungs resulting in a condition of pulmonary embolism which can be fatal.

If you experience any of the signs and symptoms of DVT, that include swelling, pain, and skin discoloration, you should consult a doctor without making any further delay in your treatment.

If you experience signs and symptoms like sudden shortness of breath, chest pain, rapid pulse, coughing up blood or dizziness, it is an indication that your condition has escalated into a pulmonary embolism. Pulmonary embolism is considered a medical emergency as it can result in complications that are immediately life-threatening.

Deep Vein Thrombosis Treatment Options & Cost

Non-surgical

There are certain non-invasive treatment options for treating a condition of deep vein thrombosis by preventing the blood clot from getting bigger or breaking loose and travelling to the lungs. Depending upon the severity of your condition, the doctor might prescribe a number medications or preventive gears that include:

• Blood thinners: A condition of DVT is usually treated with blood thinners, also known as anticoagulants. Although these drugs necessarily do not break up blood clots, they can prevent the clots from increasing in size and can reduce your risk of developing more clots.
• Compression stockings: You might consider wearing compression stockings to reduce the chances of developing blood clots and pools. These stockings can help in preventing the swelling and provide temporary relief to the symptoms caused by a condition of DVT.
• Thrombolytics/Clot busters: These are certain drugs that the doctor may prescribe in order to break the blood clots that are formed in the vessels. These are usually prescribed if you have a more serious condition of DVT that has led to pulmonary embolism or if the other medications are not working.

Surgical

There are a number of surgical or minimally invasive procedures that can help in treating blood clots or a condition of DVT. The doctor generally recommends a surgery if the medications fail in improving your condition. Conditions of deep vein thrombosis are commonly performed with a combination of one or more of the following treatment methods:

• Thrombolysis
• Thrombectomy
• Angioplasty & stenting
• Placing a vena cava filter in the deep vein
• Anticoagulant medications

Types of Deep Vein Thrombosis Surgery

• Inferior vena cava (IVC) Filter: This is a metallic device that is placed inside the inferior vena cava that runs through the abdomen. IVC filters help in reducing the risk of pulmonary embolism by trapping blood clots and preventing them from reaching the lungs. During the procedure, an incision is made around the abdomen and a catheter is inserted into the vein which is guided by an X-ray. The filter is then placed over the blood clot inside the vein and gradually, it attaches itself to the walls of the vein.  This method of treatment is usually prescribed if you are unable to take medicines to thin your blood.
• Catheter-directed thrombolysis: This is a minimally invasive procedure that dissolves the abnormal blood clots present in the blood vessels to help improve blood flow and prevent any further damage to the tissues and organs. Catheter-directed thrombolysis uses a catheter, guided by X-ray imaging that helps in applying the medical device to the site of a blood clot in order to dissolve the blockage.
• Percutaneous mechanical thrombectomy/Angioplasty: This is considered very safe and effective for treating a condition of acute iliofemoral deep vein thrombosis.  A percutaneous thrombectomy is combined with percutaneous transluminal angioplasty that includes the insertion of a catheter attached with a small inflatable balloon through a tiny incision around the site of the clot. Once the balloon is inserted, it is inflated and slowly pulled back outside, entirely removing the clot within the vein.
• Open thrombectomy: Also known as venous thrombectomy, this is a procedure that involves a surgical removal of the blood clot present inside an artery or a vein. During this procedure, the surgeon makes cuts or incisions in the blood vessels around the blood clot. Once the blood clot is identified, the surgeon removes the blood clot before repairing the blood vessels and the tissues.

Surgery Preparation – Deep Vein Thrombosis

• Before going for a deep vein thrombosis surgery, it is important for you to discuss any prescribed or over-the-counter medications you are taking, such as aspirin, vitamins, blood thinners and other supplements.
• It is always good to discuss the signs and symptoms with your doctor before the surgery. This helps in ruling out any possible complications that may take place after receiving the treatment.
• You will completely need to avoid smoking as it can delay the process of healing after the surgery.
• Before going for the treatment, you should inform your doctor if you are pregnant or are expecting pregnancy.
• Since the procedure involves the injecting of anaesthesia, you should let your doctor know about the possibilities of developing allergic reactions.
• In order to ensure a safe and effective treatment, you will need to avoid eating or drinking prior to 8 hours before the surgery.

What to expect during the Deep Vein Thrombosis Surgery

• On the day of surgery, the doctor may physically examine your condition and carry out certain medical tests such as ultrasound, venogram, arteriogram, CT scan, MRI scan and blood tests
• To make sure that you do not feel any sort of pain or discomfort during the surgery, the surgeon will sedate you with anaesthesia.
• While performing the surgery, the doctor may use continuous X-ray images to view your internal structures.
• The surgeon will make a cut or incision in the area above the blood clot that will help them to open the blood vessel and take out the clot.
• A balloon attached to a catheter will be used in the blood vessel to remove any part of the clot that remains and a stent might be put in the blood vessel to keep it open during the procedure.
• After the blood flow is restored, the doctor will cose and repair the blood vessel.
•  Once the procedure is complete, the surgeon will close the incision with stitches or sutures before applying bandages around the wound.

After the Deep Vein Thrombosis Surgery

• After the blood clot is removed and the procedure is complete, you will be placed in a recovery room until the reaction of the anesthesia wears off.
• The team of doctors and nurses will monitor your vital signs, such as your heart rate and breathing.
• Once you are fully awake, you will be shifted to a ward or hospital room.
• Depending upon your overall health conditions, you will be prepared for a discharge from the hospital.

Before & after the surgery comparison

Generally, the results of a deep vein thrombosis treatment may take some time to show up. Throughout the entire healing process, it is extremely important to properly follow to set of instructions and medications prescribed by the doctor to get the most effective results. Additionally it is adviced to attend regular and timely follow-up appointments with the doctor to ensure a proper and complete recovery.

Cost of a Deep Vein Thrombosis Surgery in India with Pristyn Care

The cost of a deep vein thrombosis surgery may range anywhere between Rs. 1,70,000 to Rs. 2,50,000. This cost should not be considered an absolute as it may vary depending on certain factors like severity of the condition, cost of hospitalization, and charges of the doctor, based on their expertise. To find out the exact cost of a deep vein thrombosis surgery for yourself, you may contact the medical assistance team of any particular Pristyn Care clinic or hospital.

Insurance Coverage - Deep Vein Thrombosis Treatment

Since DVT is a condition that is medically necessary to be treated, therefore Deep Vein Thrombosis Treatment is covered under insurance at Pristyn Care. Before you undergo the treatment, our insurance will check all your insurance related documents and inform you about the insurance coverage of the treatment. To learn more about the insurance-related formalities, you can get in touch with our coordinators.

Recovery Rate - Deep Vein Thrombosis Treatment

The recovery rate after undergoing a deep vein thrombosis surgery varies from patient to patient depending upon a number of factors such as the severity of the condition, postoperative precautions, properly following the doctor’s instructions and how the patient’s body reacts to the treatment.

In most cases, the pain and swelling caused by a condition of deep vein thrombosis usually starts to get better within a few days of the treatment and you can get back to your routine life within a week of the surgery. However, in some cases, a post-thrombotic syndrome may develop followed by symptoms like swelling, pain, and discoloration of the skin around the affected area.

Like any other case, surgeries do not necessarily end up solving the problem. Taking preventive measures play an equally important role in ensuring a faster recovery, ruling out the risks of any possible complications.