Deep Vein Thrombosis: What You Need to Know about DVT

Deep vein thrombosisIf you’ve spent much time flying you’ve probably heard suggestions to avoid developing deep vein thrombosis, “Get up! Walk around. Do some squats.” But what is deep vein thrombosis? If you never fly do you have nothing to worry about? And how do we test and treat DVT?

What is Deep Vein Thrombosis?

DVT occurs when a blood clot develops in a deep vein in the body, usually in the legs.

Think of a blood clot as a traffic jam: the torrent of vehicles trying to get out of the area make it nearly impossible for other cars to come in. The blood clot usually forms on the valves of a deep vein and creates an obstruction to the outflow of blood. This creates swelling, redness and pain.

“Deep venous thrombosis is a serious condition that needs immediate attention,” said Dr. Layla Lucas, a vascular surgeon and endovascular specialist at Saguaro Surgical.

According to the Centers for Disease Control and prevention, as many as 900,000 Americans are diagnosed with DVT annually.

Risk factors for DVT

Although blood clots have an increased prevalence with age, many assume clots only happen to older adults. However, the challenges can appear across the age spectrum from teens to seniors.

At some point in our lives, we have all been at risk of developing a DVT or subsequent pulmonary embolism. A pulmonary embolism most commonly results from a blood clot that migrates through the heart into the arteries of the lung.  It can be life-threatening if untreated.

The Cleveland Clinic Center for Continuing Education cites PE as the third most common cardiovascular illness after acute coronary syndrome and stroke.

It is important to recognize these risks in order to prevent this risk of DVT:

  • Frequent travel (long flights or car rides)
  • People who are immobilized
  • Major surgery or trauma
  • Past history of DVT
  • Pregnancy
  • Women taking oral birth-control
  • Obesity
  • Cancer
  • Autoimmune disorders such as lupus

What are the symptoms?

The symptoms of DVT can range from:

  • Minor pain and swelling to significantly swollen legs and arms
  • Changes in skin color (redness)
  • Leg pain
  • Leg swelling (edema)
  • Skin that feels warm to the touch

If the blood clot breaks off and moves through the bloodstream it can get stuck in the blood vessels of the lungs to form a pulmonary embolism.

Symptoms of a pulmonary embolism:

  • Chest pain
  • Coughing up blood
  • Light headedness
  • Sudden shortness of breath

How will your doctor test for DVT?

Your doctor will perform a physical exam and

  1. A blood test called a D-dimer is a fast way to test for evidence of a blood clot.
  2. Duplex ultrasound. TMC uses duplex ultrasound imaging to evaluate for DVT. Duplex ultrasound combines both traditional and Doppler ultrasound. The Doppler ultrasound creates a picture of the venous blood flow and can identify which vein the clot has developed in and how extensive it is.

What to expect when having a duplex ultrasound exam?

PE is best diagnosed with a CT scan of the chest. Certain high-risk patients may get another test called a V/Q scan.

How we treat DVT and PE

With a problem this prevalent, TMC has developed one of the busiest programs in the nation for minimally invasive DVT and PE interventions.

DVT is easier to treat the earlier it is caught. Patients are started on blood thinners right away. If the DVT is extensive and the symptoms are severe, they’re evaluated for intervention and clot removal.

DVT can typically be fixed during one or two treatments.

Dr. Lucas explained the treatment advancements are put to best use. “As vascular surgeons, we see the consequences of untreated DVT and PE and therefore are aggressive in our management of these conditions.”

To find out more about vascular exams and procedures at TMC please visit our website.

Dr. Layla Lucas

Dr. Layla Lucas of Saguaro Surgical is board-certified in General Surgery and Vascular/ Endovascular Surgery. Dr. Lucas has a special interest in wound healing, limb salvage, stroke prevention and treatment of aneurysmal disease. She has been trained in a wide variety of minimally invasive endovascular techniques, as well as traditional open procedures in order to treat the full spectrum of vascular diseases.

A team approach to vascular surgery: like a “well-oiled machine”

They say “no man is an island” – and a surgeon is no exception.

Tucson Medical Center vascular surgeons are surrounded by teams of highly-trained, highly-experienced medical professionals, whether they are in the main operating room or in the catheterization lab.

The concept is simple.  Surround the surgeons with health care professionals who are so well-trained on every aspect of the procedure, they can predict what will happen next.  A team approach provides a safer, more efficient way to do things. 

Ed Salazar and Silver Palomino, TMC Special Procedure Technicians

Ed Salazar and Silver Palomino, TMC Special Procedure Technicians

Special procedure technicians Ed Salazar and Silver Palomino are key players on the OR team.  Their experience is measured in decades and their role during a procedure is invaluable.  Some of the key pieces they take care of include manning the control room and managing the software and imagery surgeons depend on while they operate. 

“The vascular department is very equipment intensive.  We have millions of dollars worth of devices we use.  They know how to use every piece, and they are a huge component in maintaining everything,” said Renee Paul, TMC Operating Room manager.  The pair has received extensive training on minimally invasive, or endovascular, procedures.

The remaining four members on this team are nurses and techs who have surgery backgrounds and therefore specialize in the open procedures.  “Our team provides a good balance because we have people with a working knowledge of both endovascular and open procedures.  It’s a wonderful complement to provide excellent care to all patients.  They will have that kind of specialty at hand, regardless of the type of procedure they’re having done,” said Paul.

TMC vascular surgeon Dr. Layla Lucas,Saguaro Surgical

TMC vascular surgeon Dr. Layla Lucas,
Saguaro Surgical

TMC vascular surgeon Dr. Layla Lucas from Saguaro Surgical said, “The quality of care is absolutely improved by having a team.  Patients have the peace of mind that everyone in the room with them knows exactly what’s going on from start to finish – not just the surgeon.  These teams are very savvy with new technology.  They are truly invested in vascular surgery and we partner with them in their commitment to provide patients the absolute best care.”

These team members offer physician and patient support.  This is especially valuable in TMC’s hybrid operating room, which can be used for a minimally invasive procedure and transformed to accommodate an open procedure in seconds if the need arises during surgery.  TMC will have a total of two hybrid operating rooms when the west campus opens up this spring.  Paul has plans to grow her team in order to accommodate the expansion. 

“Consistency from a specialized team leads to even greater patient safety,” said Paul.  “This team is comfortable with the surgeons.  The surgeons are comfortable with them.  Together, they are efficient, and work very methodically—like a well-oiled machine.”

The vascular team in the Cath Lab is much larger – about two-dozen people including nurses, radiology technologists and cardiovascular technologists.  Some of these employees have been at TMC for up to 30 years. 

“Experience matters,” said Roxanne Lee, Special Procedures/Cath Lab manager.  “This specialized team is really an asset because they take their training and knowledge and build on it.  They are so well-versed on every aspect of the procedure that they can actually recommend which piece of equipment will work best in a situation.”  The Cath Lab team is different from the OR team in that they also specialize in cardiac and radiology procedures in addition to having vascular expertise.

Both Paul and Lee said the feedback they receive is overwhelmingly positive.  “These physicians are very vocal that the team helps their cases go by quicker and easier with less stress,” said Lee.

TMC vascular surgeon Dr. Luis Leon, Agave Surgical

TMC vascular surgeon Dr. Luis Leon, Agave Surgical

“I have done vascular surgery with and without a team.  The team approach is key,” said TMC vascular surgeon Dr. Luis Leon from Agave Surgical.  “Doing a case with people who have that experience makes it so much easier because they can predict my next move, which is beneficial for everyone.  Their expertise also improves communication.  Additionally, since they’re so well trained on endovascular techniques, they can answer any questions the patient or family members may have.”

Saguaro Surgical makes house call to St. Luke’s Home

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Tucson Medical Center salutes the more than 15 staff members, family and friends from Saguaro Surgical who converged on St. Luke’s Home this past Sunday. In the spirit of Thanksgiving, the group visited with the residents, played a little bingo and treated everyone to lunch from Tucson favorite Lucky Wishbone.

This was the practice’s first time visiting the home, which provides assisted living for those with limited financial means. But it won’t be the last, according to practice manager Buzz Schudy, “St. Luke’s is a great home for our elderly and a wonderful community asset. It was a rewarding experience and we encourage others to go out and make a difference in our community. You’ll be glad you did.”

Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461