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.

March Internal Vascular Series: DVT

During a traffic jam, the torrent of vehicles trying to get out of the area make it nearly impossible for other cars to come in. 

Deep vein thrombosis (DVT) is like a major traffic jam in a large vein in the body, usually in the legs – except the traffic jam is caused by a blood clot that develops.  Blood can’t get into the leg because there is so much blockage with the blood trying to get out of the leg.  The result?  A leg that suddenly swells up – sometimes even doubling in size.  If the clot breaks off, it can be life-threatening if left untreated.  Pulmonary embolism (PE) most commonly results from a clot that migrates to the lung, a process called venous thromboembolism (VTE).

DVT and its complications claim the lives of more people each year in the U.S. than breast cancer and AIDS combined!  A whopping 600,000 Americans are diagnosed with DVT annually, making it the third most common cardiovascular disease.  VTE is the leading cause of preventable hospital death.

Dr. Matthew Namanny,Saguaro Surgical

Dr. Matthew Namanny,
Saguaro Surgical

With a problem this prevalent, TMC has developed one of the busiest programs in the nation for minimally invasive DVT interventions.  Vascular surgeon Dr. Matthew Namanny from Saguaro Surgical estimates 80 to 200 of these procedures are done at TMC every year.  All are done in TMC’s hybrid operating room.

DVT awareness is gaining steam, thanks to efforts on all levels, from the nationwide Coalition to Prevent DVT, to the local level – where Dr. Namanny says educating others is not just part of the job, rather a true passion for him and his colleagues.  “We must take a multidisciplinary team approach to take care of these patients.  We all have to look for them and ask about risk factors,” he said.

Namanny in action 2Driving that point home was one of the main messages of Tucson Medical Center’s internal vascular series for the month of March, which focused on DVT.  Dr. Namanny spoke to health care workers who play a role in preventing these clots at the patients’ bedside.

Who’s at risk for blood clots?  Anyone.  “I’ve had patients who were in their teens all the way to patients in their 80’s and 90’s.  It’s not just a disease that affects older people.  It does have an increased prevalence with age, people who travel and take long flights, people who are immobilized.  Patients who have had major surgery, trauma, cancer, or who have had DVT in the past also have a higher risk, as do pregnant women, and any woman on oral contraceptives,” Dr. Namanny said.

The symptoms can be very subtle, he explains, and can range from minor pain and swelling to legs that are massively swollen to the point where circulation is compromised.  If patients have had pulmonary embolism, they can also be short of breath. 

DVT is easier to treat the earlier it’s caught.  Patients are started on blood thinners right away.  If symptoms are severe, they’re evaluated for intervention and clot removal.  Treatment options have really advanced, as the problem can typically be fixed during an outpatient procedure. 

For more information about DVT, please click here.


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