Deep Vein Thrombosis (DVT) Treatment

Benefits of DVT Treatment

DVT Treatment is primarily aimed at preventing its complications, improving the symptoms, and reducing the risk of recurrence. Whether the patient gets surgical or non-surgical treatment, the advantages include the following: 

• Prevention of Pulmonary Embolism (PE): The primary danger of DVT is the potential for a blood clot to break loose from the vein and travel to the lungs, causing a pulmonary embolism. Effective treatment helps prevent this life-threatening complication of DVT.
• Relief from Symptoms: The treatment provides long-lasting relief from symptoms caused by DVT, such as pain, swelling, tenderness, and discomfort in the affected leg, thereby improving the patient’s quality of life. 
• Reduced Risk of Complications: Treating DVT can help to reduce the risk of other complications, such as post-thrombotic syndrome (PTS). In this condition, the patient continues to feel the painful symptoms of DVT even after it is treated. 
• Prevention of Clot Formation: The treatment not only dissolves the existing blood clots but also helps to prevent new blood clots from forming. 
• Preservation of Vein Function: Quick and prompt treatment can help preserve the function of the affected veins. In some cases, minimally invasive procedures like thrombolysis or venous stenting can restore blood flow and prevent long-term damage.
• Minimized Health Risks: By addressing DVT right away, the risk of complications and more invasive treatments is reduced. 
• Enhanced Overall Well-Being: Successfully managing DVT contributes to the patient’s overall health by relieving pain, improving mobility, and reducing the risk of recurrence. 

DVT treatment plans are tailored to the individual patient’s condition, taking into account factors such as age, medical history, overall health, and risk factors. This personalized approach ensures that the treatment is appropriate and effective for the patient’s unique situation.

How to Prepare for DVT Surgery?

Once the surgery is scheduled, the doctor will provide detailed instructions to the patients to prepare them for the procedure. The patient will receive some instructions that need to be followed strictly to ensure the surgery’s success. Though the specific instructions will vary from one patient to another, some general instructions are given below:

Before Surgery: 

• Understand the procedure, its purpose, risks, benefits, and expected outcomes properly before signing the consent form. 
• Get the recommended tests done and keep a copy of the test reports in hand.  
• Inform the surgeon about all medications, prescribed and over-the-counter, and herbal supplements so that their intake can be adjusted or stopped before the surgery. 
• Stop smoking at least 2 to 4 weeks before the surgery to allow the blood vessels to heal and reduce the risk of complications during and after surgery. 
• Arrange a reliable mode of transportation to get to the hospital on the day of surgery and for return after the surgery. The patient himself/herself won’t be able to drive immediately after the procedure. 
• Avoid drinking alcohol for a certain period before the surgery as advised by the doctor. 
• Start taking a healthy and nutritional diet that will improve the body’s healing abilities. 

On the Day of Surgery: 

• Practice fasting 6 to 8 hours before the surgery. Don’t eat or drink anything, including water, for the specified time. 
• Wear comfortable and loose clothes that can be worn and removed easily. Avoid wearing jewelry, piercings, or other accessories. 
• Take a proper shower using an antibacterial soap before coming to the hospital for surgery. 
• Take the prescribed blood thinner medications as directed by the doctor. 

Adhere to the preoperative guidelines given by the doctor and his/her team. After arrival at the hospital, the nurses ask the patient to change into a clean hospital gown, and an IV line is inserted into their arm to administer medications. The anesthetist will also discuss the anesthesia options with the patient. Once the patient is prepped for the surgery, the nurses will take him/her to the operating room. 

*Note: The patients are advised to read the consent form thoroughly before signing it and don’t hesitate to ask questions prior to the surgery. 

Step-by-step Procedure for DVT Treatment 

Depending on the technique being used, the steps of DVT treatment will vary. The general step-by-step procedure will involve the following:

• At first, the patient is given anesthesia to numb the body to ensure he/she is comfortable and doesn’t feel any kind of pain or discomfort during the procedure. Depending on the type of anesthesia (local, general, or spinal), the patient may be awake or asleep during the procedure. 
• The incision site will be cleaned with antiseptic, and depending on the chosen technique, incision/s will be made in the affected area to access the vein where the blood clot is present. 
• Depending on the technique chosen, the next step will be 
• In open thrombectomy, a small incision is made over the affected vein, and the clot is broken down using specialized instruments. 
• In catheter-directed thrombolysis, a catheter is inserted into the affected vein through a small incision. Thrombolytics are delivered directly to the clot using the catheter to dissolve it over time. 
• In mechanical thrombectomy, fluoroscopy or X-ray is used for guiding, and a rotating wire is inserted into the affected vein. The clot is broken down and suctioned out using a catheter-like vacuum. In some cases, a small net-like device (stent retriever) is inserted through the catheter to reach the blood clot and grab it. Once the clot is captured, the stent retriever is pulled out, thereby removing the clot entirely. 
• In angioplasty and stenting, a small incision is made to insert the balloon-tipped catheter. Once the catheter reaches the clot, the balloon is inflated to open the narrowed blood vessel, and a stent may be placed to keep it open. 
• In some cases, if the surgeon suspects that there are risks with blood clot removal, a stent may be placed to prevent the vein from closing, and a filter may be placed in the inferior vena cava. If the blood clot breaks down and starts moving through the bloodstream, the IVC filter prevents it from entering the heart and reaching the lungs. Therefore, it eliminates the risk of pulmonary embolism. 
• Once the necessary interventions are done, the surgeon will close the incisions using sutures or surgical staples. The incision will be covered with sterile dressings. 

The entire procedure can take around 1 to 2 hours, depending on the technique being used. 

What are the non-surgical treatments for DVT?

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

What to Expect After DVT Surgery?

Immediately after DVT surgery, the patient is taken to the recovery area, where he/she will be closely monitored until the effects of anesthesia wear off. The vital signs of the patients, including heart rate, blood pressure, oxygen levels, etc., are monitored. 

The patient can expect to feel slightly disoriented, nauseous, and confused after waking up, but these side effects will improve in the next few hours. There will be mild to moderate pain in the incision site, which will be managed through pain medications. The leg may also be swollen and bruised, which can limit the patient’s mobility. 

Depending on the surgery performed, the patient may be discharged on the same day or require hospitalization. Before discharge, the patient is given detailed post-op care instructions, a diet plan, an activity guide, and a follow-up schedule to monitor the recovery. 

Recovery After DVT Surgery

The recovery timeline for DVT Treatment can vary depending on factors such as the severity of the DVT, the chosen treatment approach, and individual patient factors. Overall, patients may need 4 to 5 weeks to recover after DVT treatment. The general DVT surgery recovery time will be as below:

• In the first few days, the patient may experience slight pain or discomfort and need to take the prescribed painkillers and other medications as directed. The doctor may recommend taking help from a physiotherapist to regain strength and mobility in the affected limb. 
• In 1 week, the swelling and bruising in the treated area will start to subside gradually. The patient will need to continue wearing compression stockings and taking anticoagulant medications. 
• Within 2-3 weeks, the pain, bruising, swelling, and redness in the treated area will almost subside, and the patient will be able to resume most activities. 
• In 4-6 weeks, the patient can increase physical activities, and the residual effects of the surgery will also disappear completely. 

For the long term, the doctor may advise the patient to make certain lifestyle adjustments and continue using blood thinners and compression stockings for DVT. Even after the recovery is complete, the patient needs to regularly monitor his/her health, look out for the signs of DVT, and get regular check-ups. 

Dos and Don’ts After DVT Surgery- Care Tips to Follow

During the recovery period after DVT surgery, the patient will need to follow several instructions for optimal and smooth recovery. The common tips are given below:

• Take the prescribed medications, including anticoagulants and pain relievers, as directed. 
• Keep the surgical incision clean and dry to prevent infection.
• Use ice packs to reduce the swelling and bruising at the surgical site. It will also numb the affected area and provide relief from the discomfort. 
• Watch for signs of infection, such as increased redness, swelling, warmth, or drainage from the incision site.
• Follow the doctor’s instructions to change the dressings and clean the wound. 
• Gradually resume physical activities, and don’t overdo it. Allow the body to rest as much as possible. 
• Avoid heavy lifting and strenuous activity for as long as recommended by the doctor. 
• Wear compression stockings as directed to promote healthy blood flow and prevent swelling.
• Maintain a balanced diet to support healing and overall well-being. Stay well-hydrated to flush out toxins from the body and maintain good viscosity of the blood. 
• Start physical therapy and exercises when recommended by the doctor to regain strength and mobility in the limb. 
• Avoid long periods of immobility after the surgery, especially in the case of a high risk of DVT recurrence. 
• Consider quitting smoking entirely, as it will only damage the blood vessels and increase the chances of developing DVT-related complications. 
• Avoid alcohol intake during the recovery as it can cause dehydration in the body and increase the chances of clot formation. 
• Attend all the scheduled follow-up appointments with the doctor to monitor the progress and make necessary adjustments to the treatment plan. 
• Discuss the prevention strategies with the doctor to address the risk factors of DVT. 

Risks & Potential Complications of DVT Treatment

The specific risks and complications associated with DVT can vary depending on factors such as the type of surgery, the patient’s overall health, and any underlying medical conditions. Some potential complications of DVT surgery include the following:

• Infection: All surgical procedures carry a risk of infection at the incision site or within the body. Signs of infection include increased pain, redness, swelling, warmth, and drainage from the incision site. If an infection occurs, the patient will require antibiotics. 
• Bleeding: Surgery can lead to bleeding, both during the procedure and afterward. In some cases, excessive bleeding might require additional interventions or blood transfusions.
• Blood Clots: Although the goal of DVT surgery is to address existing blood clots, there’s a risk of new clots forming during or after the procedure. Prophylactic measures are often taken to reduce this risk. 
• Anesthesia Complications: Anesthesia carries its own set of risks, including allergic reactions, respiratory issues, and aspiration. 
• Nerve or Blood Vessel Damage: During surgery, there’s a possibility of unintentional damage to nearby nerves or blood vessels, which can result in sensory changes, pain, or other complications.
• Scarring: Surgical incisions made during the procedure can result in scarring, which varies based on individual skin characteristics and wound healing abilities. 
• Vena Cava Filter Complications: If a vena cava filter is placed, there’s a risk of complications such as migration, fracture, or perforation of the filter.
• Stent-Related Issues: If a stent is placed, there’s a possibility of stent-related complications, such as stent migration, restenosis (narrowing of the vein), or stent clotting.
• Post-Thrombotic Syndrome (PTS): Despite successful surgery, some individuals might develop PTS, characterized by chronic pain, swelling, and skin changes in the affected leg.
• Blood Clot Traveling to Lungs (PE): In rare cases, the manipulation of blood clots during surgery might cause a piece of the clot to dislodge and travel to the lungs, causing a pulmonary embolism.

In most cases, the surgeon identifies these risks beforehand and takes the necessary measures to prevent them from arising in the first place. The patients are also advised to follow the surgeon’s instructions strictly to manage the potential complications after surgery. 

Lifestyle Changes Recommended To Prevent DVT Recurrence

Preventing the recurrence of Deep Vein Thrombosis (DVT) involves making certain lifestyle changes to reduce the risk of blood clot formation. It’s important to work closely with the doctor to develop a comprehensive plan tailored to the individual needs and medical history. Here are some lifestyle changes that might be recommended to help prevent DVT recurrence- 

• Stay Active: Regular physical activity promotes healthy blood circulation and reduces the risk of blood clot formation. Aim for at least 30 minutes of moderate exercise most days of the week. Activities like walking, swimming, and cycling are good options to stay active. 
• Avoid Prolonged Immobility: Try to avoid long periods of inactivity and take regular breaks to move and stretch the legs every hour. Avoid standing or sitting in the same position for extended periods, as it may increase the risk of blood pooling and clot formation. 
• Maintain A Healthy Weight: Obesity is a major risk factor for DVT because the extra weight makes it harder for the blood vessels to circulate blood. It also contributes to a lack of activity, which aggravates venous insufficiency promoting blood stasis and clots in the legs. It’ll be best to talk to a doctor or a dietitian to create a weight loss or management plan to reduce the risk of DVT. 
• Quit Smoking Entirely: Smoking increases inflammation in the blood vessels and increases plaque buildup. It also impacts the clotting factors and makes them overactive, which increases the risk of thrombosis. Tobacco also results in the narrowing of the blood vessels, which disrupts proper blood circulation. Thus, patients with DVT are strictly advised to quit smoking. 
• Stay Hydrated: Drink plenty of water to stay hydrated and promote healthy blood flow. Proper hydration helps prevent blood from becoming too viscous and prone to clotting. 
• Eat a Healthy & Balanced Diet: Diet is one of the factors that can be controlled to manage deep vein thrombosis. By choosing foods that are good for blood circulation and avoiding foods that can interact with blood thinner medications like warfarin, the patient can optimize their overall health. It’s important to avoid foods that are rich in vitamin K, such as spinach, kale, Brussels sprouts, fish oil, etc. Also, steer away from unhealthy foods, such as refined and processed foods, sodas, candy, trans fat, red meat, excess salt, and even alcohol. The best thing would be to talk to a dietitian to get a personalized diet chart. 
• Plan Ahead for Long Travel: When traveling long distances through flights or trains, or any other mode of transportation, it’s advised to wear compression stockings, wear loose-fitting clothes, and take breaks to walk around. It’ll be best to avoid long periods of immobilization. 
• Manage Stress Levels: Stress can increase blood pressure which can decrease the amount of blood that flows through the vessels. This can increase the risk of blood clots in the body, especially the legs. 
• Use Compression Stockings: Wearing the right type, size, and pressure of compression stockings for DVT is crucial. The stockings will manage blood circulation irrespective of the activity and reduce the risk of blood clot formation. 
• Manage Chronic Conditions: Properly manage underlying medical conditions such as diabetes, high blood pressure, and high cholesterol. Keeping these conditions under control is necessary as they can increase the risk of developing blood clots. 
• Take Medications As Prescribed: Never skip the deep vein thrombosis anticoagulant medications prescribed by the doctor under any circumstance. Also, patients need to be more careful while performing any task to avoid cuts while taking blood thinners, as they can cause excessive bleeding. 
• Educate Yourself: Learn about DVT and its risk factors. Understanding the condition will empower the patients to make informed decisions and take proactive steps to prevent DVT recurrence. 

While some of the DVT risk factors can be managed and controlled by patients, there are still numerous factors that are out of control. Thus, following these guidelines alone may or may not be sufficient to prevent DVT recurrence. It’ll be best to talk to the doctor to take the necessary steps and reduce the chances of blood clot formation as much as possible. 

DVT Treatment Cost in India

DVT surgery cost in India ranges from Rs. <minCost> to Rs. <maxCost>

 or more. This is only an estimated price range, and the actual cost may vary depending on factors such as the type of surgery, the hospital or medical facility, the location or city, the surgeon’s expertise, hospital-related expenses, prescribed medications, pre-and post-surgery care, and several other factors. 

The cost of surgery usually includes fees for the surgical team, hospital stay, anesthesia, medications, preoperative and postoperative care, and other related services. Additional costs might include diagnostic tests, follow-up appointments, and any complications that arise during or after surgery. To get an estimate, call Pristyn Care and talk to our experts. 

Is DVT Treatment Covered Under Health Insurance?

Yes, DVT is a critical condition that can lead to life-threatening complications if not treated on time. Thus, its treatment is deemed a medical necessity and covered by all health insurance plans under all circumstances. The patient only needs to file a claim request with the TPA at the hospital or clinic where he/she is getting treatment and obtain a pre-authorization. Once the insurance company approves the claim, the patient can get DVT treatment as required without worrying about the cost. 

The insurance policy will cover the expense of doctor’s consultation, surgery cost, medications, diagnostic tests, hospital stay, follow-ups, anesthetist fee, operating room charges, medical consumables, and second opinions. However, there may be certain clauses, such as deductibles or copays, that may require the patient to cover certain expenses incurred during the treatment. To clearly understand the inclusions and exclusions of the insurance policy, it’ll be best to talk to the insurance providers. 

Non-Surgical Alternatives for DVT Treatment

There are several alternatives to surgical treatment for DVT, which can be used as standalone methods or in combination with surgery for effective results. The common non-surgical alternatives for DVT treatment include the following. 

Home Remedies & Lifestyle Modifications 

While DVT treatment at home is not entirely possible, home remedies can provide temporary relief from the symptoms and may improve the overall health of the patients. Some common home remedies worth trying are: 

• Ginger: It is an excellent folk medicine that helps to break down the fibrins that cause DVT and improve blood flow. Drinking ginger tea 2-3 times a day can help to prevent high cholesterol, thereby preventing plaque buildup, which inhibits blood circulation. 
• Vitamin E: Eating vitamin E-rich foods like walnuts, spinach, sunflower seeds, olive oil, bell peppers, kiwis, etc. These foods have anticoagulant properties, which help to prevent the formation of blood clots. The patient can also include more green leafy vegetables, spinach, mustard greens, fish, liver, eggs, and cereals in the regular diet. 
• Cayenne Pepper: It is a very commonly used spice in India which is an excellent source of provitamin A and vitamin C. It acts as a natural blood thinner and has various benefits, including improving blood circulation, normalizing blood pressure, and reducing cholesterol levels, all of which decrease the chances of new clot formation. 
• Garlic: It is another ingredient that can help to alleviate the symptoms of DVT due to its anti-thrombotic properties. Garlic is most beneficial when eaten raw. However, the patient should consult the doctor regarding the amount that can be safely consumed. 
• Cinnamon: It is a spice that contains a compound called coumarin, which acts as a natural anti-clotting agent. Coumarin present in cinnamon inhibits the synthesis of vitamin K (a vitamin known to increase the risk of blood clot formation), lower blood pressure, and improves blood flow. 

While these natural ingredients readily available at home can be helpful in improving blood flow and dissolving the existing blood clots due to their blood thinning properties, patients should not rely on them entirely. Furthermore, DVT patients should always consult their doctor about using these home remedies with oral anticoagulant medications as they can lead to excessive blood thinning.

Deep Vein Thrombosis Medications

Anticoagulant medications are the first line of treatment for deep vein thrombosis to prevent and dissolve blood clots. Typically, warfarin and heparin are the most commonly used DVT anticoagulation medications. In extreme cases (higher risk of pulmonary embolism), thrombolytics or thrombolysis is recommended for the patient. 

In the initial stages, injectable heparin, also called unfractionated heparin, is given to the patient intravenously for thromboprophylaxis. This anticoagulant is preferred when the clot needs to be dissolved as soon as possible. Unlike this, warfarin is an oral anticoagulant that takes around 48 to 72 hours to take effect. Some commonly used deep vein thrombosis anticoagulation medications are listed below: 

• Unfractionated Heparin (UFH): This anticoagulant medication is used instead of low molecular weight heparin for patients who have renal insufficiency. It helps to achieve full anticoagulation by activating the body’s natural clot lysis mechanism to break down the clots. 
• Warfarin: Also called vitamin K antagonist, warfarin is also a preferred method for patients with venous thromboembolism (VTE).  A 5 to 10 mg dosage of warfarin takes around 5 days to provide the desired therapeutic effect. Patients who are given warfarin need to be monitored on a regular basis to maintain their clotting tendency and prevent excessive thinning of the blood. 
• Direct Oral Anticoagulant (DOAC): As the name suggests, this is a type of anticoagulant drug taken orally. These drugs are prescribed to patients who require long-term or frequent use of blood thinning medications. In such patients, warfarin or heparin are not considered suitable as they interact with other drugs or medications and can lead to severe complications. The most commonly used DVT anticoagulation medications include the following:
• Rivaroxaban: Sold under the brand name Xarelto, this DVT anticoagulant medication works by inhibiting platelet activation by blocking the activity of clotting protein factor Xa. 
• Apixaban: Available under the brand name Eliquis, this oral anticoagulant is used for patients with a history of blood clots. It acts as a direct factor Xa inhibitor to treat and prevent blood clots in deep veins and prevent stroke and embolism. 
• Dabigatran: Sold under the brand name Pradaxa, this anticoagulant medication is given to patients who have been treated initially for 5 to 10 days with parenteral anticoagulants (usually low molecular weight heparin)
• Edoxaban: Sold under the brand name Lixiana, this drug is indicated for people who have at least one risk factor for DVT, such as previous stroke, hypertension, diabetes, or old age. 
• Low Molecular Weight Heparins (LMWH): These DVT anticoagulation medications are a common and preferable choice for patients as they can be administered on an outpatient basis. They are as effective as unfractionated heparin in reducing DVT recurrence and deactivating the coagulation factor Xa. Some common low molecular weight heparin are:

• Dalteparin (Fragmin)
• Enoxaparin (Lovenox)
• Tinzaparin (Innohep)

• Thrombolytics (Clot Busters): Also known as thrombolysis, this deep vein thrombosis medication is administered when other DVT anticoagulation methods have proven ineffective. This medication initiates fibrinolysis (a process that prevents blood clots from growing and breaking down the existing clots). Thus, it is also called fibrinolytic therapy. Once the thrombolytic drugs are injected into the blood clot directly, they target the fibrin clot and break it into soluble parts called fibrin degradation products (FDPs). Commonly used thrombolytic drugs are Alteplase (t-PA), Anistreplase, Reteplase, Streptokinase, Urokinase, etc. 

The patient should not take any anticoagulant medications without consulting the doctor or make changes (increase, decrease, start, or stop) to the dosages. In most cases, patients may also be advised to make certain lifestyle changes to prevent further problems. 

Compression Stockings for DVT 

Patients who are at high risk of DVT or have had DVT surgery may be prescribed to wear compression stockings to promote blood circulation and prevent the pooling of blood that increases the risk of blood clot formation. 

DVT stockings are special, tight-fitting stockings that gently compress the leg. The deep vein thrombosis compression stockings are usually tight at the ankle and comparatively loose at the calves. They need to be used for as long as possible and as much as possible. 

As DVT stockings are available in different lengths and sizes, it’ll be best to consult a specialist to determine which would be a more suitable and safe option. Compression stockings also come with different levels of pressure (measured in mmHg). To manage DVT, patients will likely need somewhat tighter stockings.