The main goal of DVT treatment is to stop a blood clot from breaking loose and traveling to the lungs, a condition called pulmonary embolism (PE). This can block blood flow to the lungs and cause death in some cases.
By treating your DVT, doctors hope to:
- Keep the clot from getting larger
- Stop new blood clots from forming
- Avoid long-term complications
Your treatment may change and evolve over time depending on the severity of your DVT and your risk factors for getting another one.
What’s the First Treatment for DVT?
Doctors call the time from diagnosis until the first weeks of treatment the acute phase of DVT.
The most common initial treatment is blood thinner medication (anticoagulants). These include:
- Low molecular weight heparin (LMWH)
- Indirect Xa inhibitor fondaparinux (Arixtra)
- Factor Xa inhibitors rivaroxaban (Xarelto) or apixaban (Eliquis)
- Unfractionated heparin
Rivaroxaban and apixaban are often chosen as first line therapy. Another common outpatient therapy is LMWH, which is given as a shot under the skin. It can be followed by a vitamin K antagonist, such as warfarin (Coumadin). LMWH can also be followed by dabigatran (Pradaxa) or edoxaban (Savaysa). These medications lessen your blood’s clotting ability.
Your doctor may decide to admit you to the hospital for treatment if your DVT is severe or your risk of pulmonary embolism is high. You’re also more likely to have a hospital stay if you:
- You have heart and lung problems
- Your DVT is in your pelvic area
- You can’t use blood thinners
- You have a clotting or bleeding disorder
- You’re pregnant
- You’re obese
- You’re in kidney failure
Severe DVTs may need treatment with thrombolytics. These medications break up clots but come with a high risk of bleeding.
If you can’t use blood thinners because of another medical condition, your doctor may first treat your DVT with an inferior vena cava filter. A doctor puts this filter directly into your vein. It serves as a net to catch the clot if it breaks off and stops it from reaching your lungs.
You may also be a candidate for a thrombectomy. This is when a doctor puts a tube into your vein and physically removes the clot.
Primary Treatment
Once you’ve moved past the first 5 to 10 days after diagnosis and initial treatment, you’re in the long-term phase of DVT treatment. It takes about 3 months to finish this active treatment. If this is your first DVT, your doctor will likely recommend you stay on blood thinners for 3-6 months.
Secondary Prevention
This phase of DVT treatment goes on for a long period of time after the primary treatment phase, and can last indefinitely. Once you reach this stage of DVT management, you’re working on keeping DVT from happening again.
If you’ve been taking blood thinners, this is the stage of treatment where you and your doctor will make the decision to continue or stop them. Whether you keep taking them will depend on several factors, including:
- Your risk of getting another DVT
- Your risk of bleeding
- Where your clot is
- Your preference
If you have several risk factors such as family history, clotting disorders, or certain medical conditions, your doctor may recommend staying on blood thinners indefinitely. If you have a high risk of bleeding, the cons of blood thinners may outweigh the pros.
Along with these treatments, your doctor may recommend lifestyle changes that can help DVT from coming back:
Move your body. Break up sitting for a long time by getting up often. Take short walks every day to keep your muscles contracting and blood flowing well. If you can’t stand or walk, squeeze and release your leg muscles regularly or lift and lower them to keep circulation healthy.
Stay hydrated. It’s always important to get enough water, but it’s especially key when you’ll be sitting down for a long time, such as on an extended flight.
Keep a healthy weight. Carrying too many extra pounds increases pressure on your veins and raises your risk of DVT.