What Is Venous Thromboembolism? | A Doctor’s Guide

Venous thromboembolism (VTE) is a serious medical problem in which a blood clot develops or even blocks a blood vessel deep within the tissue. Specifically, VTEs develop in veins, which are the blood vessels that carry blood from the far reaches of your body back to your heart. You are most likely to develop these blood clots in your thigh, pelvis or lower leg, but dangerous VTEs can also form in your arm.

Your Guide to VTE: Venous Thromboembolism

Also known as Deep Vein Thrombosis (DVT), venous thromboembolism is common. Scientists do not know exactly how many people develop VTE each year, but the Centers for Disease Control and Prevention (CDC) estimates that these blood clots could affect as many as 900,000 people in the United States each year, which works out to about 1 to 2 people out of every 1,000 Americans.

While anyone can develop VTE, some factors can increase the risk of developing this type of vein blood clot. These risk factors include:

  • Injury to a vein as the result of bone fractures, severe muscle injury, or major surgery of the abdomen, hip, pelvis, or legs
  • Slow blood flow associated with confinement to bed, limited movement from a cast or other causes, paralysis, or sitting for long periods, particularly with your legs crossed
  • Increased estrogen from birth control pills, hormone replacement therapies, pregnancy
  • Certain chronic illnesses, such as heart disease, lung disease, cancer, inflammatory bowel disease
  • Other factors, such as previous VTE or pulmonary emboli, family history of VTE or pulmonary emboli, age, obesity, inherited clotting disorders, and the placement of a catheter (IV) in a central vein

Is Venous Thromboembolism Life Threatening?

Venous thromboembolism can be life threatening, especially when the blood clot breaks free from its location. Once loose, the blood clot can travel into the right side of the heart and then into a lung, in a condition known as pulmonary embolism. The clot can prevent blood from flowing into the lung, which is life threatening.

Approximately 60,000 to 100,000 Americans die of VTE/PE, and 10 to 30 percent of those with VTE/PE will die within a month of receiving their diagnosis. Many patients do not realize they have a pulmonary embolism – only about half experience symptoms, according to the CDC. In fact, sudden death is the first symptom in about one-quarter of those with PE.

About one-third of those with VTE will have long-term complications, known as post-thrombotic syndrome. These complications can include pain, swelling, discoloration, and scaling of the skin in the affected limb. Blood clots can also cause chronic venous insufficiency (CVI), a disease in which the veins do not work properly.

What Does VTE Feel Like, So I Know When to Seek Treatment?

Anyone can develop venous thromboembolism, so it is important to know the symptoms of VTE. When symptoms occur, they can include:

  • Swelling
  • Pain that feels like cramping or soreness, and often starts in the calf
  • Tenderness
  • Redness or discoloration of the skin
  • Feeling of warmth in the leg

Watch this video for more details on DVT.

How Is Venous Thromboembolism Diagnosed?

Only a doctor has the tools and education to diagnose VTE, as other conditions can present similar signs and symptoms.

Physicians diagnose VTE and rule out other conditions by taking a detailed history, performing a physical exam, and doing a venous ultrasound or other tests. Doctors consider the patient’s age, whether swelling is present and if that swelling is getting better or worse, the patient’s mobility, and if the patient has a family history of blood clots or a personal history of previous VTEs, blood clots, cancer, injury, stroke, or surgery.

Next, doctors perform a physical exam of the legs. They look for signs of swelling, the presence of visible varicose veins, tenderness of the calf or thigh, skin redness, or signs of chronic venous insufficiency.

Physicians then perform a venous ultrasound, which is a non-invasive imaging test that can help doctors determine if a clot is present inside the vein. Doctors prescribe treatment based on what they find in the patient’s history, exam, and ultrasound.

Can Venous Thromboembolism be Cured?

Medical treatment, along with the body’s own healing process, can cure venous thromboembolism.

Treatment typically involves medications, the use of compression stockings, and lifestyle changes. VTE treatment may sometimes involve the surgical placement of a special filter in the vein just below the heart, which prevents clots from moving into the lungs.

Doctors may even recommend thrombolysis, a surgical procedure in which the surgeon threads a catheter through the vein into the clot, and then inject drugs that dissolve the clot; the surgeon may use a tool to vacuum out the clot, and insert a balloon or stent to hold the treated vein open.

Doctors treat blood clots with blood thinning medication, known as anticoagulants, which decrease your blood’s ability to clot. These anticoagulants, such as Heparin, Lovenox, and Coumadin, can also prevent new clots from forming. However, these “blood thinners” do not break up existing clots – only thrombolysis and the body’s natural systems can dissolve blood clots.

Most patients with a first-time VTE are on anticoagulants for three months; some patients need to stay on anticoagulation therapy for life to prevent the development of more blood clots.

Doctors frequently recommend the use of compression stockings that squeeze the calf to promote blood flow, which can help stop new blood clots from forming. Lifestyle changes include increasing exercise to stimulate circulation and prevent the formation of new clots.

What is the Best Treatment for VTE?

The best treatment for deep vein thrombosis depends on a variety of factors, such as the severity and location of the blood clots, and your personal health history. Finding the right vein treatment is as easy as getting a recommendation from a qualified vein doctor.

For more information about venous thromboembolism, consult with a vein doctor with experience in diagnosing and treating deep vein thrombosis. Simply fill out our Online Appointment Request Form or call any of our clinics in Northwest Portland , TigardHappy Valley, Hillsboro or Bend, Oregon.

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