Venous Thromboembolism

A VTE is a blood clot (thrombus) that has formed in a vein. A VTE can form anywhere in your body and block blood flow. A VTE in the deep veins in the calfs, thighs, pelvis, or arms is called a deep venous thrombosis (DVT). A piece of the clot may break loose. This is called an embolus. The embolus can travel to your lungs and cause a life-threatening clot called a pulmonary embolism (PE). It is important to go to follow-up appointments and to take blood thinners as directed. Blood thinners help prevent a PE and another VTE.

What increases my risk for a VTE?

  • Recent surgery
  • Sitting or lying in one position for a long time
  • Pregnancy and childbirth
  • History of a VTE or a clotting disorder
  • Medical conditions, such as obesity or cancer
  • Hormone replacement therapy
  • Birth control pills, especially if you smoke or are older than 35 years
  • Smoking

What are the signs and symptoms of a VTE?

Your symptoms will depend on the location of the clot. You may have any of the following:

  • Swelling
  • Redness
  • Warmth, pain, or tenderness

How is a VTE diagnosed?

  • A D-dimer blood test may be done to check for signs of a blood clot.
  • An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may be done to show a clot in your vein.
  • Contrast venography is an x-ray of a vein. Contrast liquid is used to make the vein easier to see on the x-ray. Tell a healthcare provider if you have ever had an allergic reaction to contrast liquid.

How is a VTE treated?

  • Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any other medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin:
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Clot busters are emergency medicines that work to dissolve blood clots.
  • A vena cava filter may be placed inside your vena cava to treat your VTE. The vena cava is a large vein that brings blood from your lower body up to your heart. The filter may help trap blood clots and prevent them from going into your lungs.
  • Surgery called a thrombectomy may be done to remove the clot. A procedure called thrombolysis may instead be done to inject a clot buster that helps break the clot apart.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

  • Eliquis
  • Fragmin
  • Dextran 40
  • Pradaxa
  • apixaban

How can I manage a VTE?

Wear pressure stockings as directed. The stockings are tight and put pressure on your legs. This improves blood flow and helps prevent clots. Wear the stockings during the day. Do not wear them when you sleep.

Elevate your legs above the level of your heart. Elevate your legs when you sit or lie down, as often as you can. This will help decrease swelling and pain. Prop your legs on pillows or blankets to keep them elevated comfortably.