Patient information from the BMJ Group

Deep vein thrombosis

If you have deep vein thrombosis (DVT), it means a blood clot has formed in a
blood vessel. DVT can be dangerous if parts of the clot break off and travel to your
lungs. But there are treatments that can help prevent this. You can also do things
to reduce your risk of getting DVT again.
We've weighed up the latest evidence about what treatments work best for DVT.
You can use this information to talk to your doctor and decide what treatments
are best for you.

What is deep vein thrombosis?

Veins are the blood vessels that carry blood back to your heart from all the parts of your
body. If a blood clot blocks a vein deep inside your body, it's called deep vein thrombosis.
It happens most often in the veins in your legs.
You can get a clot below your knee or above your knee. A clot above your knee is more
serious.

What are the symptoms?

DVT can cause swelling or pain in the calf or thigh of one leg. The affected part of your
leg may also feel hot and go red or purple. But it's possible to get DVT and not notice
any symptoms.
If part of the blood clot breaks free, it can travel through your blood vessels and get stuck
in your lungs. This is called a pulmonary embolism, and it can be dangerous. You may
get breathless, have chest pains, cough up blood, or feel your heart racing. Its more
likely to happen if you have DVT above the knee.
Its very important to see your doctor if you think you might have a blood clot. You may
need tests, such as an ultrasound, x-ray, or lung scan. DVT may be caused by another
medical condition, so your doctor may suggest tests to find out what caused your DVT.

What treatments work?

Medicines can treat DVT and reduce your risk of getting DVT again. Wearing special
elastic stockings may also help.
Drugs treatments for deep vein thrombosis
The main treatments for DVT are anticoagulants. These are drugs that help treat and
prevent blood clots.
You may be given a drug called heparin. It stops the clot in your leg getting bigger and
reduces your risk of getting another. You usually take it for five days to seven days.

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Deep vein thrombosis

Standard heparin is called unfractionated heparin. It's usually given in hospital, as a drip
(also called an intravenous infusion or IV). Some brand names are Monoparin and
Multiparin. The newer type is called low molecular weight heparin. Some brand names
are Fragmin and Zibor. You have this drug as an injection.
Research has shown that the newer type of heparin works better. Fewer people who
take it die from a blood clot. You have to have injections over several days. You may be
able to give yourself the injections at home, rather than keep going back to the hospital.
You'll usually be given warfarin tablets along with heparin. Warfarin helps to stop your
blood clotting. There isn't much research on warfarin for DVT, but doctors generally agree
that it works. You may need to take it for between six weeks and 12 months.
In one good-quality study, only 4 in 100 clots in the calf spread above the knee when
people took heparin and warfarin. But about 30 in 100 clots spread when people only
took heparin. DVT is more serious if it spreads above the knee.
Because warfarin and heparin help prevent your blood clotting, there's a risk you could
get unwanted bleeding. If you do have bleeding, your doctor may stop your treatment or
give you other medicines to stop the bleeding. If you're only taking it for a short time,
heparin isn't likely to cause any other serious side effects.
The effect of warfarin can be changed by other drugs you're taking or the amount of
alcohol you drink. Your doctor will be able to give you advice about this. Youll also need
regular blood tests to check that youre taking the right dose of warfarin. If you are a
woman, you can't take warfarin if you're pregnant. If you're pregnant and have DVT, you'll
probably be seen by a specialist.
Newer anticoagulants provide an alternative to heparin and warfarin for some people.
One example is rivaroxaban (brand name Xarelto). You take these drugs as tablets,
usually for at least three months. Good-quality studies show that they seem to work as
well as the older drugs for many people. They also have the advantage of not requiring
regular blood tests in order to check the dose, which makes them more convenient than
warfarin. But like all drugs that prevent blood clots, the newer anticoagulants can cause
unwanted bleeding, although some studies suggest the risk may be lower with rivaroxaban
than warfarin.
Elastic compression stockings
Following DVT, some people get swelling, sores on their skin, or damage to the tissue
around the blocked vein. Wearing special compression stockings may help prevent these
problems. In studies, 2 in 10 people who wore compression stockings had problems, but
4 in 10 to 5 in 10 people who didnt wear them had problems.
Your doctor may suggest you wear a compression stocking on the leg you had a DVT
in for several years. You can buy them at a pharmacy. It's important to get them properly
fitted to suit the size of your legs.

BMJ Publishing Group Limited 2014. All rights reserved.

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Deep vein thrombosis

Deep vein thrombosis and travel
Some research has found that long-distance travel puts you at higher risk of DVT. One
study suggested that about 1 in 100 people get signs of a blood clot after long-haul air
travel. If you think you might be at risk, talk to your doctor. You might need to take drugs
or wear compression stockings when you travel.
Some doctors advise not drinking a lot of alcohol and not taking sleeping tablets during
long journeys. They also say you should try to exercise your legs by stretching them as
you sit or by walking around as much as you can. But there hasn't been any research
on whether this helps.

What will happen to me?

What will happen depends partly on where the DVT happens in your body. Blood clots
in the veins in your thigh are more dangerous than clots below your knee. If you have
DVT below your knee, you may need more tests after about one week to make sure the
DVT hasn't travelled above your knee.
Without treatment, about 1 in 10 people with a clot above their knee will have a clot that
travels to their lungs. A blood clot in your lungs can be bad enough to kill you, but
treatment can help prevent it.

This information is aimed at a UK patient audience. This information however does not replace medical advice.
If you have a medical problem please see your doctor. Please see our full Conditions of Use for this content.
For more information about this condition and sources of the information contained in this leaflet please visit the Best
Health website, http://besthealth.bmj.com . These leaflets are reviewed annually.

BMJ Publishing Group Limited 2014. All rights reserved.

Last published: Sep 04, 2014
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