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What is a DVT?
Deep Vein thrombosis (DVT) is the term used for blood clots that occur in the main draining veins of the legs, pelvis and abdomen or occasionally the arms and chest.
What are the risks of DVT?
The major risk of DVT is the blood clots breaking off and travelling to the heart and lungs, called pulmonary embolism (PE). PE can be very serious causing stress on the heart and sometimes death.
Another risk of DVT that can occur further down the track is called Post Thrombotic Syndrome (PTS). PTS is caused by poor venous drainage that happens after extensive DVT has damaged the veins. It results in chronic leg swelling and pain. In its worst form, PTS can result in skin pigment changes and ulcers.
How can DVT be treated?
The standard treatment of DVT is blood thinning medication. Sometimes IVC filters need to be placed to prevent PE (see IVC filters below).
If patients can’t have blood thinning medication or their DVT is very extensive then other treatments may be needed like Pharmacomechanical Thrombolysis to get rid of the DVT. If the DVT is caused by a narrowing or blockage in the main vein in the pelvis, venous stenting may need to be performed to open up the narrowing.
What is Pharmacomechanical thrombolysis?
Pharmacomechanical thrombolysis (PCT) is a minimally invasive technique in which a special device is used to suck out the DVT. The device is inserted either through the main vein in the neck or behind the knee depending on the site of the DVT and directed into the clot. It is then moved up and down the DVT, lining it with clot busting medication then sucking out the clot like a vacuum cleaner.
What is Venous Stenting?
When the DVT is caused by a narrowing in the main vein in the pelvis the vein can be opened with a stent. Stents are flexible metallic tubes that are placed across the narrowed blood vessel. They can then be expanded, opening the narrowed portion of the vein.
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What is an IVC Filter?
An IVC filter is an implanted metallic device shaped like an umbrella that is placed in the main vein in the abdomen called the Inferior vena cava (IVC). IVC filters stop blood clots that may have formed in the leg or pelvic veins from breaking off and travelling to the lungs where they can cause pulmonary embolism (PE). PE can be very serious, causing stress on the heart and sometimes death.
How is an IVC Filter placed?
The procedure takes about 30 minutes and is done using local anaesthetic.
Through a tube placed either in the main vein in the neck or groin the IVC filter (which is like a closed umbrella before deployment) is guided to the right place in the abdomen. Once in position it is opened so it can begin filtering the blood draining from the legs and pelvis, stopping any large clots going to the lungs.
How is an IVC Filter taken out?
Once you can have blood thinning medication and or the risk of developing PE has reduced you will be ready to have the IVC filter retrieved.
It is taken out in a similar way to how it is put in with a tube placed in the main vein in the neck and guided to the filter. It is then captured with a special device, the umbrella is collapsed, and the filter is taken out.
Sometimes IVC filters are placed in other hospitals and no plan is in place for IVC filter retrieval. If you have an IVC filter in place and don’t have a retrieval plan talk to your doctor and book an appointment to see Dr Robertson.
For further information or to book an appointment to see Dr Jonathan Robertson please contact us
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