Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism
Patient Guideline Summary
- Venous thromboembolism (VTE) describes blood clots forming in veins and traveling, usually into the lungs.
- We will use the abbreviation DVT throughout this summary to refer to deep venous thrombosis and PE to refer to pulmonary embolism.
- There are two conditions in view here.
- DVT: blood clots in veins, most commonly in a leg. Severe cases threaten blood circulation in the affected limb.
- Embolism: – the movement of a clot, usually into a lung. Large or multiple emboli can be life-threatening.
- Some of the most common causes of VTE are cancer, trauma, heart conditions, paralysis, and extended time sitting, as in an airplane.
- Symptoms of DVT include pain, swelling, warmth, and discoloration of the affected limb.
- Symptoms of PE include difficulty breathing, chest discomfort, heart pounding, faintness, and coughing up blood.
- This patient summary focuses on the management of venous thromboembolism.
- Uncomplicated DVT and PE can be managed at home. More severe cases or otherwise unhealthy patients may require hospitalization.
- Medical treatment entails preventing the extension of the clot or dissolving the clot, or both.
- Thrombolysis (clot-dissolving) can be accomplished by giving certain drugs intravenously or through a catheter directly into a clot.
- Anticoagulation prevents further clotting by “thinning” the blood. There are several classes of anticoagulants.
- Intravenous low molecular weight heparin
- Oral agents:
- Vitamin K antagonists (blockers)
- Rivaroxaban, apixaban, edoxaban and dabigatran
- Surgical treatments:
- Open removal of clots
- Catheter placement of a filter above the clot to prevent it from moving into the lungs
- Compression stockings help prevent blood from pooling in the legs.
- Duration of medical treatment is an individual decision weighing the severity of the condition, the risk of continued medication, and the general health of each patient.
- ASH: American Society Of Hematology
- DVT: Deep Venous Thrombosis
- PE: Pulmonary Embolism
- VTE: Venous Thromboembolism