A deep vein thrombosis (DVT) is a blood clot that occurs in the veins. The clot can either partially or fully block the vein from being able to transport blood out of the legs. This causes symptoms in the legs such as swelling, skin tightness, and heaviness. A venous clot can also break off of the vein and travel to the lungs causing a life threatening condition called pulmonary embolism.
Patients with leg swelling and additional symptoms will first undergo a noninvasive imaging study, venous doppler, to assess the extent and location of the clot in their leg veins. Afterwards, your vascular surgeon will analyze the studies and listen to the severity of your symptoms to determine if you are eligible for a clot removal procedure.
Venous dopplers will help the surgeon assess if your DVT is above or below the knee. If your DVT is located below the knee, it is usually treated non surgically with blood thinners and leg elevation. This is because the risk of the clot breaking off and traveling to the lungs is low, and the the veins are usually too small to guide wires and clot busting devices through them. Above the knee DVT can be surgically treated because this condition poses an increased risk of significant swelling, pain, and pulmonary embolism. In addition, the veins above the knee are large enough for surgery.
Timing is also another crucial component to be eligible for a procedure. Usually, clot needs to be less than a couple of months old for a successful procedure. This is because the new clot is fresh and squishy and can be removed easily. If a clot is chronic, and has been in the vein for a long time, it becomes hardened and entrenched in the vein and cannot be removed.