Deep Vein Thrombosis (DVT) is a serious condition where blood clots form in the deep veins, typically in the legs. This condition can lead to significant health issues if not treated promptly, including the risk of a Pulmonary Embolism (PE), where a clot travels to the lungs, causing a potentially life-threatening blockage.
Pulmonary Embolism
A pulmonary embolism occurs when a blood clot from the deep veins travels to the lungs, obstructing blood flow. Symptoms include sudden shortness of breath, chest pain, and coughing up blood. Immediate medical attention is crucial for managing PE and preventing severe complications.
Thrombolysis / Thrombectomy
Thrombolysis involves dissolving blood clots using medication, while Thrombectomy is a procedure to physically remove clots. These treatments are essential for patients with severe DVT or PE, offering rapid relief and preventing further complications. At VIR Chicago, we use advanced imaging and techniques to perform these procedures safely and effectively.
May-Thurner Syndrome / Iliac Vein Stenting
May-Thurner Syndrome is a condition where the iliac vein is compressed by the overlying artery, increasing the risk of DVT. Iliac Vein Stenting involves placing a stent to keep the vein open, restoring normal blood flow. VIR Chicago’s specialists are skilled in diagnosing and treating May-Thurner Syndrome using minimally invasive stenting procedures.
IVC Filter Placement / Retrieval
An Inferior Vena Cava (IVC) Filter is a device placed in the large vein of the abdomen to prevent blood clots from traveling to the lungs. This is particularly useful for patients who cannot take blood thinners. The filter can be placed temporarily or permanently, depending on the patient’s needs. VIR Chicago provides both the placement and retrieval of IVC filters, ensuring comprehensive care for DVT and PE prevention.
Do you need deep vein thrombosis treatment? Our physicians perform a minimally-invasive, non-surgical alternative called thrombolysis. Our Illinois clinic can perform this minimally invasive procedure on an in-patient basis or at one of the Adventist Midwest Hospitals in and around Chicago. We have participated in the multi-center ATTRACT Trial, a randomized trial to evaluate the benefit of aggressive non-surgical removal of leg vein and abdominal vein clotting.
Deep vein thrombosis (“DVT” or clots in the deeper leg veins) is a well-known cause of leg pain and swelling. Risk factors for DVT include:
- recent trauma
- major surgery
- cancer
- paralytic stroke
- estrogen treatment (birth control pills)
- immobilization
- obesity
- increased age, and history of previous clotting problems in the patient or family
A small catheter is passed into the affected vein via a tiny skin nick during a deep vein thrombosis treatment.
(Left) A large ulcer in a patient with chronic venous disease.
(Right) Vein damage by previous clots can result in chronic leg swelling and skin problems.
When confined to the lower leg, deep vein thrombosis treatment is usually anti-coagulation with heparinoids (injectable blood-thinners) followed by Coumadin, or other newer anticoagulants. DVT may be a source of life threatening clots traveling to the lung arteries.
Occasionally, lower leg DVT may extend up the thigh veins and into the pelvic veins. When that occurs, the delicate one-way valves in the veins may become permanently damaged. In a significant number of cases, this may lead to chronic, i.e., permanent, leg swelling and skin changes in the affected leg, despite coumadin as a deep vein thrombosis treatment. Coumadin and heparin can stop further clots from forming but do nothing to remove clots that have already formed. In cases of severe, extensive DVT, interventional radiologists can sometimes remove the clots from the leg and pelvic veins by introducing a tiny catheter (see photo) and injecting “clot busting” type drugs.
The procedure, called venous thrombolysis (which means “vein clot dissolving”), is performed by skilled interventional radiologists. Rapid intervention is needed, usually within the first week or two. Thrombolysis is performed on patients who are still leading active lives and might be disabled by chronic leg problems. The risk of serious complications, like dangerous bleeding, is quite low since only very small doses of the clot busting drug are infused.
A clotted leg vein before, then after infusion of a clot busting drug. The vein is open, and flowing well.
Sometimes, a special blender-suction catheter is used for more rapid clot removal.
Unfortunately, some patients with extensive clots who are denied the thrombolysis treatment may develop a condition known as chronic post-phlebitic syndrome. Chronic swelling, discoloration of the skin and even the development of sores may occur if deep vein thrombosis treatment is not given.
If extensive clots are allowed to permanently damage the leg veins, they cannot be dissolved later, since they rapidly harden into scar tissue.
Our physicians are very experienced in performing deep vein thrombolysis procedures.
Deep Vein Thrombosis in Large abdominal and Pelvic veins
Large veins in the abdomen may be opened with large stents, if clot removal fails. Here, a picture shows clogged veins in the pelvis and abdomen (left) with clots stopping flow. On the right, clots have been melted away, and metal stents hold open the veins allowing clear flow.
