Deep Vein Thrombosis (cont.)

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Surgery for deep vein thrombosis (DVT)

Surgery is a rare option in treating large deep venous thrombosis of the leg in patients who cannot take blood thinners or who have developed recurrent blood clots while on anti-coagulant medications. The surgery is usually accompanied by placing an IVC (inferior vena cava) filter to prevent future clots from embolizing to the lung.

Phlegmasia Cerulea Dolens describes a situation in which a blood clot forms in the iliac vein of the pelvis and the femoral vein of the leg, obstructing almost all blood return and compromising blood supply to the leg. In this case surgery may be considered to remove the clot, but the patient will also require anti-coagulant medications.

What are the complications of deep vein thrombosis (DVT)?

Pulmonary embolism is the major complication of deep vein thrombosis. It can present with chest pain and shortness of breath and is a life-threatening condition. Most often pulmonary emboli arise from the legs.

Post-phlebitic syndrome can occur after a deep vein thrombosis. The affected leg can become chronically swollen and painful with skin color changes and ulcer formation around the foot and ankle.

Can deep vein thrombosis (DVT) be prevented?

As is the case with most medical illnesses, prevention is of prime importance. Minimizing risk factors is key to deep vein thrombosis prevention.

In the hospital setting, the staff works hard to minimize the potential for clot formation in immobilized patients. Compression stockings are routinely used. Surgery patients are out of bed walking (ambulatory) earlier and low dose heparin or enoxaparin is being used for deep vein thrombosis prophylaxis (measures taken to prevent DVT).

For those who travel, it is recommended that they get up and walk every couple of hours during a long trip.

Compression stockings may be helpful in preventing future deep vein thrombosis formation in patients with a previous history of a clot.


Fauci, Anthony S., et al. Harrison's Principles of Internal Medicine. 17th ed.
United States: McGraw-Hill Professional, 2011.

Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2_suppl):e737S-e801S. doi:10.1378/chest.11-2308.

Vieg, van Hylckama. et al. The Venous Thrombotic Risk of Oral Contraceptives, Effects of Oestrogen Dose and Progestogen Type: Results of the MEGA Case-control Study. BMJ. 2009; 339:b291.

Medically Reviewed by a Doctor on 5/13/2015

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