Deep vein thrombosis - treatment at a glance
A deep vein thrombosis in the lower leg can usually be treated on an outpatient basis, whereas thigh and pelvic vein thromboses are usually treated in hospital. The following treatment options are used:
- Heparin is a medication used to thin the blood and is administered as an infusion. The medication reduces blood clotting and prevents the thrombus from growing further, being carried away or forming new blood clots.
- Low-molecular-weight heparins (LMWH) are similar drugs to heparin and are administered as an injection.
- Blood thinners (anticoagulants) in tablet form in the coming months: New oral anticoagulants (NOACs) such as dabigatran, rivaroxaban, apixaban and edoxaban. Vitamin K antagonists (coumarins) are also used, such as the active ingredients phenprocoumon or warfarin.
- Metal filter (vena cava filter): this is used if the patient must not be given any anticoagulant medication (e.g. due to a life-threatening risk of bleeding). This small metal filter is inserted via a catheter into the large vena cava in the abdominal cavity above the kidneys. It intercepts any blood clots that could migrate from the leg to the lungs.
- Compression bandage and compression stockings: reduce the risk of post-thrombotic syndrome
- Lysis therapy: In the case of severe thromboses, especially pelvic or inguinal vein thromboses, an attempt is made to dissolve the blood clot with medication as a venous infusion or via a catheter directly in the thrombus. One example of a lysis drug is recombinant tissue plasminogen activator (rtPA). Lysis drugs are very effective, but can rarely cause severe bleeding, which is why special monitoring is necessary.
- Surgically removing blood clots – surgical thrombectomy is the technical term for this. Thanks to minimally invasive options with special catheters, open surgery is rarely performed nowadays.