Deep Vein Thrombosis (DVT) can be treated effectively but needs to be dealt with carefully and can be prevented by regular physical activity especially if an inpidual is immobilized for longer time. Deep Vein Thrombosis is a serious condition characterized by formation of a blood clot in the veins usually leg veins or pelvic veins and may occur in renal vein (kidney vein), portal vein (liver vein), mesenteric vein (intestinal vein), inferior venacava, retinal vein (eye vein), cortical vein (brain vein).As a part of the International DVT awareness month Dr Ravul Jindal, Vascular Surgeon, Fortis Hospital, Mohali, said all DVT patients are living a happy life post treatment. Citing examples, he said, all these patients presented with acute onset swelling of the leg and they had extreme pain. They were managed successfully either with medication and certain patients had to undergo clot removal and stenting of these veins.
Most of these patients’ symptoms settled within two to three weeks. They were allowed to move around within 1-2 days. They are on blood thinners which are continued either for 6 months to life long.
The incidence of DVT in India as reported is one percent of the adult population after the age of forty and is 15 to 20 percent in hospitalized patient and the risk of DVT is 50 percent in patients undergoing orthopedic surgery particularly involving the hip and knee, he said. It is 40 percent in those patients undergoing abdominal or thoracic surgery and one in 100 patients who develop DVT dies, usually from the blood clot traveled to the lungs - pulmonary embolism. The Deep veins are responsible for returning the blood to heart and lungs and these veins weaken in their functions of propelling blood over a period of time especially when a person is confined to immobilization. The veins may be partially or completely blocked by the blood clot causing DVT.
The commonest risk factors are inpiduals after the age of forty with prolonged immobilization such as prolonged bed rest due to respiratory failure, heart failure, paralysis, after fractures, heart attack, trauma, abdominal, thoracic or neurosurgery and in cancer patients. Obese inpiduals with diabetes are more prone to DVT patients with malignancy and smokers and those women who are on oral contraceptive pills are more vulnerable.The common symptoms of DVT are pain in the calf or thigh region with tenderness, swelling with or without pitting edema below the knee or up to the groin and increased local skin temperature. Some of the complications which come with DVT are – fatal pulmonary embolism (clot in the lung), post thrombotic syndrome and recurrence of venous thrombosis.
The need of DVT prophylaxis cannot be over emphasized. Only 10 percent of inpiduals who require DVT prophylaxis actually get it, remaining 90 percent of inpiduals are deprived of this DVT prophylaxis because of ignorance, lack of awareness or lack of skill. The need of DVT prophylaxis is usually underestimated.The treatment of DVT depends on the extent of DVT. Usually partial DVT is treated with low molecular weight heparin such as enoxaparin. However, in extensive DVT one uses thrombolytics (clot dissolving agents) followed by low molecular weight heparin. Patients get immediate relief and are discharged after 2 days. One should always investigate the cause of DVT and the treatment is instituted accordingly.