Knowing about available DVT treatments can help improve the dialogue with your doctor
After your doctor assesses the severity of your DVT along with other lifestyle or risk factors, he or she will most often prescribe a tablet medication, an injection medication or a combination thereof. However, other treatments as well as surgery for acute cases are also available. You can read about the various treatment options here.
The name “blood thinners” can be misleading, as anticoagulants are actually designed to interrupt the clotting process, both to prevent a DVT from growing larger and to reduce the chances of a new clot forming. This is why anticoagulant treatments last several months – the treatment is continually administered as the body itself dissolves the clot.
Heparin and Low Molecular Weight Heparin (LMWH)
Heparin comes in two forms: unfractionated heparin (UFH) and low molecular weight heparin (LMWH); both are administered as an injection.
Heparin works by deterring the blood’s “coagulation cascade”, which is the series of steps and triggers that blood undergoes in order to form a clot. LMWH works by inactivating thrombin in the coagulation cascade. This stops the formation of fibrin, the essential component of blood clots.
The recommended treatment for cancer associated thrombosis is Low Molecular Weight Heparin (LMWH) for 6 months. You may get a Low Molecular Weight heparin prescription on its own or your doctor may decide to prescribe it in conjugation with a vitamin K antagonist.
VKA medicines (or warfarin)
Come in tablet form and work by inhibiting or slowing down the normal clotting process. Everyone responds differently to this type of treatment, so frequent blood tests are needed to monitor results and adjust dosage if needed. As it can take several days for VKA medications to reach their desired effectiveness, your doctor may begin your treatment with both a VKA and a heparin prescription.
Direct Oral Anticoagulants (DOAC)
These also come in tablet form and work in a similar way to vitamin K agonists but are not normally recommended for use in cancer associated thrombosis. This is because there can be interactions with some cancer treatments and they are yet to demonstrate their effectiveness in cancer associated thrombosis. If you are given these tablets your doctor may have decided this option is most suitable for you.
Thrombolytics or “clot busters”
The name sounds like a quick fix for getting rid of your clot and moving on. And true to form, thrombolytics do actually dissolve the clot itself (unlike heparin and VKA treatments). However, this option is typically only prescribed in more severe situations because the drug can cause sudden bleeding.
Depending on your circumstances, your doctor may determine that the best method of treatment is surgery. Two types are available: vena cava filter and venous thrombectomy.
A vena cava filter is a small device that physically catches blood clots in order to stop them from moving into the lungs. As this is a filter, it allows blood to pass through, but it cannot do anything to actually dissolve the clot itself or prevent new ones from forming.
Venous thrombectomy is a rare procedure that is performed in serious and complex situations. In this case, a surgeon goes into the deep vein and physically removes the clot.
If you would like more details about the particular medicines or procedures available, or to understand more about the risks and benefits associated with any of these treatments, please ask your doctor.