Having Percutaneous Transcatheter Treatment of Deep Vein Thrombosis (DVT)
Percutaneous transcatheter treatment is a way to treat a deep vein thrombosis (DVT). DVT is a blood clot that forms in a large, deep vein. It happens most often in one of the veins of your legs. You may have pain, swelling, warmth, and redness from the DVT.
The treatment is done with a long, thin tube (catheter). The catheter is used to get to the blood clot to help remove it or break it up. Percutaneous means that it’s done through a small cut (incision) in the skin. Your healthcare provider may use the catheter with medicine, tools, or other tiny devices (balloons, wire mesh) to treat the clot. Thrombolysis or thrombectomy with transcatheter treatment are rare and are usually reserved for people with specific types of clots or for people who can't use anticoagulants.
What to tell your healthcare provider
Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. And tell your healthcare provider if you:
Have had any recent changes in your health, such as an infection or fever
Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local and general)
Are pregnant or think you could be
Tests before your treatment
You may have tests before the treatment. The tests may include:
Ultrasound. This is done to help diagnose the DVT and measure the flow of blood in your leg.
Venogram. This is done to get images of the blood clot and of your veins.
CT scan. This is done to get more detailed images of the blood clot.
MRI. This is done to get more detailed images of the blood clot.
Blood tests. These are done to check your overall health and to check for blood clotting problems.
Getting ready for your treatment
Talk with your healthcare provider how to prepare for your percutaneous transcatheter treatment. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your procedure. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.
Also, make sure to do the following:
Ask a family member or friend to take you home from the hospital. You can't drive yourself.
Don't eat or drink after midnight the night before your treatment.
Follow all other instructions from your healthcare provider.
You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully. Ask questions if something is not clear.
On the day of your treatment
Your percutaneous transcatheter treatment will be done by a doctor who is a blood vessel (vascular) specialist. It can be done in several ways. Ask your doctor about the details of your treatment. In general, you can expect the following:
An intravenous (IV) line will be put in a vein in your arm or hand. You’ll receive medicines and anesthesia through this IV. You may also get medicine to help you relax (sedation) or numbing medicine (local anesthesia).
You may be given a blood thinner, such as heparin, to help prevent blood clots from forming during treatment.
The healthcare provider will make a small cut (incision) through your skin and into a blood vessel in your groin, the area between your abdomen and your thigh.
He or she will then insert a long, thin wire into the incision. The wire acts as a guide during the treatment.
The healthcare provider may use continuous imaging to help see the wire, catheter, vein, and clot.
The healthcare provider will then insert a catheter using the wire as a guide. He or she may then send clot-dissolving medicine through the catheter. Small tools may be used to help break up the clot. A tiny balloon or mesh may be inserted to open the vein.
The healthcare provider will then remove the wire and catheter.
He or she will close the incision and then bandage it.
After your treatment
After the treatment, you will spend time in a recovery room. Your healthcare team will watch your vital signs, such as your heart rate and breathing. You may need to lie flat without bending your legs for several hours. This is to help stop bleeding from the incision. You may be able to go home the same day. Your healthcare provider will tell you more about what to expect.
Recovering at home
Make sure you follow all of your healthcare provider’s instructions. This includes instructions about medicines, activity, and incision care.
After you go home, you may need to take medicines to help prevent blood clots. You may need to take them for a short time, or take them for a longer time. You may also need to take medicines to prevent clots before any future surgery. Your healthcare provider will let you know about any other changes in your medicines. You can take pain medicine at home if you need it.
You can go back to your normal activities when you get home. But don't do strenuous activities or heavy lifting for several days. Your doctor may give you more instructions.
You may need to wear elastic (compression) stockings. The stockings help to keep your blood flowing and stop clots from forming. If you smoke, you will need to stop. This will also help to stop blood clots. Talk with your healthcare provider if you need help to quit smoking.
Your healthcare provider may want you to have imaging tests of your blood vessels. Make sure to go to all of your follow-up visits.
When to call your healthcare provider
Call your healthcare provider right away if you have any of these:
Swelling or pain that gets worse
Weakness or numbness in your leg
Bleeding from the incision or other places
Symptoms of a blood clot (swelling, pain, warmth, and redness)
Shortness of breath or trouble breathing
March 16, 2018
Overview of the treatment of lower extremity deep vein thrombosis (DVT), Up To Date
Hanrahan, John, MD,Sudheendra, Deepak, MD