Deep Vein Thrombosis (DVT) Treatment | Vascular & Interventional Physicians

DVT Lysis and Interior Vena Cava Filter Replacement

A Deep Vein Thrombosis (DVT) is a large blood clot that has developed in the deep veins in an upper or lower extremity (an arm or a leg). This can cause pain, redness, swelling, and tenderness in the extremity and poses multiple risks to the patient, including:

Pulmonary embolism (which happens when a piece of the blood clot breaks off and travels through the bloodstream to the lungs and can be fatal)
Post-thrombotic syndrome (long-term pain, swelling, and ulcerations of the legs)
Limb ischemia (when the swelling in the legs becomes so severe that it can obstruct the blood flow through the arteries and cause limb death).

Deep Vein Thrombolysis is a procedure to treat DVT by removing and/or dissolving clot. This is done by placing a small catheter into the vein, which is used to deliver medicine that can loosen or dissolve the clot and extract it. Afterwards patients are typically placed on a blood thinner to reduce the chance of additional clots.

Patients with DVT are sometimes treated by placement of an IVC filter. An Inferior Vena Cava (IVC) Filter is a metal basket of various designs which are placed in the largest vein (vena cava) in the abdomen to trap clots from going to the lungs. Vena cava filters are used when blood thinners pose excessive risk for bleeding (such as recent stroke, recent surgery, brain tumors, bleeding ulcers, eye hemorrhage) or when patients have lung clots despite being on/taking blood thinners. Vena cava filters are also placed in order to catch any clots that may travel to the lungs upward from the legs into the Inferior Vena Cava during a DVT lysis procedure. Vena cava filters are more than 90% efficient in preventing clots from traveling to the lungs. Some filters are considered retrievable, meaning that they may be removed if the patient no longer needs it in place.

Patients with DVT are almost always placed on a blood thinner. This is called anticoagulation. Although the length of treatment varies it is typically between 6-12 months unless a patient has had more than one episode of DVT, which may then require a longer treatment period. This decision is typically made by the primary care physician or hematologist in conjunction with an interventional radiologist.

Preparing for DVT Lysis:

A representative will call you prior to your procedure to review instructions and complete registration.
You will need to arrange for a driver to take you home

PRE-OP:

Do not eat or drink anything for 12 hours prior to your procedure.
Make sure to let your doctor know if you are on any blood thinners, including Coumadin (Warfarin), Heparin, Lovenox, Plavix or over-the-counter medications such as Aspirin.
Make sure to tell your doctor if you are, or could be, pregnant.

INTRA-OP:

The procedure itself is not painful, however light sedation medications may be administered through an IV in order to prevent any discomfort.
A catheter will be placed into the vein that contains the clot, usually starting in the back of the knee, after local anesthetic has been applied.
After the procedure, the catheter will be removed from the vein and a sterile dressing will be applied to the site.

POST-OP:

You will be monitored for approximately 2 – 4 hours, and then may be discharged to home.
You may resume light activities after 24 hours and may resume your normal activities after 48 hours.

If you develop fever or severe pain contact our office at 352-333-7847 (7VIP) or call your referring physician. After hours or on weekends, go to the nearest emergency room or call North Florida Regional Medical Center at 352-333-4000 and ask for the Interventional Radiologist on call.

Preparing for IVC Filter Placement:

A representative will call you prior to your procedure to review instructions and complete registration.
You will need to arrange for a driver to take you home.

PRE-OP:

Do not eat or drink anything for 12 hours prior to your procedure.
Make sure to let your doctor know if you are on any blood thinners, including Coumadin (Warfarin), Heparin, Lovenox, Plavix or over-the-counter medications such as Aspirin.
Make sure to tell your doctor if you are, or could be, pregnant.

INTRA-OP:

The procedure itself is not painful, however light sedation medications will be administered through an IV in order to prevent any discomfort.
These filters are usually placed through a vein in the neck or leg. A local anesthetic will be administered to the area prior to accessing the vein.
An X-Ray dye study is then done of the vena cava prior to placing the filter by injecting X-Ray contrast (“dye”) into this vein.
After the filter has been successfully placed, the catheters will be removed, and a sterile dressing will be applied to the site in the neck.

POST-OP:

You will have to be monitored for approximately 2 – 4 hours and then may be discharged to home.
You may resume your normal activities after 24 hours.

Preparing for IVC Filter Removal:

A representative will call you prior to your procedure to review instructions and complete registration.
You will need to arrange for a driver to take you home.

PRE-OP:

Do not eat or drink anything for 12 hours prior to your procedure.
Make sure to let your doctor know if you are on any blood thinners, including Coumadin (Warfarin), Heparin, Lovenox, Plavix or over-the-counter medications such as Aspirin.
Make sure to tell your doctor if you are, or could be, pregnant.

INTRA-OP:

The procedure itself is not painful, however light sedation medications may be administered through an IV in order to prevent any discomfort.
A catheter will be inserted into the vena cava and will be used to capture the filter.
The filter will then be removed and a sterile dressing will be applied to the site in the neck.

POST-OP:

You will be monitored for approximately 2 – 4 hours and then may be discharged to home.
You may resume your normal activities after 24 hours.