Dr. Darren Klass answers questions about deep vein thrombosis, a potentially fatal type of blood clot that can strike anybody, any fitness level, any age.

Darren Klass, MD, is Clinical Instructor of Interventional Radiology at the University of British Columbia and the Vancouver Coastal Health Association.

In layman’s terms, what is DVT?

DVT is deep vein thrombosis; this term generally refers to the development of a clot in the deep veins in the legs and pelvis.

The deep veins in the legs run between muscle compartments and cannot be seen without medical imaging.

How is it caused?

DVT is caused by blood within moving veins clotting. The clot is cause by three factors:

  1. Slow flow in the vein
  2. Abnormal clotting factors in the blood which cause it to clot more than normal
  3. Damage to the lining of the vein

Are there ways to prevent?

There is no way of completely preventing blood clots without medication, which in itself has risks. Ways to decrease the risks are:

  1. Keep well-hydrated; dehydration thickens the blood.
  2. Avoid sitting in the same position for long periods of time (i.e., long plane flights).
  3. Avoid tight constricting clothing at the hip, which may squash the vein in the groin and slow flow.

How can I be on the lookout for a clot?

If one part of your leg (the calve, thigh or both) suddenly becomes swollen and painful, or suddenly veins which were not visible under your skin become more prominent, you should consult your family doctor.

What are the risks if it’s not caught?

DVT may cause little or no long term complications if treated early. If left untreated, the risks are the following:

  1. Piece of the clot may break off and travel to the lung causing a pulmonary embolism.
  2. The clot may extend into the main vein in the abdomen (termed the IVC) and stop the flow of blood from the pelvis and opposite leg, which may cause complications.
  3. If the clot involves the veins in the pelvis, this may require treatment in a hospital to break up the clot (thrombolysis performed by an interventional radiologist). The aim of the treatment is to clear as much clot from the veins as possible and allow healing of the vein.

If the vein is left untreated and the clot is absorbed by the body, the vein is often left scarred.

The scarring may damage valves in the vein, which can lead to a chronic swollen leg, which is difficult to treat and may cause significant limitation in everyday activity. This condition is called post-phlebitic syndrome.

What are the options for treatment of DVT?

DVT can be treated in the following ways:

  1. Medication to thin the blood and decrease the risk of the clot extending. However, the clot remains in the vein until the body reabsorbs it and the vein is often left scarred.
  2. The clot can be removed by a minimally invasive procedure performed by an interventional radiologist. The procedure involves using special medication and advanced equipment to break up the clot and remove it from the vein and restore flow immediately.

The procedure is done through a tiny hole made in the vein behind the knee and a very small cut in the skin about 3 mm in length.

Dr. Klass specializes in interventional oncology, aortic intervention, PVD, venous disease and venous access. He has been inducted into The Leading Physicians of the World, published by the International Association of HealthCare Professionals.

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