While varicose veins may be the most visible form of vein disease in the U.S. (50-55% of women and 40-45% of men have them), the most dangerous form of vein disease has to be deep vein thrombosis, or DVT. Although exact numbers are not known because DVT has few overt symptoms, the Centers for Disease Control and Prevention estimate that as many as 900,000 people are affected by it every year, of whom 100,000 to 300,000 die of complications arising from the disease (primarily pulmonary embolism and stroke). Among those who have DVT, if it is not treated, over half will experience long-term complications known as post-thrombotic syndrome, which cause swelling, pain, discoloration, and scaling in the affected limb.
All in all, DVT constitutes a pretty scary public health care problem, and unlike heart disease and cancer, most people don’t even know that the disease exists, much less that they could be at risk from it. Therefore in this article we’ll explain a bit about how DVT is diagnosed and treated at Vein Clinics of Hawaii.
What Hawaii residents need know about DVT diagnosis
The first thing you should know is that except in rare situations in which DVT symptoms begin to manifest on the surface of the skin, you probably won’t ever know whether you have the disease or not unless you have a venous health screening. During these painless, non-invasive screenings, the best vein doctors in Hawaii at VCH use ultrasound, blood pressure readings, and other tests to determine whether blood clots have begun to form in the large veins of your legs. If they have, that’s it – you have DVT. And unless you have the disease treated, you are at risk of all the complications talked about in our first paragraph above.
So if I have DVT, how can it be treated?
The answer to this question depends on how many blood clots your Oahu varicose vein doctor finds, how large they are, and where they are located, among other factors. If we catch DVT early, and the blood clots are small, in many cases we can treat the condition with anticoagulent medicines such as heparin and warfarin. These drugs are often called “blood thinners,” but they don’t really thin the blood – what they do is alter chemicals within the blood to prevent clots from forming as easily.
Drug treatment of DVT is also almost always supplemented by recommending that the patient wear compression stockings. These stockings help to prevent calf pain and swelling, lower the risk of ulcers forming, and lower the risk of post-thrombotic syndrome. Compression stockings should be fitted professionally, and the prescription should be checked and possibly changed every three months. Your Kauai vein care specialist may also suggest other lifestyle changes, such as walking every day and keeping your legs elevated.
If I have a more serious case of DVT, how is that treated?
Compression stockings and increased gentle exercise will also be part of the treatment regimen for more advanced cases of DVT, but if the blood clots are large enough to impair your blood flow or in a location that makes them more likely to travel to the lungs or brain, the recommendation is usually to have the blood clots removed using endovenous laser therapy (EVLT). This is a minimally-invasive procedure that can be performed in the comfort of our offices, and allows the doctors to insert a special catheter into the diseased veins and then zap the blood clots with a tiny laser. In extreme cases, where blood clots have been removed but then form again later, small mesh devices called inferior vena cava filters can be inserted in a vein to trap fragments of blood clots and stop them from traveling to the lungs or the brain.
The first step in all of this treatment is, of course, to find out whether you have or are at risk of developing DVT. And you can do this by simply calling our vein practice on Maui and Kauai to set up an appointment for a venous health screening. The screening takes only about an hour, and whether it finds DVT of not, you’ll be happy you had it performed, and know for sure.