Venous thromboembolism (VTE) generally refers to blood clots that form in the veins, usually in the legs or arms. An embolism is a blood clot that gets swept into the bloodstream and, eventually, lodges in a vein to cause a blockage. A pulmonary embolism occurs when a blood clot blocks and stops blood flow to an artery in the lung. VTE treatment is required to prevent potentially life-threatening complications.
What are the Treatments for Venous Thromboembolism?
The choice of treatment for venous thromboembolism depends on the location and severity of the blood clot, the individual’s risk factors, and whether they have had VTE before. The doctor will conduct tests to confirm the diagnosis and determine if the clot requires urgent treatment. Outpatient treatment is possible for many low-risk patients, while hospitalisation may be necessary for large clots or unstable patients. Treatment goals are to stop the blood clot from growing, prevent it from breaking off and causing pulmonary embolism, and reduce the risk of another VTE. The options include:
Blood thinners (anticoagulants):
Blood thinners are usually the first line of treatment for VTE. They prevent existing clots from getting bigger and stop new clots from forming. Types of blood thinners include heparin, warfarin, and newer direct oral anticoagulants (DOACs). The doctor will decide which medicine is suitable based on the patient’s medical history. A patient may need injections, pills, or intravenous (IV) blood thinners for months or even a lifetime.
Medicines to dissolve blood clots (thrombolytics):
Thrombolytics rapidly dissolve severe, dangerous blood clots such as pulmonary embolisms. However, as these medicines also increase bleeding risk, doctors reserve them for emergencies. Healthcare professionals administer thrombolytic drugs through an IV.
Catheter-assisted blood clot removal:
In emergencies, doctors may perform catheter-directed thrombolysis to break up or remove blood clots. This minimally invasive procedure involves inserting a thin, flexible tube (catheter) through a vein. The doctor guides the catheter directly to the blood clot using live X-ray imaging. They then deliver clot-busting medicine or insert tools to break or remove the clot.
Vena cava filters:
A vena cava filter is an alternative if you cannot take blood thinners. This device catches clots before they reach the lungs. But it does not prevent new clots. Doctors do not generally recommend filters for patients who can use anticoagulant medicines.
Conclusion
Venous thromboembolism requires prompt medical care to avoid severe complications such as pulmonary embolism. First-line treatments are usually anticoagulant medicines to stop clot progression and dissolution. Invasive techniques such as catheter-directed thrombolysis or filters are alternatives when medicines are unfeasible or fail. With appropriate treatment guided by a healthcare provider, most patients with VTE can avoid life-threatening phases and reduce the risk of recurrence. Health insurance plays a vital role in covering the costs of VTE treatment.