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Venous Disease

Treatment of Deep Vein Thrombosis (DVT) & Venous Ablation

Deep Vein Thrombosis

What are the causes of DVT?

Having a family history of blood clots or blood that coagulates easily can lead to DVT.  Smoking, obesity and high blood pressure can lead to DVT.  People at risk for DVT include pregnant women, women taking oral contraceptives and patients who have injured their veins as a result of trauma, athletic injury, or surgery.  Sedentary behavior such as prolonged bedrest or sitting on an airplane or car for several continuous hours without moving is a leading cause of DVT.

What are the symptoms of DVT?

Leg pain, swelling, skin discoloration and/or redness are all symptoms of DVT.  It is not unusual for people to notice symptoms in just one leg.  In fact, air travelers who have developed DVT may notice that one leg is swollen or painful after a long flight.

What can happen if the DVT is not treated?

The worst thing that can happen from a DVT is that a piece of clot can break off and travel to the lungs.  This is called a pulmonary embolism, which can be lethal.  Blood thinners such as heparin or lovenox and Coumadin can prevent a pulmonary embolism from occurring.  If the DVT is large, it can stay within the vein for many years and cause long term pain and swelling.  If the swelling progresses, venous stasis ulceration can develop.

What cutting edge technologies are available to treat my DVT?

At VIP, we use mechanical thrombectomy catheters in conjunction with powerful clot busting drugs to break apart and remove the DVT in a safe and minimally invasive manner.  The procedure can be performed on an outpatient basis and is a safer and more efficacious treatment compared to compresson stockings and blood-thinnning medications.  Patients who have undergone thisprocedure, called DVT thrombolysis, are more likely to return to their previous level of physical activity.

The images above demonstrate x-ray dye being injected into a vein with DVT (two images on left).  The two images on the right show the normal appearance of the same vein after the DVT has been removed.

Venous Ablation

Venous insufficiency is a very common condition resulting from decreased blood flow from the leg veins up to the heart. Normally, one-way valves in the veins keep blood flowing toward the heart, against the force of gravity. When the valves weaken and don't close properly, blood flows backwards. This condition is called reflux. Veins that have lost their valve effectiveness become elongated, rope-like, bulged, and thickened. These are commonly known as varicose veins.

What is Venous Ablation?

For patients suffering from varicose veins, vein ablation is a minimally invasive procedure that treats the veins from the inside. This outpatient procedure is performed by an interventional radiologist and uses heat energy from a laser to seal the afflicted vein.

Is Venous Ablation right for me?

Your physician and an interventional radiologist can best determine if you are a candidate for the procedure. Enlarged and swollen blood vessels commonly associated with varicose veins can also cause pain and impaired walking that can generally worsen as the day goes on. In more severe cases darkening of the skin can occur. Compared to traditional “vein stripping” techniques, venous ablation is effective, has fewer negative outcomes (up to 95% success rates), leaves virtually no scars and has much less pain during recovery.

Is Venous Ablation safe?

Venous ablation is extremely safe, however as with all surgical procedures, there are risks that should be fully discussed with a physician. Some of these risks, although minimal, can include perforation of the vein, thrombosis, pulmonary embolism, phlebitis, infection and skins burns if the vein treated is close to the surface of the skin.

How should I prepare for this procedure?

No special preparation is necessary. However you must let your technologist or physician know if you are allergic to anesthetics, have a pacemaker, internal defibrillator or other implanted medical device. You will be asked to wear protective glasses while lasers are in use. To minimize the risk of bruising and bleeding, patients who take blood thinners may be asked to stop their medication prior to the procedure. The leg being treated will be sterilized and covered with a surgical drape and a local anesthetic will be administered to the site where the incision will be made, generally immediately above or below the knee.

What should I expect during this exam?

Unlike more invasive procedures that surgically strip veins from the leg, venous ablation uses a catheter, which is inserted through a single and very small incision. The skin is sterilized, local anesthesia administered, and a small needle is inserted into the vein to be treated using ultrasound for guidance. An external ultrasound transducer is used to study the vein and track its path. It is also used to guide the insertion of the catheter and gauge effectiveness of the procedure. The tip of the catheter utilizes fiber optics to deliver laser energy to heat and seal off the vein. Sealing off the faulty vein does not adversely affect circulation because other veins assume management for blood return back to the heart. The treated vein shrinks and seals and is unlikely to reopen and cause a recurrence of symptoms. Your physician may prescribe compression stockings to enhance your comfort and request that you have a follow-up ultrasound exam in two to four weeks to ensure that the procedure was successful.

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