Blood clots deep in the legs, called deep venous thrombosis or DVT, are a serious health concern. If a clot breaks free and travels to the lungs, it can be potentially fatal. Blood clots in the lungs are the third leading cause of death in people who are hospitalized, according to the medical text "Current Medical Diagnosis & Treatment 2014."
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Blood thinners, called anticoagulants, are the major form of treatment for DVTs. Frequently, when a blood clot is first diagnosed, two blood thinners are used. One starts working within minutes, and other does not reach its full effect for several days. The fast-acting blood thinner is given in a shot or intravenously. Commonly used drugs include heparin, enoxaparin (Lovenox) and fondaparinux (Arixtra). These drugs provide protection until a frequently used oral blood thinner called warfarin (Coumadin, Jantoven) takes effect. There is at least a 5-day overlap period when both forms of treatment are needed.
While warfarin has been used for decades and was standard treatment for blood clots for many years, it is not without drawbacks. For instance, people on warfarin need regular blood work to make sure the blood is not too thick or thin. Warfarin also has the potential to interact with many other medications. Several newer pills are used to treat blood clots, such as rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Lixiana). When using one of these medications, a shot or injection is not needed. Unlike warfarin, these newer drugs are effective when used alone.
If the blood clot in the leg is severe, a "clot buster" medication may be used to dissolve the clot. These drugs are stronger than other treatments for blood clots, but they are also more dangerous. Therefore, they are reserved for special cases. Common drugs include alteplase (Activase), streptokinase (Streptase) and urokinase (Kinlytic).
Leg elevation can help decrease swelling associated with a blood clot in the leg. In addition, doctors sometimes recommend fitted compression stockings to help decrease the risk of swelling that may persist even after the blood clot is gone. Walking, not bed rest, is encouraged when it is feasible.
Superficial Blood Clots
Blood clots may occur in superficial leg veins, near the skin surface. These superficial clots are not as likely to break off and travel to the lungs. They do sometimes progress, however, involving increasing area within the vein. This progression may extend to involve the deep veins, although this is uncommon. Applying heat to the area and nonsteroidal antiinflammatory drugs, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), are frequently the only treatments needed for superficial blood clots in the leg.
A blood clot in the leg may cause warmth, swelling, redness and pain, though not all symptoms may not be present. However, any of these symptoms should prompt an immediate medical evaluation.
- American Heart Association: Management of Deep Vein Thrombosis and Pulmonary Embolism
- UpToDate: Treatment of Lower Extremity Deep Vein Thrombosis
- The Washington Manual of Outpatient Internal Medicine; Thomas M. De Fer, M.D., et al.
- Current Medical Diagnosis & Treatment 2014; Maxine A. Papadakis, M.D., et al. (eds.)
- UpToDate: Overview of Acute Pulmonary Embolism
- UpToDate: Fibrinolytic (Thrombolytic) Therapy in Acute Pulmonary Embolism and Lower Extremity Deep Vein Thrombosis
- Chest: Evidence-Based Management of Anticoagulant Therapy
- British Medical Journal; Venous Thromboembolism: Pathophysiology, Clinical Features, and Prevention
- Pulmonary and Critical Care Medicine: Initial Treatment of Acute Deep Venous Thrombosis (DVT) of the Leg (ACCP/Chest Guidelines)