Venous Thrombectomy

 

Blood clots in the deep veins of the legs (DVT) are a potentially lethal disorder if these clots travel to the lungs (pulmonary embolism or PE). They also, however, pose a more long-term threat. By obstructing the return of blood from the lower extremity to the heart, a DVT can cause significant and sometimes debilitating swelling in the legs. The valves in the veins, that prevent blood from refluxing back down and pooling in the legs, are often damaged by a DVT, and the longer the clot remains in the vein, the more difficult it becomes to regain normal function of the valves.

A minimally invasive procedure (known as percutaneous mechanical thrombectomy) can be performed in appropriate patients in order to remove as much clot from the veins as possible. A special catheter is inserted into the vein and with x-ray guidance, the diseased areas are treated by breaking up the clot with a combination of a strong clot-dissolving medication and a catheter that churns the clot so that it is exposed to the medication.

Usually, a special filter is placed to prevent the movement of the clot into the lungs. The success of the surgery depends upon the duration of the clot within the veins, with the more recently developed clots being more easily treated. Some patients require an overnight stay in the intensive care unit for continued administration of the clot dissolving medication. All patients are placed into compression stockings for their extremities long term, and a blood thinner orally for at least 4-6 months.