How to dissolve blood clots in legs
Medical Evaluation and Therapy Is Essential
Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein, typically in the legs. Treating a DVT is crucial, as the clot can break loose from the affected vein, move through the bloodstream to the heart, and lodge itself within the lung’s main artery. This complication—what’s known as pulmonary embolism—can be fatal.
Blood-thinning medications called anticoagulants are essential for preventing pulmonary embolism after a DVT diagnosis. Other therapies like taking a clot-dissolving drug or placing a device near the heart to trap blood clots are considered in select clinical scenarios.
This article will explore the treatment of DVT and the management of post-thrombotic syndrome, a common DVT complication. Supportive remedies, like early ambulation and compression stockings, will also be briefly reviewed.
<p>Oliver Helbig / Getty Images</p>
Oliver Helbig / Getty Images
Important Note
Home or natural therapies like compression stockings are intended to be supportive and not therapeutic when it comes to DVT care. Medical treatment is vital to treating DVT and helping prevent pulmonary embolism, among other complications.
Treatments for Blood Clots in Legs
The cornerstone of treatment for deep vein thrombosis is taking an anticoagulant, also known as a blood thinner.
In select cases, other options may be considered, namely administering a powerful “clot-busting” drug (thrombolytic) or placing a filter near the heart to help trap clots traveling up from the legs.
Anticoagulants
Anticoagulants do not dissolve blood clots. Instead, they impair clot formation, giving the body’s “fibrinolytic system” time to lyse or degrade the clot.
The primary reason for taking an anticoagulant for a DVT is to prevent pulmonary embolism. Other goals include:
Preventing the existing blood clot from enlarging
Preventing recurring blood clots
Preventing long-term complications, such as post-thrombotic syndrome (discussed below)
Anticoagulant agents to treat DVT include:
Direct oral anticoagulants (DOACs) are pills taken by mouth. They include Eliquis (apixaban), Pradaxa (dabigatran), Savaysa (edoxaban), and Xarelto (rivaroxaban).
Low molecular weight heparin (LMWH) is given as a shot underneath the skin. They include Lovenox (enoxaparin) and Fragmin (dalteparin).
Arixtra (fondaparinux) is given as a shot underneath the skin.
Heparin is given as a shot underneath the skin or intravenously (through the vein).
Jantoven (warfarin) is a pill and requires regular blood test monitoring.
Selecting an anticoagulant regimen depends on several factors, including:
Bleeding risk
Presence of underlying health conditions (e.g., liver or kidney disease)
Risk for medication interactions
Patient preference
Convenience (e.g., need for monitoring)
Thrombolytics
Thrombolytics dissolve clots by forming an enzyme (plasmin) that degrades the fibrin (strands of protein) that hold blood clots together.
Thrombolytics can be administered in two ways:
Catheter-directed thrombolytic therapy is performed by an interventional radiologist. The thrombolytic tissue plasminogen activator (tPA) is most commonly administered directly into the clot using a thin tube (catheter).
Systemic thrombolysis involves administering a thrombolytic like streptokinase intravenously close to the blood clot. This method is less common.
The drawback with thrombolytics is that they carry a risk of significant bleeding. They are reserved for high-risk cases, like extensive proximal (upper leg vein) blood clots or people with phlegmasia cerulea dolens (PCD).
PCD is a severe complication of DVT associated with extreme leg swelling, pain, and a bluish-purplish skin discoloration. It results from a massive blood clot that blocks blood flow through the affected leg.
IVC Filter
An IVC filter is a small wire device placed in the inferior vena cava to trap traveling blood clots and prevent pulmonary embolism.
What Is the Inferior Vena Cava?
The inferior vena cava is a large abdominal vein that returns oxygen-poor blood from the lower half of the body to the heart.
IVC filters do not prevent the formation of new clots and are not nearly as effective as anticoagulation in preventing pulmonary embolism. That said, sometimes they are the next best and only option.
An interventional radiologist usually performs this procedure as an outpatient. This minimally invasive procedure involves guiding a catheter with a collapsed filter mounted on it through a cut in the groin or neck.
Once in place, the filter opens (imagine an umbrella), and the catheter is withdrawn. The filter anchors itself to the wall of the IVC to trap blood clots before they reach the heart while still allowing blood to flow freely.
Indications for IVC filter placement include:
Individuals with an absolute contraindication to anticoagulation (e.g., active bleeding, planned high-bleeding-risk surgery, and major trauma)
Individuals who fail or develop a complication related to anticoagulation
How Long to Keep Treating a Blood Clot in Legs
Anticoagulation is started immediately after a DVT is detected unless there is a clear contraindication, such as active or high risk of bleeding.
The specific duration of anticoagulation depends on a person’s risk of developing another blood clot. That said, anticoagulation is generally given for a minimum of three months. In some cases, it’s continued for six to 12 months or even indefinitely.
Providers use various tools to help predict blood clot recurrence risk. A person’s risk of major bleeding is also factored into the decision regarding treatment duration.
Managing Post-Thrombotic Syndrome
Post-thrombotic syndrome is the most frequent complication of DVT, manifesting in 20% to 50% of people within two years of being diagnosed.
It’s a form of chronic venous insufficiency that results from the damage caused by the blood clot in the affected leg vein.
Typical symptoms include:
Leg heaviness, pain, swelling, and itching
Skin changes including new varicose veins (bulging superficial veins), darkening of skin color, and skin thickening
Venous ulcers (open sores) due to poor blood flow (in severe cases)
The key to preventing post-thrombotic syndrome is to take your anticoagulant therapy precisely as instructed and to follow closely with your provider.
If post-thrombotic syndrome does develop, management strategies include the following:
Wearing graduated compression stockings
Elevating the affected leg when at rest
Walking and various leg exercises to improve calf muscle strength and leg flexibility
Maintaining a healthy body weight
Sometimes, a venous-return assist device—a compression pump worn on the calf to optimize blood flow—may be considered.
Various surgical procedures like stenting (placing a tube in the vein to improve blood flow) can also be performed on people with severe symptoms.
Habits to Promote Better Circulation
Early walking after being anticoagulated for a blood clot in the leg is strongly encouraged to prevent post-thrombotic syndrome, increase quality of life, and decrease leg pain and swelling.
Elastic graduated compression stockings are also sometimes worn for up to two years after being diagnosed with a DVT. However, keep in mind the research supporting their benefit in preventing post-thrombotic syndrome is mixed.
Besides preventing post-thrombotic syndrome, early ambulation and wearing compression stockings during situations that pose a high risk for developing leg blood clots (e.g., after surgery and during air travel, respectively) can also help prevent DVTs.
Other lifestyle habits to help prevent DVTs include:
Smoking cessation
Maintaining a healthy weight
Adopting a highly anti-inflammatory eating pattern (e.g., Mediterranean diet)
Certain medications are also linked to a higher DVT risk—for example, birth control pills and hormone replacement therapy (estrogen or estrogen and progesterone).
Speak With Your Healthcare Provider
If you have a personal or family history of DVTs or clotting disorder, be proactive and speak with your prescribing healthcare provider before taking any new medication to ensure it is safe and appropriate for your care.
Complementary Role of Food in Dissolving Leg Blood Clots
Certain herbs and supplements—for example, turmeric, ginseng, and vitamin E— are known to have blood-thinning properties, although their ability to help prevent blood clots remains unknown.
Moreover, these and other herbs or supplements can interact with medications, including blood thinners, so they should only ever be taken under the guidance of a healthcare provider.
Ultimately, natural remedies should never substitute medical care for a blood clot in the leg.
Summary
A deep vein thrombosis (DVT) is a blood clot found in a vein, usually within the leg. The primary concern with a DVT is a potentially life-threatening complication called a pulmonary embolism (when the blood clot travels through the bloodstream to a major lung artery).
Taking an anticoagulant (blood-thinner) is the mainstay treatment for DVT. Anticoagulants can help prevent pulmonary embolism, new clots from forming, and other long-term DVT complications like post-thrombotic syndrome.
In select cases (e.g., a person cannot take an anticoagulant due to active bleeding), a small device called an IVC filter is placed near the heart to prevent blood clots from traveling to the lungs. Less commonly, a clot-busting drug called a thrombolytic may be administered.
Supportive or home remedies play a complementary role in treating DVTs, namely early ambulation after starting anticoagulation. Lifestyle habits like wearing compression stockings during extended travel, maintaining a healthy weight, smoking cessation, and staying active can also help prevent DVTs.
A healthcare provider must evaluate all suspected blood clots. If a DVT in the leg is diagnosed, anticoagulation is vital to preventing it from traveling to the heart and potentially causing death.
Read the original article on Verywell Health.
