When we hear “blood clot,” it can be overwhelming and frightening. With today’s technology, treatment for blood clots is much less invasive, resulting in shorter hospital stays and quicker recovery for patients. While some patients require a minimally invasive procedure, many can be successfully treated with medications only.
There are three methods to treat a thrombus (clot) in a vein or an artery:
Treatment is determined by a vascular surgeon or cardiologist and is based on a variety of factors such as the size and location of the thrombus, how the thrombus is affecting blood flow to other veins or arteries, and the patient’s overall health.
Mechanical/Endovascular Thrombectomy is a minimally invasive procedure to remove a thrombus (clot) from an artery or vein due to an ischemic stroke (blockage), pulmonary embolus (PE), peripheral artery disease (PAD), or deep vein thrombosis (DVT). This procedure is performed in a cath lab under light sedation, with a catheter placed in the affected vein or artery and the clot is either pulled or sucked out so blood flow is restored. Your healthcare provider is able to view the procedure live with the help of X-ray technology. Based on the location of the clot, your provider may place a stent in the affected vein or artery to ensure continued blood flow. Prior to thrombectomy, your doctor may start you on a blood thinner or anticoagulant to break up the clot.
Catheter Directed Thrombolysis/Thrombolytic Therapy is the use of “clot busting medications,” delivered directly to the clot via a small catheter inserted into a blood vessel. The provider is able to view the progress via X-ray. In some cases, the clot may be removed manually. If the clot cannot be removed, the catheter is kept in place to continually deliver medication until the clot dissolves. This may take anywhere from two to forty-eight hours. Based on the location of the clot, your doctor may place a stent in the affected vein or artery to ensure continued blood flow.
When an intervention is not an appropriate option for the patient, a DOAC (direct-oral anticoagulant) is prescribed. These medications help prevent formation of new clots and is in the form of a pill that is taken daily for several months as determined by your doctor. Patients with DVT will typically take a DOAC for about six months, with ultrasound checks to determine status of clot. Patients with pulmonary embolism (PE) or ischemic stroke will often be on DOAC for life, based on a variety of factors. Once you are prescribed a DOAC, it is important to take it exactly as prescribed by your healthcare provider.
Patients who receive mechanical thrombectomy or thrombolytic therapy will still be placed on DOAC (direct-oral anticoagulation) medications for a period determined by their healthcare provider. Some patients may not be candidates for DOAC due to bleeding disorders, active GI bleed or upcoming surgery.