DVT therapy that endures and improves your quality of life.
DVT or bloodclots can lead to post thrombotic syndrome (PTS)
Hello and welcome to the web site of Patricia Thorpe,MD,FSIR who is a Board Certified physician and surgeon, recognized in the field of Interventional Radiology. She specializes in the evaluation and treatment of patients with bloodclots, both acute and chronic. The diagnosis and treatment of Deep Vein Thrombosis (DVT) have slowly evolved over the past 60 years since the introduction of Heparin therapy and the discovery that anticoagulation can inhibit enlargement of the "clot" . Anticoagulation can decrease the incidence of "clot migration" known as pulmonary embolization (PE). This is when a piece of thrombus migrates from the original place of formation (ususally the leg) to the vessels in the lungs. If the "clot" is large, it can obstruct blood flow in the lungs and result in serious respiratory and/or cardiac abnormalities. Heparin does not remove clot, but it helps prevent a given clot from increasing in size. If blood flow is very slow, however, the clot still might grow, despite anticoagulation therapy. A patient can experience PE and still have obstructing clot remain in the pelvic or lower leg veins. This can lead to signs and symptoms of DVT.
Over the past 20 years, special medicines that dissolve "clot" have been effectively used in many patients to decrease the amount of clot that develops in the leg or arm or migrates to the lung . These medications are called thrombolytic agents. The commonly used drugs include urokinase and alteplase (or t-PA). Although the cells lining the blood vessels do secrete these two enzymes, the amount of enzyme required to efficiently and rapidly dissolve obrstucting "clot" is generally inadequate to do the job.Some people do, in deed, recover from having a bloodclot with out permanent damage to the vein. Most individuals ( ~70%) with "clot" that involves the blockage or one or more vein segments experience the signs and symptoms of inclomplete removal or resolution of the clot. This manifests as pain or swelling in the affected extremity It is worse at the end of the day and improves with leg or arm elevation and rest. This Post-Thrombotic Syndrome (PTS) is also referred to as the post-phlebitic syndrome. It can be mild or very incapacitating. Most doctors treat the condition with compression stockings. If your body develops adequate collateral vein pathways to carry blood flow, you may not have much swelling or discomfort. If the leg swells and becomes tight and heavy, the blockage of the veins may represent a more serious vascular problem that can progress over time. The high pressure in the venous system can result in skin changes such as hyperpigmentation and stasis ulcers at the ankle area.
The endovascular surgeons and interventional radiologist associated with venous.com specialize in treatment of acute and chronic DVT. It is preferable to treat DVT early. It is easier to remove fresh "clot" from veins. But, older or chronic clot can be managed with endovascular techniques. We use state-of-the-art catheters and stents in hospital angiography suites. The treatment of DVT involves the use of thrombolytic drugs and anticoagulants. If appropriate, mechanical removal of "clot" might be accomplished with thrombectomy catheters including the Trellis, Angiojet and Ekos devices.Metallic stents might be used to open damaged veins. As a Board Certified Interventional Radiologist, I have been doing this work since 1987, when I was a Fellow at Stanford. I have continued my work with DVT patients at Creighton University, and the University of Minnesota and University of Iowa. Over 200 men and women have received lasting endovascular results after treatment of their symtomatic DVT. Men and women with symptoms enduring years after the initial episode have been successfully treated with endovascular therapy. The average patient age is 43 years. The intervention requires detailed pre-authorization with the insurance company and entails a 3-10 day hospital stay, depending on the extent of venous disease and individual response to therapy.
If you or someone you know is disabled with acute DVT or chronic venous obstruction involving the legs, arms or IVC or SVC, please contact me at patricia-thorpe@venous.com. As an endovascular specialist, I recommend a thorough clinical evaluation and discussion before treatment.
acute left leg deep vein thrombosis
two years after endovascular therapy
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