Treatment Options for Blocked Veins

leg bones, arteries and veins

Deep vein thrombosis (DVT) is a condition in which a blood clot forms in one of the deep-seated veins in your body.

Certain genetic conditions increase your risk for DVT, as do medical conditions (such as obesity or pregnancy) and certain medications. Lifestyle factors such as sitting for extended periods of time or smoking also increase your risk of DVT.

Whatever the cause, we can help mitigate symptoms and lessen the likelihood of serious problems caused by DVT.

Problems

One acute and serious problem that can occur with deep vein thrombosis is when the clot or part of the clot breaks away and travels to the lungs, causing pulmonary embolism (blockage from a clot in the lung). This is a serious development that requires immediate medical attention.

Chronic or long-term DVT can also cause problems locally. Though not life threatening, these complications can be painful and debilitating.

Early symptoms of DVT include swelling, pain, warmth and redness in the involved leg. The location of the blood clot in the body determines how we treat the problem.

Blockage below the knee

When the clot or blockage is limited to the blood vessels below the knee (the tibial veins), your body repairs itself in 90 percent of all cases. The blood vessel finds a way around the blockage and restores proper blood flow.

This restoration process takes between three and six months. During that time, we usually provide anti-coagulant or anti-clotting medication and follow the patient closely with ultrasound checkups.

Blockage above the knee

When the clot extends above the knee joint and impacts the larger femoral or iliac veins, the risk for hypertension (increased blood pressure) in the veins that supply the affected limb increases. Between 40 to 60 percent of patients who have DVT of the ilial femoral segment of the vein in the thigh or pelvis will experience venous hypertension.

Chronic venous hypertension causes pain and swelling of the limb, further restricts blood flow and can ultimately lead to ulceration and open sores.

Treatment options

If the clot or obstruction is limited to the femoral vein in the thigh, we rely on compression of the calf and foot (using compression stockings and socks) and the body’s natural development of workaround venous pathways. Sometimes we will use lysis if these clots in the femoral vein are found early (within the first three weeks) to reduce long-term risks of venous hypertension. Currently, there is little available to improve the chronic obstruction process.

If the obstruction extends into the pelvis, venous thrombolysis (clot buster medication) and possibly venous stenting (the use of metallic mesh tubes to hold the vein open) of the responsible iliac vein have been very successful. If the clot is more than one month old, then the clot buster is not as effective, but outcomes can be improved with stenting.

If appropriate, we can insert a stent higher up, all the way to the inferior vena cava, which drains blood from the lower body.

Several companies are developing stents specifically for use in the venous system, but these are not commercially available in the United States. However, even with existing technology (stents used primarily for arteries), we have had excellent success in improving chronic blockage of the pelvic venous system.

Successful procedures

We have evaluated and treated a large number of patients with chronic DVT.  And, we have had very good long-term success in treating patients with stents.

We have also helped patients who have had problems with previously placed stents. For these patients, we can stent either around or through the earlier placed stents to decrease the pressure of veins in the legs and to improve their symptoms.

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Daniel Clair, MD

Daniel Clair, MD, is Chairman of the Department of Vascular Surgery at Cleveland Clinic. In 2007, Dr. Clair was named one of America’s Top Doctors.
  • Harvey

    It’d be nice to know how an informed vegan diet compares to other diets, healthwise. In terms of animal rights it’s easy to compare.

  • TV53

    I’m sorry, but there is plenty of scientific data to back diets by Esselstyn, Ornish, and others. It must drive Dr. Esselstyn crazy to read articles like this coming from his own organization. The Pritiken center has released dozens of studies over the years, and Medicare thinks enough of the Ornish diet to now provide coverage. I guess if Esselstyn’s 20 year study, and more recent 200 person study don’t qualify as data, with their remarkable results, then I guess there’s no convincing you. Then again, you recommend a low carb diet despite the enormous volume of evidence that these diets are harmful over the long run, so it’s pretty clear that this article is not taking full account of the weight of evidence. Maybe all the local doctors who end up calling Dr. Esselstyn to help with their own heart issues might have a different opinion.

  • Ken

    Sad to see this advice with little or no reference to the impact of plant based diets on preventing and curing heart diseases, especially out of the Cleveland Clinic. Is anybody there looking at all the latest research on the impact of plant based diets on heart diseases?

  • http://www.myitnet.com Duke G

    It looks like there is a typo in this sentence:Folate and B vitamins have low risk as supplements, but there is little evidence there is improvement in PAD or lowered cardiovascular risk with these agents. They also can be harmful in patients with kidney disease. Low dose intake(400g) has been recommended for overall health.
    I doubt that 400 grams is recommended. Likely milligrams – mg.

    • The_Beating_Edge_Team

      thank you for the note! We have corrected it to (400 mcg)

  • ethel burton

    hi is there anybody out there who has a vein trapped in a curved spine that as turned to bone the vascular surgeon says he cannot remove the bone as it is too dangerous but he can put a baloon inside to open up my vein so the blood can flow better

    • The_Beating_Edge_Team

      Ethel, I spoke to Dr. Clair about your question and he stated that you should have a second opinion evaluation by a physician who sees these problems regularly. If you would like to see one of our doctors or have an online second opinion, let us know. We are happy to help you. http://www.clevelandclinic.org/heartnurse betsyRN