Question: I've been diagnosed with deep vein thrombosis (DVT) from a weight-lifting exercise about a month ago. I neglected to treat the injury and played tennis for almost a month several hours a day before seeing a doctor. The ER doctor administered a regimen of Coumadin and Fragmin.
It's been almost four weeks, and I would like to see a vascular surgeon who can remove the clot with ultrasound and get off Coumadin. Is this possible?
Dr. Hibberd's Answer:
Removing a clot with ultrasound is almost always a wasted effort unless done in the first several hours of a deep vein thrombosis, if at all. The vein almost always restenoses (narrows) and then the clotting scenario starts all over again, as well as the risks of having a pulmonary embolism ... definitely a bad situation.
You are going to have to adjust to the Coumadin for now. If intolerable, you may have to consider an inferior vena cava (IVC) filter that is used for recurrent DVT with the risk of pulmonary embolism or for those who cannot use Coumadin. I don't believe an IVC filter would be good for you since it doesn't prevent DVT but only protects pulmonary embolism.
Your clotted vein will likely recanalize (form a new path) all by itself over the next three to six months, and you are probably wiser in remaining on closely monitored Coumadin depending upon the advice of your vascular surgeon/consultants.
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