Below knee deep venous thrombosis treatment. Dr. Anton Titov, MD How important for treatment decision is the notion that the blood clot from the leg vein might extend beyond the knee area Does location of blood clot below the knee or extension of clot above the knee alter the treatment of DVT Dr. Kent Yucel, MD Vascular imaging specialist, Tufts Medical Center That’s a controversial area, and the pendulum has swung back and forth over the years. Opinion changed from aggressively treating clots below the knee to ignoring clots below the knee to repeat imaging for clots below the knee.
Now, the consensus is to be more aggressive and go ahead and treat the clots below the knee. Everyone agrees because those veins are much smaller than the veins above the knee. The blood clots if they travel to the lungs are much lower risk for massive pulmonary embolism because there are much smaller. That’s the reason that people have thought maybe it’s not worth being worried about deep venous thrombosis below the knee. The problem with clots below the knee is that they can keep growing. They can spread above the knee to the big veins. And for that reason the developing consensus now is to be more aggressive and go ahead and treat those people for deep vein thrombosis DVT.
Dr. Anton Titov, MD And a major treatment remains anticoagulation or filters in the inferior vena cava Dr. Kent Yucel, MD Right. The best therapy for deep venous thrombosis is anticoagulation, if patients can receive it. But there are people who cannot be anticoagulated for variety of risk factors. Generally risk of bleeding is a contraindication to anticoagulation. And those DVT patients can have filters in their inferior vena cava. It is a big vein in their abdomen that goes to the heart and lungs. It used to be that vena cava filters were permanent devices. So it was a big decision, especially for young patient, to leave a permanent device in for a temporary disease. But now inferior vena cava filters can be removed.
Deep Venous Thrombosis Treatment Principles Below the Knee and Above the Knee DVT Difference