Deep Vein Thrombosis also known as DVT or Traveller's Thrombosis

This website has been written to inform interested parties about Deep Vein Thrombosis - or DVT.

Deep Vein Thrombosis (DVT) is more common than often expected, and is frequently missed - usually because it is not thought of.

Most deep vein thromboses (DVTs) are small, harmless and resolve by themselves. However, some can go on to damage the deep veins, leading to major problems in the future (leg ulcers and "post phlebitic limb"), or can fly off causing the potentially lethal Pulmonary Embolism (PE).

This web site has been written by the vein specialists at The Whiteley Clinic to:

• explain what deep vein thrombosis (DVT) is
• explain how to differentiate it form other conditions often mis-diagnosed as DVT
• explain the current treatment and management
• offer contact details for those who are anxious about themselves and who would like a second opinion or our specialised tests

In our experience at the The Whiteley Clinic, we have seen a great many people who, after having ‘standard’ tests for DVT, have been told they do not have one; but with our high resolution duplex, we have identified that there is in fact a DVT.

We have also found patients who have had a ‘standard’ course of Warfarin, usually for 3 or 6 months, who have been taken off of the Warfarin without checking that the DVT has gone, only to find there is still DVT present or that there is damage to the deep veins, causing narrowing – which both mean that the Warfarin should probably be continued.

The rest of this website is set out to give you a thorough understanding of DVT - however, as most people want quick answers from websites, there are a couple of summaries below for those who want some quick answers.

"Standard" prevention, diagnosis and treatment of DVT

Most people who are in situations that have a high risk of DVT are given advice or help to reduce the risks:

• When flying you are advised to wear properly fitted flight socks and to keep well hydrated
• When having a general anaesthetic most patients have either TES stockings or heparin injections - or both
• When in the heat, you are advised to drink water to keep well hydrated

When DVT is suspected, a variety of tests are used to screen for it

• Venography - An X-ray with contrast injected into the foot - now out of date and not needed
• Thermography - an infra-red device is used to see if the leg is warmer than the other - quite inaccurate and useless if both legs have DVTs!!
• Blood test - tests checking for signs of clots in the blood are simple to perform and, although often right, do quite often give the wrong results. This means either patients get treatment they don't need until a specialist scan is done, or are even sent home with a DVT
• Duplex Ultrasound scan - this is the gold standard - but only if done by a specialist who checks from pelvis to ankle (taking 30 mins +). Many non-specialists or doctors or nurses who have "been on a course" will be able to see a massive DVT in the thigh, but will often miss small DVTs in the lower leg, where the veins are tiny.

Treatment is usually with Heparin injections then oral Warfarin tablets. The level of anti-coagulation (clotting level) is regularly checked with the INR blood test. Warfarin is usually stopped 3 or 6 months after the diagnosis of the DVT.

The Whiteley Clinic protocols for DVT

We do not specify how long any treatment should last. Instead, we regularly scan to let the patient's body tell us when the clot has been reabsorbed and the deep veins are back to normal. By doing this, we have often avoided stopping Warfarin too soon when a clot is still present, or avoided stopping it in patients who have narrowed veins and who should stay on the Warfarin to prevent further DVTs.