By Joseph G. Magnant, MD, FACS, RPVI
The month of March is DVT awareness month. DVT is an abbreviation for deep vein thrombosis, which a blood clot that forms in the deep veins of the lower extremities which, if left unrecognized or undiagnosed can progress. In fact, if left untreated, the clot can break loose and travel to the lungs, also known as a pulmonary embolism. A pulmonary embolism can be fatal in as many as 60,000-70,000 patients each year in the United States. As we mark this month as DVT awareness month, it is appropriate to review the signs and symptoms of DVT as well as the potential types of patients who may be at higher risk for deep vein thrombosis.
Many years ago, Dr. Virchow identified three risk factors (Virchow’s Triad) for developing DVT; 1. stasis or pooling of blood, 2. injury, and 3. hypercoagulable (prone to clotting) conditions, such as cancer or inherited blood disorders which makes you more likely to form clots. These hypercoagulable conditions may be easily tested for through standard laboratories or through a hematologist (blood specialist). Everyday examples of Virchow’s Triad of risk factors for developing deep vein thrombosis include advanced age, major surgical procedures (abdominal, pelvic or orthopedic), trauma, sedentary states of activity such as seen in hospitalized illnesses or malignancy, and extended immobilization (long car or plane trips). Other risk factors include pregnancy, use of estrogen supplements or oral contraceptives. Orthopedic procedures such as total knee replacements and total hip replacements are also associated with increased risks of postoperative DVT. The relationship between venous insufficiency or varicose veins and increase risk of DVT is not as well documented as some of the other risk factors listed above, but the pooling of blood within dilated veins, in combination with reduced mobility due to operations or illnesses likely act in synergy to increase the risk of DVT in patients with venous disease.
Signs and symptoms of DVT include swelling, redness and pain, especially in the calf. Patients may experience fever, generalized fatigue and shortness of breath, which may indicate pulmonary embolism (when a blood clot breaks loose and travels to the lungs). It is very important to recognize the signs and symptoms of deep vein thrombosis both pre- and post-operatively. Perhaps the most treatable potential risk factor for DVT is venous insufficiency. Venous insufficiency is defined as the state where the valves in the veins in the legs which are supposed to allow one-way flow from the legs back to the pelvis, fail to close tightly. Basically, they are like one-way check valves that aren’t checking properly, which allows for pressure to build as blood pools in the lower extremities from the groin all the way down to the ankle. As the blood pools it becomes “stale” in a sense and is more likely to form clots.
DVT awareness month is designated to help increase public awareness of the various signs and symptoms of DVT, as well as to explain what may occur if a DVT is unrecognized or untreated. With modern ultrasound technology, DVT can be accurately diagnosed in the small calf veins, where 95% of clinically significant DVT start. One recent example of a patient evaluated at Vein Specialists was a woman in her early 70’s referred by her orthopedic surgeon for an ultrasound exam to rule out DVT prior to a planned total knee replacement the following week. This woman had severe osteoarthritis requiring a knee brace to ambulate and clearly was in need of a total knee replacement. She was referred to our vascular lab and underwent ultrasound evaluation on a Friday afternoon and was found to have acute DVT of the left popliteal vein (behind the knee). Had her orthopedist not had a heightened awareness of the possibility of her having a DVT, and not obtained that screening ultrasound, she might have undergone her total joint replacement as scheduled and likely would have had progression of her DVT and possibly pulmonary embolism. However, due to her orthopedic surgeon’s understanding of the risk factors for DVT and his/her heightened awareness, this patient had her knee replacement postponed and she was started on therapeutic blood thinner therapy and will remain on medication for at least 3–6 months until her blood clot is dissolved. In summary, this screening ultrasound which revealed a major DVT, led to a shift in treatment and postponement of major joint replacement and potentially saved her life. DVT awareness improves outcomes and can save patient lives.
Our team is led by Dr. Joseph Magnant, a board certified vascular surgeon, 4 advanced providers (APRN & PA’s), 6 registered vascular technologists, 8 medical assistants, 5 patient concierge representatives, and a half dozen support staff whose mission is to make your journey as a patient as smooth as possible. We are focused 100% on the management of venous disease, and our 2 office locations are the only IAC accredited vein centers in Southwest Florida.
If you or a loved one has any of the signs or symptoms of DVT or any of the other signs or symptoms of venous disease, please consider visiting our website.
Vein Specialists has offices in Fort Myers and Bonita Springs and is the leading outpatient vein center is Southwest Florida. Veins specialists is committed to excellence in vein care and is dedicated to increasing physician and public awareness of venous disease.
For more information about vein disease and Vein Specialists, please visit WeKnowVeins.com or call 239-694 VEIN(8346)
1500 Royal Palm Square Blvd., Suite 105, Fort Myers, Florida | 3359 Woods Edge Circle, Suite 102, Bonita Springs, Florida
Joseph G. Magnant,
MD, FACS, RPVI
Board Certified Vascular Surgeon
Trust your leg vein care to Dr. Joseph G. Magnant & the Vein Specialists team.
. SWFL’s only IAC accredited vein centers (Fort Myers & Bonita Springs)
. More than 25,000 patients treated since 2006
. State of the art vein treatment techniques including Closurefast, Laser, VenaSealTM and Ivus