Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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Removing Clots with Ultrasound

Thursday, 03 Nov 2011 08:05 AM

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.

© HealthDay

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