What is the Gold Standard for Diagnosing DVT & How is it Treated?
Deep vein thrombosis or DVT is an ailment that happens due to the formation of clots by blood in veins. It commonly manifests the deep veins present in the leg, but it can also occur in arms, cerebral sinus, mesentery, and retina.
The sequel of the condition varies from resolving the clots without any ill effects to death caused by pulmonary embolism. Health issues result in post-thrombotic syndrome, swelling, limb pain, ulcers, hyperpigmentation, venous gangrene, and dermatitis. No single investigation is capable of providing answers to the presence of deep vein thrombosis or DVT. It involves a series of tests carried out sequentially or combined.
What is the Gold Standard for Diagnosing DVT?
The definite diagnosis for deep vein thrombosis or DVT is the answer to visualize the presence of the clots in the veins. The investigations include ultrasonography, contrast venography, magnetic resonance imaging, and computed tomography. Of the investigations, contrast venography is the gold standard for deep vein thrombosis or DVT.
Contrast venography is an investigation procedure that uses x-ray to find out the presence of clots in the veins. The investigation procedure is invasive and requires the use of a special dye injected into the veins or bone marrow. The important part is that the caretaker will inject the dye consistently through a catheter. The catheter reaches the appropriate site through the groin, and the caretaker will navigate through the vascular system.
Although contrast venography is a gold standard for deep vein thrombosis or DVT, because of its cost and invasive technology, only a few doctors opt for this procedure to diagnose the condition. Apart from diagnosing the presence of clots in the veins, contrast venography is also helpful in distinguishing obstructions from blood clots, which is useful in learning about the functionality of deep vein valves present in the leg.
Identifying Deep Vein Thrombosis or DVT
As contrast venography is an invasive procedure and may not provide appropriate results, doctors often opt for other investigations such as ultrasonography, MRI, and CT scans. In rare cases, the physician will choose for a combination of tests to have a clear idea about the presence of the clots, the location, and the size.
How is DVT Treated?
Upon diagnosing the presence of deep vein thrombosis or DVT, it is essential to begin the treatment immediately to prevent the occurrence of pulmonary embolism or PE. The initial management system of using intravenous unfractionated heparin along with the continued transition of oral anticoagulants changed recently to low molecular weight heparin.
Majority of the doctors recommend the patients receive the low molecular weight heparin for at least four days, which helps in bringing down the normalized ratio into therapeutic range. The guidelines prepared by thrombosis and haemostasis task force state that the patient with the first episode of deep when thrombosis will receive anticoagulants for 3 to 6 months.
Additional Treatments for DVT
Upon the condition faced by the individual and the symptoms, the doctor will prescribe the use of heparin along with other therapies to prevent recurrence chances. In most cases, heparin will be helpful in reducing the formation of the clot (deep vein thrombosis or DVT) and help in reducing the time required for the growth of the existing clots. Along with this, physical activities such as swimming, running, and jogging are helpful in lowering the chances of turning the clots to grow in size.
In a few cases, physicians opt for inferior vena cava filter. It will be helpful in reducing the chances of the occurrence of pulmonary embolism or PE. The use of inferior vena cava filter is only applicable to those who show recurrence of blood clots (deep vein thrombosis or DVT) despite offering adequate anticoagulation. Use of elastic compression stockings is also helpful in bringing down the post-thrombotic syndrome.