The initial treatment of clots in the deep veins of the legs is anticoagulation (“thinning of the blood”). This substantially reduces the risk of clots traveling to the lungs, an event that can be fatal. If the clot is located in the iliac or femoral veins, it is important to clear the clot entirely. This is often accomplished with an endovascular procedure called thrombolysis. Catheters are used and placed in the clot and then using medication and in some cases a special clot breaking device, the clot is removed from your body. This helps prevent longterm swelling and pain in the leg.
Some patients either cannot be put on anticoagulation because of the risk of bleeding or have had clots travel while on appropriate doses of medicine. In this situation a filter is inserted through a small puncture in a vein in the groin and is placed into the main vein in the abdomen, the vena cava, under X-ray guidance. This filters the blood coming from both legs. In some patients a temporary filter can be placed that can be removed when the risk of clots has sufficiently declined. The filter can be removed through a small puncture under local anesthesia, similar to placement of the original device.