New Guidelines Issued on Blood Clot Treatment

The American Heart Association (AHA) has new guidelines for treating life-threatening blood clots that result from a condition called deep vein thrombosis (DVT).

Each year, about 250,000 people in the U.S. are hospitalized for DVT, in which a blood clot forms in a leg vein. The danger occurs if the clot breaks loose and travels through the veins to the lungs, causing a pulmonary embolism, or a blockage in the blood vessels of the lungs. This type of blockage can be fatal.

About 50 percent of the time, DVT has no symptoms, making it tricky to diagnose. Typically, it occurs in people who are confined to bed after trauma, surgery, or other medical problems like cancer. Some people also develop DVT on long plane flights.

Range of treatment

Until now, the common treatment for all cases of DVT has been blood thinners, which reduce the risk that a blood clot will develop. The new guidelines address the most serious cases of DVT, which produce large clots either high up in the leg or in the lungs, or cause chronic high blood pressure in the lungs.

For these, the AHA now recommends using clot-busting drugs; catheters, or long, thin hollow tubes, to open up blood vessels; and possibly surgery to remove the clots and insert filters.

DVT and pulmonary embolism are as common as heart valve disease, although the severe forms of these problems - highlighted in the guidelines - are less common.

"Practitioners are aware that these invasive therapies are out there but often have trouble identifying who might benefit from them," says guidelines co-author M. Sean McMurtry, M.D., at the University of Alberta in Edmonton, Canada. "This document will help the practitioner identify folks who might be candidates."

The new guidelines were published in the March issue of the journal Circulation.

Guidelines praised

Gregg C. Fonarow, M.D., at the University of California-Los Angeles, welcomed the new guidelines. DVT is one of the most preventable causes of death in the hospital, he says.

"Application of these guidelines into clinical practice should help to improve outcomes for patients with the most serious forms of deep vein thrombosis," Dr. Fonarow says.

Always talk with your health care provider to find out more information.