Deep vein thrombosis (DVT) prophylaxis is medical treatment to prevent the development of DVT in a patient at risk of this condition. In patients with DVT, a blood clot forms in the deep veins of the arm or leg, occluding blood flow and potentially leading to complications. The most serious complication is a pulmonary embolism (PE), where a clot breaks loose, travels to the lungs, and blocks the airway. PE can be fatal, and the onset can be so rapid that the patient never gets a chance to seek treatment.
Doctors screen patients before procedures that might create a risk of DVT, like long surgeries, to determine if they need DVT prophylaxis. Provision of preventative care to patients who may not necessarily develop the condition is more cost-effective than providing retroactive treatment to a patient who experiences DVT. DVT prophylaxis is standard at many hospitals and clinics to protect the health and safety of patients.
Numerous options are available for DVT prophylaxis, and a doctor may consider combination therapy if it is warranted. In mechanical DVT prophylaxis, the patient uses physical means like compression stockings, electrical stimulation, and rotating tables to prevent the formation of blood clots. These measures all stimulate blood flow, inhibit clotting, and make the risk of a large embolus less likely. They can be used in a variety of settings, like long-haul flights where there are concerns about clotting because of prolonged immobility.
Pharmacological DVT prophylaxis involves the administration of drugs like low molecular weight heparin to prevent clotting. The patient may take these drugs for varying amounts of time, depending on the risks and the situation. They inhibit the formation of clots so the blood will continue to flow freely through the deep veins. These preventative measures can be slightly more risky, as they create an increased risk of uncontrollable bleeding, and the doctor must balance this concern with the risks of providing no prophylactic treatment at all.
Patients who may need DVT prophylaxis include surgical patients over 40 as well as anyone needing surgery that will take longer than two hours; people with a history of surgery or severe physical trauma; and cancer patients going into surgery. Coagulopathies can also be a reason to recommend preventative care if a patient is preparing for surgery. The guidelines vary between nations, and some hospitals and clinics may have their own, more aggressive guidelines for care providers to use when deciding if patients require DVT prophylaxis.