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*Please note: This slide show represents a visual interpretation and is not intended to provide, nor substitute as medical and/or clinical advice from your doctor.
When a blood clot forms in the veins of the body it is called VTE, or venous thromboembolism. Let’s break down the meaning of these long words: venous means vein, thrombus means clot, and an embolism is where the clot moves through the bloodstream to another part of the body.
There are three types of VTE: (1) a clot in veins just under the skin is called superficial vein thrombosis, (2) a clot deep in the body is called deep vein thrombosis (or DVT) and (3) a clot that moves to the vessels of the lungs is called pulmonary embolism (or PE). DVT and PE are the most dangerous types of VTE.
VTE is common, very serious and can cause death. It is important to take steps to keep VTE from happening and to get the right care if you have VTE.
Some risk factors make having a dangerous blood clot more likely to happen. These risk factors include:
  • Not moving for a long time (such as on a long trip or when staying in bed because you are sick or hurt);
  • Staying in the hospital or having surgery;
  • Having a baby;
  • Taking birth control pills;
  • Smoking;
  • Having cancer; and/or
  • Having some genetic abnormalities.
There are a number of ways to reduce the risk of a dangerous blood clot from forming.
Sometimes special compression stockings can keep clots from forming in the legs.
Some medicines can also help prevent dangerous blood clots. These drugs are called blood thinners (or anticoagulants).
Blood thinners are given to some patients who need surgery and to people who are likely to experience blood clots.
There are two main types of medications used to treat VTE:
  • Blood thinners (also called anticoagulants); and
  • Clot busters (also called thrombolytic therapy).
Blood thinners make it more difficult for the blood to clot. These blood thinners make it less likely for a clot to get started and they also stop clots from growing larger.
Blood thinners include: Warfarin, heparin, low molecular weight heparin (or LMWH), and fondaparinux.
There are also blood thinners called direct oral anticoagulants (or DOACs for short). These include: apixaban, dabigatran, edoxaban, and rivaroxaban.
DOACs work very fast and do not need to be regularly monitored by your doctor. They do not affect other medications or food you may have taken.
Warfarin does not work as quickly and can cause problems with other medications, and limit what you can eat. Warfarin needs to be monitored regularly with blood tests.
Heparin and low molecular weight heparin are short-acting medicines that have to be given through an IV or in the form of shots
Heparin needs to be monitored with blood tests.Heparin needs to be monitored with blood tests.
Low molecular weight heparin does not require regular monitoring.
DOACs are the first choice for treatment of VTE in people who may have blood clots, but who do not have cancer.
The second choice is warfarin.
Low molecular weight heparin is preferred in patients with cancer; however it is the third choice for most patients with VTE since it requires daily injections. Fondaparinux is used on occasion as well.
If you need to take blood thinners because you have dangerous blood clots, you will usually take them for at least 3 months. Therapy may need to be longer as well depending on several different factors. People with blood clots and cancer need to take blood thinners until the cancer is gone.
People with previous blood clots may need to be treated for their entire life.
You and your doctor should talk about how long you should take the blood thinner based on your risk factors.
If you have blood clots in the vessels of the lungs and your doctor feels that something must be done to get rid of the clots faster than your body can get rid of them, medicines (called thrombolytic therapy), can be given through an IV or they can be delivered to the clot in the vessels of the lungs with plastic tubes called catheters. These catheters can deliver the medicines to bust up the clot and sometimes even suck the clot out of the blood vessels of the lungs.
The decision to use this type of therapy depends on what is available at your hospital and also on your doctor's judgment about what is the best thing to do for you.
Usually, these thrombolytic medicines are only used for patients who are at high risk of dying from these dangerous blood clots.
Sometimes patients cannot be treated with a blood thinner because of bleeding or because they are at high risk of bleeding while taking one of these blood thinners.
When a blood thinner cannot be used in a patient with a VTE blood clot, a wire basket, which is called a “filter” can be placed to catch any clots that may break off and go to the lungs. This filter is placed in the large vein (called the vena cava) that drains the vessels of the legs and body parts within the belly to bring blood back to the heart.
Although these filters have some risks over time, they lower the chances of getting a new blood clot in the lung for a short period of time.
Because taking a blood thinner is the best way to treat VTE blood clots, a blood thinner should be started as soon as it is safe.
Sometimes, these vena cava filters can be removed if they are no longer needed. You should discuss with your doctor if your filter can be, or should be, removed.
Treatment for blood clots has several goals. Doctors treat blood clots to:
  • Keep new clots from forming;
  • Stop existing clots from enlarging in size;
  • Stop pieces of a clot from moving and limiting blood flow in other parts of the body;
  • Avoid complications caused by blood clots; and
  • Keep clots from traveling to the lungs, brain, or heart where they can be fatal.
VTE blood clots can cause life-long health problems and may cause death. If you have risk factors for VTE, or have had a VTE in the past, be sure to talk to your doctor about ways you can prevent VTE and reduce your risk of life-threatening complications.
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Slide Show - Preventing and Treating Venous Thromboembolism (VTE)

Watch this slide show to learn about the medications and treatments most commonly used for venous thromboembolism (VTE), as well as how they work and how they are taken. The main types of treatments are anticoagulants (also called blood thinners) and thrombolytic therapy (also called clot busters). The use of compression stockings and vena cava filters are also explained.

Animation - Preventing and Treating Venous Thromboembolism (VTE)

This animation explains the medications and treatments most commonly used for venous thromboembolism (VTE), as well as how they work and how they are taken. The main types of treatments are anticoagulants (also called blood thinners) and thrombolytic therapy (also called clot busters). The use of compression stockings and vena cava filters are also explained.

Expert Video - What medications are used for VTE blood clots? What are anticoagulants or blood thinners?

Anticoagulants (also referred to as “blood thinners”) are the medications most commonly used to treat venous thromboembolism (VTE) blood clots. In this video Dr Sandra Adams explains that blood thinners make it harder for blood to clot, lower the chances of patients forming new clots, reduce the risk of existing clots growing bigger, and allow the body to dissolve the clot over time. Blood thinners include heparin, low molecular weight heparin, warfarin, fondaparinux, apixaban, dabigatran, edoxaban, and rivaroxaban. On rare occasions, other medications may be needed.

Expert Video - Old and new blood thinners: How do they work?

In this video, Dr Sandra Adams explains how older and newer blood thinners work for the treatment of VTE blood clots, and how they are taken. The main older blood thinner used is called warfarin, which blocks the liver from making the clotting proteins that require vitamin K. If you are taking Warfarin you will need frequent monitoring with blood tests. Warfarin is also affected by other medications and your diet because high levels of Vitamin K are found in dark green or leafy vegetables. The newer blood thinners fall into two groups. The first group includes low molecular weight heparin and fondaparinux that are taken as shots. These medications are much more predictable than warfarin and do not require frequent monitoring with blood tests. The second group includes pills that are taken by mouth, such as apixaban, dabigatran, edoxaban, and rivaroxaban. They do not require monitoring, are not affected by other medications or food, and work very quickly. All of these medications have been shown to work well to prevent more blood clots from forming.

Expert Video - Which type of blood thinner is best for me?

Dr Sandra Adams explains in this video that a number of factors go into deciding what is the best blood thinner for each patient with VTE blood clots, including: how well your kidneys work, if you have any liver damage, your weight, what you usually eat, any other illnesses you may have, and how often you can see a healthcare professional for follow up visits and monitoring. Your physician will evaluate your current condition and your medical history to recommend a blood thinner that best suits you.

Expert Video - Can blood thinners cause bleeding? Are they safe?

Blood thinners are lifesaving medications because they can treat or prevent VTE blood clots. The biggest safety concern for anyone taking a blood thinner is the risk of bleeding, explains Dr Sandra Adams in this video. This risk of bleeding may be slightly lower with the newer agents than for warfarin. If you are taking blood thinners, you should be very careful to avoid hurting yourself. Because blood thinners prevent clotting, a tiny cut or bruise will bleed a lot more if you are taking blood thinners. Even if you don't have a cut or bruise, a bump or fall could cause you to bleed internally. Therefore, when taking blood thinners, your body may need help to stop the bleeding. Be sure to discuss the benefits and risks of blood thinners with your health care professional.

Expert Video - How often should I see my doctor when I’m on blood thinners?

Dr Sandra Adams explains in this video that if you are taking blood thinners you should have regular follow up visits with your doctor to make sure your medications are working well and that there are no serious side effects. If you are on warfarin, you will need to go in for more frequent check-ups to make sure that you are getting enough to reduce the risk of blood clots, but not so much that you have a high risk of bleeding. Most patients take blood thinners for at least 3 months, but the length of time will vary based on your personal risk factors. People with cancer need to be treated until the cancer is gone. People who have had blood clots before may need to take blood thinners for the rest of their lives.

Expert Video - Is warfarin safe for me to take?

In this video, Dr Sandra Adams explains that warfarin is in the same family as some of the older chemicals that were used to kill rats, but it is not rat poison. Warfarin has been used in humans with good results for many years. It is still a very effective and safe medication when used correctly and monitored closely. Any blood thinner can cause bleeding and should be monitored closely. Be sure to discuss the benefits and risks of blood thinners with your health care professional.

Expert Video - What are clot-buster medications (thrombolytic therapy)?

The most commonly used medications to treat VTE blood clots are anticoagulants (also referred to as “blood thinners”). But there are also “clot busting” medications called thrombolytics which quickly dissolve or get rid of clots. As Dr Sandra Adams explains in this video, thrombolytic therapy may be used depending on the resources available at your hospital and your doctor’s opinion of how likely your clot will cause harm in the long run. Clot buster medications increase the risk for major bleeding so they are usually reserved for patients with very extensive clots and for life-threatening situations.

Expert Video - Will I need surgery to remove a blood clot?

Most patients will recover from their blood clot after it is recognized and treated, but as Dr Sandra Adams explains, sometimes surgery is needed for patients with high-risk blood clots. In a small number of patients whose bodies are not able to completely dissolve their blood clots, surgery may be needed to remove the scars caused by the blood clots. Other patients cannot be treated with blood thinners due to a high risk of bleeding or because they started to bleed on a blood thinner. If a patient with VTE blood clots cannot take blood thinners, a wire basket or filter may be placed in the large vein (or vena cava) to catch any clots that might break off from the leg veins and go to the lungs.