Dealing with deep vein thrombosis

Written by: Dr Julian Hague
Edited by: Cal Murphy

Blood clots can be a scary idea – a clump of congealed blood rattling around in your veins. While clotting is necessary to stop bleeding if you cut yourself, this quality can become damaging to the health if a clot forms in the bloodstream and blocks a blood vessel. If the clot reaches and causes a blockage in a major organ like the heart or lungs, it can be downright deadly. When a clot forms in a deep vein, usually in one of the legs, it is known as deep vein thrombosis. Dr Julian Hague, a top clinical and interventional radiologist based in London explains:

What are the symptoms of deep vein thrombosis in the leg?

A deep vein thrombosis (DVT) is a blood clot in the veins deep in the leg or thigh. These are very common and are sometimes seen after a big operation, or after being injured or unwell. Sometimes, they occur if there are underlying problems with blood clotting or an abnormal tendency to form blood clots.

In a proportion of patients (about 40%) these blood clots are very extensive and can block the blood flow from the leg. If this happens, the leg becomes very swollen and painful. This is called iliofemoral DVT (IF-DVT). This can be diagnosed with a simple jelly ultrasound scan.


How do you treat DVT?

Most of the time these blood clots in the leg can be treated with blood thinning medication (either tablets or injection) which will prevent the blood clot travelling to the lungs where serious problems can occur. It is very important if you think you have a DVT to see your doctor or a specialist.


Iliofemoral DVT

IF-DVTs have traditionally been treated with blood thinning injections or tablets. However, some patients (about 50%) have ongoing problems like swelling and pain in the leg – in order to prevent this, some specialists have used clot-busting drugs or clot-removing devices to open up the blood vessels again. Whilst these treatments are not appropriate for everyone with IF-DVT, they have been shown to be very helpful in many patients. Furthermore, opening up veins that have been blocked for a long time is a relatively new procedure (called deep vein stenting) which, again, has been shown to have remarkable results in some patients.

By Dr Julian Hague
Interventional radiology

Dr Julian Hague is a leading clinical and interventional radiologist based in London. He specialises in endovascular procedures, liver-directed tumour treatments, and treating deep vein thrombosis. He is an expert in liver chemo-embolisation (DEB-TACE) - a procedure for treating certain types of cancer which delivers a large dose of chemotherapy directly to liver tumours.

Qualifying from the Royal Free Hospital in 1995, Dr Hague subsequently trained at University College Hospitals and Middlesex Hospital, gaining the skills in surgery and radiology that today make him one of the best in his field. He became a Fellow of the Royal College of Radiologists (FRCR) in 2006, after which he was appointed Consultant Radiologist at both UCH and the Royal Free. Dr Hague is actively involved in research and his work has been widely published.

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