Minimally Invasive Procedures for Deep Vein Thrombosis

As a first approach, NYU Langone doctors often treat people who have deep vein thrombosis, or DVT, with anticoagulant and thrombolytic medications. However, if a very large blood clot has formed and threatens to break loose into the bloodstream, your doctor may recommend a minimally invasive procedure to prevent pulmonary embolism.

These procedures may also be performed in people who cannot take anticoagulants and thrombolytics because of a health condition such as a bleeding disorder.

Thrombectomy

In a thrombectomy, your doctor injects a contrast dye, which helps locate the clot using X-ray guidance. The clot can usually then be removed using a thin tube called a catheter, which is inserted through a vein in the groin or arm and threaded to the location of the blood clot.

NYU Langone’s vascular specialists use several minimally invasive methods of retrieving or breaking up and then removing blood clots using catheters. For example, one technique uses a catheter with a number of holes at the tip. The device sprays a jet of salt water into the clot to dissolve it and then, using suction, pulls the clot fragments into the catheter for removal. Other techniques may remove the clot whole.

Before the procedure, your doctor gives you a sedative, but you are awake. If you have multiple blood clots, or if imaging doesn’t clearly reveal the location of the clot, doctors may use general anesthesia. 

Afterward, your recovery time depends on the size and seriousness of the clot, your health, and your medical history. Your doctor may prescribe anticoagulant medications to thin the blood to prevent additional clots from forming.

Inferior Vena Cava Filter

Medication is often sufficient to dissolve even large blood clots. But if you can’t take the medication for health reasons, placement of an inferior vena cava, or IVC, filter may be an option. In this procedure, a surgeon implants a filter into the inferior vena cava, the large vein that carries blood from the lower body to the heart.

The filter is designed to catch a blood clot that breaks loose from a vein in the legs and is in transit to the lungs, where it can cause a life-threatening pulmonary embolism. The filter does not treat the blood clot, but it can be critically important to prevent clots from traveling to the lungs.

Using a local anesthetic and needle stick, your doctor places an intravenous (IV) line in the groin and threads a small catheter through it to the inferior vena cava in order to insert the filter. The filter can be removed up to a year later.

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