Doctors are encouraged to consider therapies in addition to blood thinners to treat certain patients with potentially dangerous blood clots that form in the deep veins and travel to the lungs, according to a new scientific statement from the American Heart Association. The statement is published online in Circulation: Journal of the American Heart Association.
More than 250,000 people in the United States are hospitalized with deep vein thrombosis each year. Previously, there has been limited guidance for physicians on some of the more serious conditions caused by deep vein thrombosis, when blood clots form in veins buried deep in the body.
The statement offers advice for cardiologists and a range of other physicians who treat the disorder. Guidance is provided for identifying and treating people with massive and submassive pulmonary embolism (dangerous blockage in veins in the lungs), iliofemoral deep vein thrombosis (blockage in the main vein of the pelvis and leg), and chronic thromboembolic pulmonary hypertension (serious high blood pressure in the lungs caused by blood clots).
"It is important for doctors to be able to identify the severity of these disorders and to select who might be eligible for more invasive therapies, such as clot-busting drugs, catheter-based treatments or surgery," said M. Sean McMurtry, M.D., Ph. D., co-chair of statement writing group. "Venous thromboembolism is very common, and frequently a complication of other ailments. While most patients need blood thinners only, patients with more severe forms of venous thromboembolism may benefit from more aggressive treatments."
The statement outlines multiple treatment options including the use of fibrinolytic drugs (drugs that dissolve blood clots), catheter-based interventions (inserting a small plastic catheter into an artery to open it), treatment with surgery to remove the blood clots and use of implants called filters that prevent clots from traveling in the veins from the legs to the lungs, where they can cause strain on the heart. Additional guidance for treating pediatric patients is also included.
Co-authors include Michael R. Jaff, D.O., Co-Chair; Stephen L. Archer, M.D.; Mary Cushman, M.D., M.Sc.; Neil Goldenberg, M.D., Ph.D.; Samuel Z. Goldhaber, M.D.; J. Stephen Jenkins, M.D.; Jeffrey A. Kline, M.D.; Andrew D. Michaels, M.D., M.A.S.; Patricia Thistlethwaite, M.D., Ph.D.; Suresh Vedantham, M.D.; R. James White, M.D., Ph.D.; and Brenda K. Zierler, Ph.D, RN, RVT. Author disclosures are on the manuscript.
The American Heart Association has more information about peripheral artery disease at www.heart.org/pad.