Percutaneous Transcatheter Treatment of Deep Vein Thrombosis (DVT): Before Your Surgery

What is it?

Percutaneous transcatheter treatment is a way to treat a deep vein thrombosis (DVT). DVT is a blood clot that forms in a large, deep vein. It happens most often in one of the veins of your legs. You may have pain, swelling, warmth, and redness from the DVT.

Your percutaneous transcatheter treatment will be done by a doctor who is a blood vessel (vascular) specialist. It can be done in several ways. Ask your doctor about the details of your treatment. In general, you can expect the following:

• An intravenous (I.V.) line will be put in a vein in your arm or hand. You’ll receive medicines and anesthesia through this I.V. You may also get medicine to help you relax (sedation) or numbing medicine (local anesthesia).
• You may be given a blood thinner such as heparin to help prevent blood clots from forming during treatment.
• The doctor will make a small cut (incision) through your skin and into a blood vessel in your groin, the area between your abdomen and your thigh.
• The doctor will then insert a long, thin wire into the incision. The wire acts as a guide during the treatment.
• Continuous imaging may be used to help see the wire, catheter, vein, and clot.
• The doctor will then insert a catheter using the wire as a guide. The doctor may then send clot-dissolving medicine through the catheter. Small tools may be used to help break up the clot. A tiny balloon or mesh may be inserted to open the vein.
• The wire and catheter will then be removed.
• The doctor will close the incision and then bandage it.

You may have tests before the treatment. The tests may include:

• Ultrasound. This is done to help diagnose the DVT and measure the flow of blood in your leg.
• Venogram. This is done to get images of the blood clot and of your veins.
• CT scan. This is done to get more detailed images of the blood clot.
• MRI. This is done to get more detailed images of the blood clot.
• Blood tests. These are done to check your overall health and to check for blood clotting problems.

How do you prepare for surgery?

• Tell your doctor about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. And tell your doctor if you:
  • Have had any recent changes in your health, such as an infection or fever.
  • Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local and general).
  • Are pregnant or think you could be.
• Talk with your doctor about how to prepare for your percutaneous transcatheter treatment. You may need to stop taking some medicines, such as blood thinners and aspirin, before the procedure. If you smoke, you may need to stop before your procedure. Smoking can delay healing. Talk with your doctor if you need help to stop smoking.
• Ask a family member or friend to take you home from the hospital. You can't drive yourself.
• Follow any directions you are given for not eating or drinking before your treatment.
• Follow all other instructions from your doctor.
• You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully. Ask questions before you sign if something is not clear.

What happens on the day of surgery?

Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.

• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no surgical site errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.

When should you call for help?

• You have questions or concerns.
• You don't understand how to prepare for your surgery.
• You become ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the surgery.