Deep vein thrombosis (DVT) is when a blood clot forms in a deep vein. These clots usually form in the lower leg, thigh, or pelvis, but they can also occur in the arm. Sometimes the DVT will break off and go to the lungs. This is called a pulmonary embolism (PE). Cancer patients, especially cancer patients who are receiving chemotherapy, have a much higher risk of DVT than other people. Patients with brain, pancreatic, stomach, and lung cancers are at the highest risk. What Raises the Risk of DVT? Some things can raise your risk of getting a blood clot in a deep vein. For cancer patients, the most common risk factors are— Injury to a vein during major surgery. Slow blood flow. Staying in bed for a long time can cause this. Having a catheter in a central vein. As many as half of cancer patients with a central venous catheter for long-term chemotherapy get DVT. Getting older. Having obesity. How Can I Lower My Risk for DVT? Before getting surgery or having a catheter placed in a central vein, ask your doctor about medicine to lower your chance of getting a blood clot. This medicine is called an anticoagulant or blood thinner. Wear compression stockings (tight-fitting socks or stockings) to improve blood flow in your legs. What Are the Symptoms of DVT? About half of people with DVT have no symptoms at all. The most common symptoms of DVT are: Swelling. Pain. Tenderness. Redness of the skin. Skin redness or discoloration If you have any of these symptoms, call your doctor right away. What Health Problems Can DVT Cause? Pulmonary Embolism (PE) - Part of a blood clot in a vein (DVT) can travel through the bloodstream to the lungs. This is known as a pulmonary embolism (PE). People can recover from this if the clot is small and they get the right treatment. But a large clot can stop blood from reaching the lungs, causing death. This is the leading cause of death in people with cancer after the cancer itself. A pulmonary embolism can cause— Trouble breathing. A fast or irregular heartbeat. Chest pain that usually gets worse if you cough or take a deep breath. Coughing up blood. Low blood pressure, lightheadedness, or fainting. A test called a CT scan, or CAT scan, may be used to find a pulmonary embolism. As many as half of all PEs in cancer patients are found in this way. Seek immediate medical attention if you experience any of these signs of a blood clot in your lung. Post-Thrombotic Syndrome Nearly one-third of people who get a DVT will have long-lasting health problems as a result. This is called post-thrombotic syndrome (PTS). PTS can cause swelling, pain, darkening or redness of the skin, and other problems. It makes the skin prone to infection (cellulitis), which can spread to the bloodstream, causing sepsis and death. Note: DVT (a blood clot in a vein) does not usually cause a heart attack or a stroke, as it occurs in a vein. Arteries carry oxygen-rich blood from the heart to the body. A blood clot in an artery, called arterial thrombosis, can cause heart attacks or strokes. Vascular Surgery Treatment of DVT Venous Thrombectomy Venous thrombectomy is the surgical removal of a vein clot. This procedure is most commonly used to treat DVT when the large vein that drains the leg, called the iliac vein, is involved. This procedure is rarely performed in the United States. Who is Eligible? Patients with an acute clot in the leg veins are eligible for venous thrombectomy. Pre-Treatment Guidelines: When a physician suspects DVT, he or she may order duplex ultrasound or venography. What to Expect A vascular surgeon performs thrombectomy in a hospital operating room. Just before the procedure begins, the patient is given an intravenous (through the vein) blood thinning agent called heparin. The physician inserts a catheter sheath (short tube) through a small incision in the femoral vein in the groin or the popliteal vein below the knee. Contrast dye is injected through the sheath and venography is performed, allowing the physician to see the area of the vein being treated on an x ray screen. For a percutaneous mechanical thrombectomy, the physician inserts a guide wire through the sheath in the femoral vein, advances the wire past the clot. There are multiple devices available for your surgeon to perform mechanical or aspiration thrombectomy. The procedure takes approximately 1 to 2 hours. Post-Procedure Guidelines and Care After the procedure, compression bandages are applied to the leg to reduce swelling. For up to 6 hours after the procedure, the patient may be asked to walk for 15 minutes, then rest for 45 minutes, and repeat. The patient is fitted with compression stockings after any leg swelling has subsided. Intravenous heparin is given during the recovery period to prevent blood clots. The patient should notify his or her physician immediately if he or she notices any of the following symptoms of excessive bleeding: Blood in urine or stools; Nosebleeds; Unusual bruising or bleeding from cuts or wounds; Unusually heavy or unexpected menstrual bleeding; Abdominal or stomach pain or swelling; Back pain or backaches; and Coughing up blood. Potential Complications Venous thrombectomy is controversial because it has been associated with repeat clotting. Other complications for treatment of DVT include: Pulmonary embolism; Post-thrombotic syndrome; Phlegmasia cerulea dolens; Excessive bleeding (hemorrhage); and Stroke.