Diagnostic Venogram: A venogram is usually the first step of any venous procedure. This step is used to visualize the flow in the vein and the precise location of treatable blood clots. A small incision is usually made behind the knee to access the vein. A catheter (long, thin tube) is then guided through the puncture site. Next, contrast dye is injected in the vein and visualized using x-ray technology. In addition, a specialized catheter with an ultrasound device at the tip may be placed in the vein to visualize the inside of the vein and perform measurements. Combined, these imaging studies allow the surgeon to assess the location and extent of the venous clot and plan a treatment. The venogram is followed by a combination of thrombolysis, thrombectomy, and/or venous stenting.
Thrombolysis: Thrombolysis is a procedure in which a small puncture is made in the back of the knee to access the vein. A catheter (long, thin tube) is then guided through the puncture to the site of the clot. “Clot busting” medication is then delivered to the DVT in the vein to dissolve the blood clot and re-open the vein. Sometimes, a small device is inserted in the vein to mechanically break up the clot and/or a stent is placed in the vein to keep it open and prevent swelling. This procedure occurs at Buffalo General Hospital and usually requires a patient to stay overnight to allow the clot busting medication to fully dissolve the clot.
Thrombectomy: Thrombectomy is a procedure in which a small puncture is made in the back of the knee to access the vein. A catheter (long, thin tube) is then guided through the puncture to the site of the clot. A small device is then guided on the catheter to the site of the clot. The device is then controlled by the vascular surgeon to mechanically break up, collect, and remove the clot. This procedure can be performed on its own or after a thrombolysis in the hospital. In addition, thrombectomy can be performed safely and effectively at our outpatient facility, Access Care, with discharge home the same day.
Venous Stenting: In addition to a blood clot, sometimes patients with a DVT have an underlying compression of their vein. A compressed vein limits blood flow out of the leg, and can cause increased swelling even after the blood clot is removed. Therefore a stenting procedure is performed where a small puncture is made in the back of the knee to access the compressed vein. A catheter (long, thin tube) is then guided through the puncture to the narrowed vein. A stent is then guided along the catheter and placed inside the vein. The stent can help alleviate swelling and prevent blood from pooling in the veins and causing an additional DVT.