A few years ago, Dr Julian Hague, Consultant Radiologist at The Physician’s Clinic noticed that patients with deep vein thrombosis (DVT) were treated much differently in the UK compared with the USA. “When I was in the US I realised that surgeons and interventional radiologists there were making great efforts to remove the blood clot that causes DVT – and were showing that this was a safe and quick procedure. By contrast, in the UK, drug treatment was given to prevent further clots but the original clot was left in place. It was clear from the US results that removing the clot reduced the long term disability that DVT can cause. Patients were being discharged from hospital more quickly, and returning to work and normal activities sooner,” explains Dr Hague. Together with colleagues Dr Duncan Brennand and Dr George Raja, both fellow interventional radiologists at The Physicians’ Clinic, Dr Hague went on to research and publish scientific evidence to show that surgical clot removal is often the best way to manage a DVT. Their work contributed to the large weight of evidence supporting a surgical approach and the National Institute of Clinical Excellence (NICE) in the UK now accepts this as best practice.
What is DVT?
Deep vein thrombosis – a blood clot in one of the deep veins in the legs - is an incredibly common condition. It can occur with a pulmonary embolism (a blood clot on the lungs) and when this combination is diagnosed it is termed venous thromboembolism (VTE). Studies have shown that around five in every 100 people in the UK population will be affected by a DVT or VTE at some point in their life.
How did we used to treat DVT in the UK?
Until a few years ago, treatment for DVT had not changed significantly in the 50 years since blood thinning drugs such as warfarin were first developed. Use of blood thinners remains the cornerstone of DVT treatment as these drugs prevent further clots forming. However, the original blood clot in the leg vein was usually ignored. Dr Paul Glynne, Founder Director at The Physicians’ Clinic, stresses the importance of assessing a patient presenting with an episode of unexplained DVT. “Diagnosis and treatment is provided by a Consultant Radiologist and a Consultant Haematologist often in conjunction with a Consultant Physician, who looks into the wider aspects of the patient’s health and medical history. It is important to recognise that DVT may be a symptom of a more serious underlying medical condition, which needs to be recognised early and managed effectively.”