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Forum Name: Clots & Anticoagulants

Question: Blood Clot (DVT)

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 Izzy - Wed Apr 21, 2004 1:36 pm

I have a friend that is diagnosed with a DVT in her right leg. She (age 32) is an inmate of the prison system and has reciviving coumadin treatment for a year and her leg and clot have not improved. In fact her clot has extended further. Her clotting index (I forget the abreviation) is 2.5-3.5. She wants to know what is typicaly done in such a case (ie what are the typical options other than do nothing which is what is current status). She has had a history of DVTs in the same leg.
 Dr. Yasser Mokhtar - Sat Apr 24, 2004 7:51 am

User avatar Dear Lzzy,

Having repeated blood clots in the veins of the legs or anywhere else without provoking factors (such as laying in bed for a long time, having surgery or travelling lets say in a car or plane for prolonged periods of time) can be suggestive of a disorder where the blood has a higher tendency to clotting than the normal.

This could be related to having a congenital disorder, where the naturally occuring anticoagulants in the body are deficient and/or defective.

It could also be related to
- Cancer. Your friend should be checked for cancer.
- Heart failure which leads to blood stagnation.

Coumadin is the treatment of choice if your friend has a higher tendency to clotting and if your friend has an underlying precipitating factor (like cancer) till this precipitating factor is gone.

An index of 2.5-3.5 is good. But if the dvt is recurrent eventhough the index is within therapeutic range, i think your friend has to see a specialist in blood diseases so that he checks why she is getting recurrent blood clots and decide whether she needs an even higher doses of coumadin and run an even higher index.

Thank you very much for using our website and i hope that this information helped.

Yasser Mokhtar, M.D.

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