Anticoagulation is the cornerstone for treating deep venous thrombosis and pulmonary embolism. Anticoagulation medications reduce the body’s ability to form blood clots. Some people call anticoagulants "blood thinners," but they do not actually "thin" your blood, they impair its ability to clot.
Blood vessels get small defects as part of everyday life, and the clotting system patches those defects to prevent bleeding. The clotting system is also responsible for stopping bleeding when you cut yourself. The goal of anticoagulation therapy is to find a middle ground where you continue to clot when your body needs to clot, yet at the same time prevents your thrombosis or embolism from getting worse. That is, anticoagulation therapy seeks to prevent new clots and the growth of current clots, while your body’s natural system for removing clots — called the 'lysis' or 'lytic’ system — clears the thrombus or embolism.
Anticoagulation therapy traditionally involves heparin or heparin-like medicines given by vein or by a shot under the skin, followed by an oral medication called warfarin (Coumadin). Patients taking warfarin need regular monitoring with a blood test called an INR. New oral anticoagulants are becoming available that do not require regular blood test monitoring, and some of them do not require receiving anticoagulants by vein or under the skin. For now, however, most DVTs and PEs are treated by medicines given by vein or under the skin, followed by an oral anticoagulant, most commonly warfarin.
In some circumstances, patients need a physical device, a "filter," inserted into the large vein that leads from their legs to their heart, called the inferior vena cava. The filter serves to block any future emboli from reaching the lung. While only a small fraction of patients require such a device, UCSF has world-class interventional radiologists who work closely with our hematologists to provide expert insertion and removal of these filters when needed.
For obstetrical patients who have had or are predisposed to having a blood clot, UCSF hematologists work closely with the UCSF high-risk obstetricians to provide optimal treatment plans before, during and after pregnancy.
Reviewed by health care specialists at UCSF Medical Center.