Treatments
What are the treatments for a pulmonary embolism?
Pulmonary embolisms are most commonly treated with drugs known as anticoagulants, which can be taken orally (in pill form) or by injection. Anticoagulants are also called “blood thinners.”
Other treatments are used more rarely and only after discussion with your healthcare professional:
- Drugs designed to “dissolve” the blood clot (or thrombosis);
- A thrombectomy, which is surgery aimed at removing the blood clot.
Treatments of a pulmonary embolism
Goals of anticoagulant treatment
Duration of the anticoagulant treatment
When choosing the type and duration of treatment, a discussion with your healthcare professional can help you understand the choices available.
The choice of treatment depends on your general state of health and will be adjusted if:
- You have cancer or kidney disease;
- You are pregnant or intend to breastfeed;
- You are taking other medication with consequences for the treatment.
The duration of the treatment depends on the cause of the problem and can range from a few months to several years.
- For a temporary or reversible cause (ex., hip surgery): the treatment can last approximately 3 months;
- If a specific cause has not been identified and there is a high risk of a new thrombus, the treatment will be extended (several years);
- Certain medical conditions also require prolonged treatment when these causes are still present (in the case of an active cancer or inflammatory disease, for example).
DVT & PE: Choosing whether to treat or not?
The different anticoagulants
Several types of anticoagulants are available for the treatment of DVT and PE. Your doctor will discuss the different options with you and help you choose the most appropriate treatment for your situation. The different treatment options are presented below.
This treatment is administered at the hospital using heparin.
This treatment with low-molecular-weight heparin can be started in the hospital, but is then continued at home. You can inject it yourself, or you can get help from a nurse or a family member who has learned the technique.
Warfarine (Coumadin™) a medication with a long history of use)The tablet is taken once a day.
Frequent blood tests are necessary at the outset of treatment in order to adjust the dosage. Afterwards, blood tests are performed every 6 to 12 weeks.
Follow-up can be done in healthcare clinics and pharmacies.
Direct oral anticoagulants
Apixaban: Eliquis™
Dabigatran: Pradaxa™
Edoxaban: Lixiana™
Rivaroxaban: Xarelto™
The treatment has existed for several years. Blood tests are not necessary for follow-up.
What are the side effects of anticoagulant treatment?
Anticoagulant treatment is usually well-tolerated, with very few side effects. When the treatment is done by injection, it can be uncomfortable and cause bruising at the injection site. These reactions are often minor and without adverse effect.
Since the purpose of the treatment is to thin the blood, the main risk of anticoagulants is bleeding. If you are taking an anticoagulant and you are injured (a cut or fall) or during menstruation in women, the bleeding may be slightly heavier. In almost all cases, the bleeding is light and stops on its own, without further treatment.
If you are concerned about the risks associated with anticoagulant treatment, it is important to discuss your concerns with your healthcare professional.
If you are taking an anticoagulant and you have bleeding, it is important to discuss it with a healthcare professional.
If you see black or red blood in your stool, vomit, urine or sputum, seek medical advice immediately.
What are the benefits of anticoagulant treatment?
The main advantage of anticoagulant treatment is that it prevents blood clots that have already formed from growing in size. It also:
- Prevents the blood clot from travelling to the lungs;
- Alleviates the discomfort from symptoms;
- Removes the blood clot by dissolving it;
- Prevents the formation of new clots.
How can you participate in the choice of treatment?
The first step is to talk to healthcare professionals and to seek out information, like you’re doing now by accessing this portal.
In most cases, treatment with an anticoagulant offers more benefits (improvement of symptoms and prevention of blood clot growth and the formation of new clots) than risks (bleeding).
When choosing a treatment, your physician will take into account your health and your preferences.
Compression stockings are not a treatment for PE and DVT. They can be used to improve symptoms related to leg swelling following deep vein thrombosis and to prevent long-term complications.