Treatment is aimed at keeping the blood clot from getting bigger and preventing new clots from forming. Prompt treatment is essential to prevent serious complications or death.
- Blood thinners (anticoagulants). These drugs prevent new clots from forming while your body works to break up the clots. Heparin is a frequently used anticoagulant that can be given through the vein or injected under the skin. It acts quickly and is often overlapped for several days with an oral anticoagulant, such as warfarin, until it becomes effective, which can take days. A newer class of anticoagulants, referred to as novel oral anticoagulants (NOACs), has been tested and approved for treatment of venous thromboembolism, including pulmonary embolism. These medications work quickly and have fewer interactions with other medications. Some NOACs have the advantage of being given by mouth, without the need for overlap with heparin. However, all anticoagulants have side effects, with bleeding being the most common.
- Clot dissolvers (thrombolytics). While clots usually dissolve on their own, there are medications given through the vein that can dissolve clots quickly. Because these clot-busting drugs can cause sudden and severe bleeding, they usually are reserved for life-threatening situations.
Surgical and other procedures
- Clot removal. If you have a very large, life-threatening clot in your lung, your doctor may suggest removing it via a thin, flexible tube (catheter) threaded through your blood vessels.
- Vein filter. A catheter can also be used to position a filter in the body's main vein — called the inferior vena cava — that leads from your legs to the right side of your heart. This filter can help keep clots from being carried into your lungs. This procedure is typically reserved for people who can't take anticoagulant drugs or when anticoagulant drugs don't work well enough or fast enough. Some filters can be removed when they are no longer needed.