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Deep vein thrombosis

Deep vein thrombosis. Color duplex scan of DVT Venogram shows DVT

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Text of Deep vein thrombosis. Color duplex scan of DVT Venogram shows DVT

  • Slide 1
  • Deep vein thrombosis
  • Slide 2
  • Color duplex scan of DVT
  • Slide 3
  • Venogram shows DVT
  • Slide 4
  • Patient with suspect symptomatic Acute lower extremity DVT Venous duplex scan negative Low clinical probability observe High clinical probability Repeat scan / Venography negative positive Evaluate coagulogram /thrombophilia/ malignancy Anticoagulant therapy contraindication yes IVC filter No pregnancy LMWH OPD LMWH hospitalisation UFH + warfarin Compression treatment
  • Slide 5
  • Thrombophilia screening Factor V leiden, Prot C/S deficiency Antithrombin III deficiency Idiopathic DVT < 50 years Family history of DVT Thrombosis in an unusual site Recurrent DVT
  • Slide 6
  • Recommendation for duration of warfarin 3-6 months first DVT with reversible risk factors At least 6 months for first idiopathic DVT 12 months to lifelong for recurrent DVT or first DVT with irreversible risk factors malignancy or thrombophilic state
  • Slide 7
  • Diagram 6
  • Slide 8
  • Slide 9
  • Phlegmasia cerulea dolens Venous gangrene
  • Slide 10
  • Catheter directed-thrombolysis Consider in: Acute< 10 days iliofemoral DVT. Long-term benefit in preventing post-phebitic syndrome is unknown.