US review March 9, 2011.

Slides:

Advertisements

Similar presentations

DEEP VEIN THROMBOSIS.

Advertisements

Shara WY Lee, Kim S Khaw, Warwick D Ngan Kee

VTE Toolkit Chapter Five Venous Disease Coalition

Atiya Khalid GPST1 A & E;AGH. Defination: DVT is the formation of a thrombus (blood clot) in a deep vein, usually in the legs, which partially or completely.

Detecting Pelvic Disease With Duplex Ultrasound Ron Bush, MD, FACS Midwest Vein & Laser Center Dayton, Ohio.

Thrombophlebitis Thrombus = related to blood clots Phlebitis = vein inflammation.

DPT 732 SPRING 2009 S. SCHERER Deep Vein Thrombosis.

Approximately 600,000 new cases are diagnosed in the U.S. each year Thrombus formation in deep veins of legs or thighs Tibial veins, soleal/gastrocnemius.

Leg DVT Ultrasound Caitlin Gardiner.

Thandiwe Murape  Acts as a reservoir to hold blood.  Acts as a conduit to return blood to heart and lungs.  Is composed of single tissue layer.

TURANDOT SAUL, M.D. SEPTEMBER 12TH, 2007 ST. LUKE’S ROOSEVELT HOSPITAL DEPARTMENT OF EMERGENCY MEDICINE Deep Venous Thrombosis.

DVT & VARICOSE VEINS.

Venous Reflux Disease and Current Treatment Modalities VN20-03-B 10/04.

Chronic Venous Disease Treatment - Part II Vein closure and rerouting of blood through normal veins with Ultrasound Guided Foam Sclerotherapy S. Lakhanpal.

VEINS OF LOWER LIMB Dr. Ahmed Fathalla Ibrahim.

Health Assessment Across the Lifespan NRS 102.  Structure and Function  Subjective Data—Health History Questions  Objective Data—The Physical Exam.

What is it? A deep vein thrombosis is a condition where the blood clots in a distal, deep vein A blood clot is considered a thrombosis as long as it is.

Deep Vein Thrombosis (DVT) Formation of a clot within a vein Occurs when there is i) venous stasis ii)Vessel injury ii)hyper coaguability.

Ultrasound Diagnosis of Lower Extremity Venous Insufficiency S. Lakhanpal MD President & CEO Center for Vein Restoration.

Thromboembolism IT training Presentation Midwifery update Marie Lewis.

Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Peripheral Vascular System and Lymphatic System.

Venous complications in pregnancy and puerperium ASSOCIATE PROFESSOR IOLANDA ELENA BLIDARU MD, PhD.

CARDIOVASCULAR MODULE: DEEP VENOUS THROMBOSIS THROMBOPHLEBITIS Adult Medical-Surgical Nursing.

Venous Doppler Remains primary modality for assessing deep venous thrombosis of upper & lower extremities Diagnostic Criteria for DVT: Most reliable is.

PHLEGMASIA Tracy Groller & Deb Halliday Journal Article Presentation MEDU 610 Professor: Camie Modjadidi April 7, 2011.

DVT Protocols The following provides details of Upper and Lower Limb DVT protocols used in our practice. Paige Fabre

Deep vein thrombosis and pulmonary embolism.

Venous Disease.

Lower limb Cases.

Lower Extremity Venous Sonography Harry H. Holdorf PhD, MPA, RDMS (Ob/Gyn, Ab, BR), RVT, LRT(AS)

DEEP VEIN THROMBOSIS BLOCK 2 Lecture Professor Nora Martin Vetto.

One of the main causes of DVT is inactivity! When a person is inactive, your blood normally collects in the lower part of your body. (in your legs) This.

Serial 2-Point Ultrasonography Plus D-Dimer vs Whole-LegColor-CodedDopplerUltrasonography for Diagnosing Suspected Symptomatic Deep Vein Thrombosis A Randomized.

Color Duplex Imaging Goals: Adjunct to physiologic testing

PhD, MPA, RDMS (Ob/Gyn, Ab, BR), RVT, LRT(AS), CCP

Venous Duplex / Color Flow Imaging

New England Society of Interventional Radiology Case Presentation

MIXED OBSTRUCTION/REFLUX

pharmacotherapeutics III Case presentation on deep vein thrombosis

History : Case March 26, year old male patient with complaints of left calf pain (Typical Claudication) at rest and on exertion (Fontaine II/B).

Is bilateral ultrasound scanning of the legs necessary for patients with unilateral symptoms of deep vein thrombosis? Nicholas D. Garcia, MD, Mark D.

Lackawanna College Vascular Technology Program

Factors affecting outcome of open and hybrid reconstructions for nonmalignant obstruction of iliofemoral veins and inferior vena cava Nitin Garg, MBBS,

Anne Knisely, MS4 Diagnostic Radiology elective

Peripheral Vascular System and Lymphatic System

Understanding Vascular Ultrasonography

Factors affecting outcome of open and hybrid reconstructions for nonmalignant obstruction of iliofemoral veins and inferior vena cava Nitin Garg, MBBS,

Neovascularization in acute venous thrombosis

Understanding Vascular Ultrasonography

Common femoral endovenectomy with iliocaval endoluminal recanalization improves symptoms and quality of life in patients with postthrombotic iliofemoral.

Is bilateral ultrasound scanning of the legs necessary for patients with unilateral symptoms of deep vein thrombosis? Nicholas D. Garcia, MD, Mark D.

Christine J. Evans, MB, ChB, Paul L. Allan, FRCR, Amanda J

Extraluminal lipoma with common femoral vein obstruction: A cause of chronic venous insufficiency Antonios P. Gasparis, MD, Stylianos Tsintzilonis, MD,

Point of Care Ultrasound

Axial transformation of the profunda femoris vein

Real-time duplex ultrasound mapping of the greater saphenous vein before in situ infrainguinal revascularization Bruce A. Ruoff, M.D., John J. Cranley,

Post-thrombotic Syndrome.

Diagnostic Medical Sonography Program

Extension of saphenous thrombus into the femoral vein: A potential complication of new endovenous ablation techniques Geza Mozes, MD, PhD, Manju Kalra,

Quantification of venous reflux by means of duplex scanning

Duplex scanning in the assessment of deep venous incompetence

Clinical case of a swollen limb Emphasis on diagnosis

Chapter 20Peripheral Vascular and Lymphatic Assessment

John J. Skillman, MD, K. Craig Kent, MD, David H

Continuous – Wave Doppler

History : Case April’ year old female patient with past medical history of presents with complaints of bilateral claudication in buttocks, hip.

Point of Care Ultrasound

DVT = deep vein thrombosis

Elna M. Masuda, MD, Robert L. Kistner, MD, Eugene B. Ferris, MD

Presentation transcript:

US review March 9, 2011

Rule out DVT

If the vein completely compresses there is no underlying clot.

no clot clot

Linear Array Probe (5-10 mHz)

Patient reclines at 45o Hip externally rotated

Note: SFV – “superficial” femoral vein is a deep vein!

Just 2 key areas to compress

Our protocol: 4 compression clips CF-saph bifurcation pop “trifurcation”

A normal exam:

Clip #1 CF-saph

CFV – G. Saphenous Junction

Clip #2 bifurcation

Bifurcation: SFV and DFV

Clip #3 pop

Pop V

Clip #4 “trifurcation”

“trifurcation”: pop divides

Some clots:

DVT in CFV

Clip: partially occlusive DVT

movie: mobile DVT

movie: DVT in CFV

Movie: DVT in pop

Chronic DVTs look different

Chronic DVT shrunken fibrotic (hyperechoic) collaterals recanalized

clip: lymph node

The exam is simple!

Stuff you don’t have to know:

You can skip: the mid-thigh the calf Doppler

mid-thigh: SFV

Calf veins: OK to skip

Calf DVTs - Unreliable to diagnose: < 70% sensitivity - Unclear significance: 75% resolve without treatment

But what if you find a calf DVT? Plan A: anticoagulate Plan B: ASA only. Monitor for extension (Not all calf veins are equally important)

Clip: calf veins

Is Doppler needed? No. Compression is sufficient. Color can sometimes help identify vessels. Doppler can give false normals: eg non-occlusive DVT has normal augmentation.

Doppler flow info: Augmentation: - squeeze the calf and blood rushes past the probe - implies no obstruction between calf and probe Respiratory phasicity: - flow stops on inhale, goes on exhale - implies no obstruction up in pelvis

Venous flow (note respirations)

phasic flow and augmentation

What is “duplex”? 2 modalities together: U/S + Doppler

Quiz!

A C B

A C D B

A B

Where on the leg are we?

The End