DR. ahmed Abanamy hospital DOCTOR Nazih Mohammed Alothman Vascular Surgeon

deep venous thrombosis

deep vein thrombosis, commonly referred to as “DVT,” occurs when a blood clot or thrombus, develops in the large veins of the legs or pelvic area. some DVTS may cause no pain, whereas others can be quite painful. with prompt diagnosis and treatment, the majority of DVT’S are not life threatening. however, a blood clot that forms in the invisible “deep veins” can be life threatening. a clot that forms in the large, deep veins is more likely to break free and travel through the vein. it is then called an embolus. when an embolus travels from the legs or pelvic areas and lodges in a lung artery, the condition is known as a “pulmonary embolism,” or PE, a potentially fatal condition if not immediately diagnosed or treated

most common signs and symptoms of DVT Sudden swelling of one limb Pain or tenderness Skin that is warm to the touch Fullness of the veins just beneath the skin Change in color (blue, red or very pale)

common signs and symptoms of PE Shortness of breath Sudden chest pain A feeling of apprehension Sudden collapse Coughing Sweating Bloody phlegm (coughing up blood)

Causes VIRCHOES TRAID VENOUS STASIS hypercoagulability ENDOTHELIAL

risk factors acquired Old age Major surgery and orthopedic surgery Cancers Inactivity and immobilization Pregnancy and postpartum period Oral contraceptive Trauma and minor leg injury Inflammatory disease and autoimmune disease\ Nephrotic syndrome Antiphospholipid syndrome Hormonal replacement thereby Obesity Infection Chemotherby Intra venous drug use Polycythemia Vera central venous catheter HIV

risk factors Inherited  Anti thrombin deficiency  Protein C deficiency  Protein S deficiency  Factor V leiden  Prothrombin G20210A  Dysfibrinogenemia  Non – O blood type

Risk factors mixed  Low free protein c  Activated protein c resistance  High factor VIII levels  high factor XI levels  High factor IX levels  High fibrinogen levels

diagnosis Clinical assessment Duplex veins D- dimer

Do not sit for long periods of time Elevate legs if you are sitting for moderate periods of time If you are on an airplane for more than four hours-get up and walk in the aisles, pump your feet up and down If you are flying, drink plenty of non-alcoholic beverages Keep hydrated-drink six glasses of water a day Talk to your doctor about the need for medications or graduated elastic compression stockings for long airplane flights If you have varicose veins, wear support hose (especially if pregnant) Do not wear constricting garments around the legs or waist (elastic bands or garters) To find AVOID DVT

There is more than one goal of treatment for deep vein thrombosis (DVT). The goals include:  Preventing a clot from growing  Preventing a clot from breaking off and traveling to the lung or other organ  Avoiding long-lasting complications, such as leg pain and swelling  Preventing blood clots from recurring Goals of treatment for DVT

Blood thinners (also called anticoagulants) are the most common type of treatment for DVT. The two main types of anticoagulants are HEPARIN and WARFFRIN Blood thinners can:  Keep a clot from growing or breaking off  Prevent new clots from forming But blood thinners cannot:  Thin blood  Dissolve an existing clot blood thinners for DVT

 People with DVT may receive heparin in their vein or SC in the hospital for about five to seven days.  You may also continue the injections at home, once or twice daily.  And because it is more consistent and predictable, it doesn't require regular blood tests. heparin

As a DVT treatment, you take warfarin (Coumadin) by pill once a day, beginning while you're still on heparin. Treatment may continue for three to six months or more. While on warfarin, you will need regular blood tests to ensure you have the correct dosage -- too little increases your clot risk, too much increases your risk for bleeding. Warfarin can also interact with other medicines, vitamins, or certain foods rich in vitamin K -- making regular monitoring even more important. If you're pregnant, your doctor will prescribe other types of treatment because warfarin can cause birth defects. DVT treatmentCoumadinpregnantbirth defects WARFARIN

If you have DVT, your body will dissolve a blood clot over time, but damage can occur inside your vein in the meantime. For this reason, your doctor may recommend a clot-busting drug called a thrombolytic agent. This DVT treatment may be necessary: For larger clots If you're at high risk for pulmonary embolism If you have DVT in an arm, instead of a leg Catheter-directed thrombolysis rapidly breaks up a clot, restoring blood flow. It may also preserve valve function in the vein that contained the clot. The procedure is done in the hospital and carries a higher risk of bleeding problems and stroke than does anticoagulant therapy.stroke This is how a catheter-directed thrombolysis is done to treat DVT: With imaging guidance, an interventional radiologist inserts a thin tube (catheter) into and through a vein in your leg. The radiologist then puts the tip of the catheter into the clot and infuses a clot-busting drug directly into it. If the vein appears narrowed, the radiologist may do a balloon angioplasty or stent placement to widen it and help prevent future blockages. DVT and catheter-directed thrombolytic

DR. nazih Mohammed al -othman thanks