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

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Presentation on theme: "Deep vein thrombosis. Color duplex scan of DVT Venogram shows DVT."— Presentation transcript:

1 Deep vein thrombosis

2 Color duplex scan of DVT

3 Venogram shows DVT

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

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

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

7 Diagram 6

8

9 Phlegmasia cerulea dolens Venous gangrene

10 Catheter directed-thrombolysis Consider in: Acute< 10 days iliofemoral DVT. Long-term benefit in preventing post-phebitic syndrome is unknown.


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