Deep vein thrombosis. Color duplex scan of DVT Venogram shows DVT.
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Transcript of Deep vein thrombosis. Color duplex scan of DVT Venogram shows DVT.
Patient with suspect symptomatic Acute lower extremity DVT
Venous duplex scan negative Low clinical probability observe
High clinical probability
Repeat scan /Venography
negativepositive
Evaluate coagulogram /thrombophilia/ malignancy
Anticoagulant therapycontraindication
yes IVC filter
No
pregnancy LMWH
OPD LMWH
hospitalisation UFH+ warfarin
Compression treatment
Thrombophilia screeningFactor V leiden, Prot C/S deficiency
Antithrombin III deficiency
• Idiopathic DVT < 50 years
• Family history of DVT
• Thrombosis in an unusual site
• Recurrent DVT
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