Diagnosis and treatment of deep-vein thrombosis

Scarvelis, Dimitrios; Wells, Philip S.
October 2006
CMAJ: Canadian Medical Association Journal;10/24/2006, Vol. 175 Issue 9, p1087
Academic Journal
Deep-vein thrombosis (DVT) is a common condition that can lead to complications such as postphlebitic syndrome, pulmonary embolism and death. The approach to the diagnosis of DVT has evolved over the years. Currently an algorithm strategy combining pretest probability, D-dimer testing and compression ultrasound imaging allows for safe and convenient investigation of suspected lower-extremity thrombosis. Patients with low pretest probability and a negative D-dimer test result can have proximal DVT excluded without the need for diagnostic imaging. The mainstay of treatment of DVT is anticoagulation therapy, whereas interventions such as thrombolysis and placement of inferior vena cava filters are reserved for special situations. The use of low-molecular-weight heparin allows for outpatient management of most patients with DVT. The duration of anticoagulation therapy depends on whether the primary event was idiopathic or secondary to a transient risk factor. More research is required to optimally define the factors that predict an increased risk of recurrent DVT to determine which patients can benefit from extended anticoagulant therapy.


Related Articles

  • Differential Effects of Unfractionated Heparin and Low-Molecular-Weight Heparins on Tissue Thromboplastin Inhibition Test. Gerbutavicius, Rolandas; Iqbal, Omer; Messmore, Harry; Hoppensteadt, Debra A.; Demir, Muzaffer; Khan, Erum; Bacher, Peter; Fareed, Jawed // Clinical & Applied Thrombosis/Hemostasis;Oct2000, Vol. 6 Issue 4, p190 

    Circulating anticoagulants are endogenously produced substances that interfere with in vitro tests of coagulation like activated partial thromboplastin time (APTT). and cause prolongation of the clotting times. Evaluation of the abnormal APTT involving various factor assays and mixing studies...

  • Hemorrhagic Complications in Patients Treated with Anticoagulant Doses of a Low Molecular Weight Heparin (Enoxaparin) in Routine Hospital Practice. Ellis, Martin H.; Hadari, Ruth; Tchuvrero, Noa; Shapira, Shirley; Kovlenko, Irena; Kozmìakova, Mariana; Zissin, Rivka; Elis, Avishay // Clinical & Applied Thrombosis/Hemostasis;Apr2006, Vol. 12 Issue 2, p199 

    Low molecular weight heparins (LMWHs) are a rapidly growing class of anticoagulant drug. Their efficacy has been demonstrated in several clinical settings where they are rapidly becoming the anticoagulant of choice. Controlled clinical studies in patients with deep vein thrombosis, pulmonary...

  • Thrombosis during off pump LVAD placement in a patient with heparin induced thrombocytopenia using bivalirudin. Awad, Hamdy; Bryant, Richard; Malik, Obaid; Dimitrova, Galina; Sai-Sudhakar, Chittoor Bhaskar // Journal of Cardiothoracic Surgery;2013, Vol. 8 Issue 1, p1 

    Here we present our attempt at off pump HeartMate II left ventricular assist device (LVAD) implantation using the anticoagulant bivalirudin in a patient with heparin induced thrombocytopenia, which resulted in thrombosis within the LVAD device. This required that our procedure be converted to on...

  • Taming killer clots. Comarow, Avery // U.S. News & World Report;3/10/2003, Vol. 134 Issue 7, p56 

    Focuses on efforts to treat deep vein thrombosis (DVT) a blood clot that lodges itself in patients' legs. Number of people who have died from DVT; Use of the blood thinner heparin in treating the condition.

  • Initial management of deep venous thrombosis in the outpatient setting. Groce, James B. // American Journal of Health-System Pharmacy;5/1/2008, Vol. 65 Issue 9, p866 

    The article relates the author's perspective concerning the management of deep venous thrombosis (DVT) with low-molecular-weight heparin (LMWH) in an outpatient setting. He contends that outpatient treatment with LMWH is well tolerated and effective and can result in overall cost savings. He...

  • Endoluminal Recanalization in a Patient with Phlegmasia Cerulea Dolens Using a Multimodality Approach. Lin, Stephanie C.; Mousa, Albeir; Bernheim, Joshua; Dayal, Rajeev; Henderson, Peter; HoUenheck, Scott; Kent, K. Craig; Faries, Peter L. // Vascular & Endovascular Surgery;May/Jun2005, Vol. 39 Issue 3, p273 

    Phlegmasia cerulea dolens is a limb-threatening form of deep venous thrombosis and should be treated aggressively. The authors report a patient who presented with iliocaval and femoral deep venous thrombosis and posed an additional therapeutic challenge based on a recent history of...

  • Heparin-induced thrombocytopenia: an update. Franchini, Massimo // Thrombosis Journal;2005, Vol. 3, p14 

    Heparin-induced thrombocytopenia (HIT) is the most important and most frequent drug-induced, immune-mediated type of thrombocytopenia. It is associated with significant morbidity and mortality if unrecognized. In this review, we briefly discuss the main features of heparin-induced...

  • Propagation of Tibial Vein Thrombus in Patients Systemically Anticoagulated or Receiving Antiplatelet Therapy. Hirko, Mark K.; Kasirajan, Karthikeshwar; Turner, John J.; Rubin, Jeffrey R. // Vascular Surgery;May/Jun1999, Vol. 33 Issue 3, p351 

    The objective of this study was to evaluate the incidence of infrapopliteal deep vein thrombus propagation in postoperative orthopedic patients. This was a retrospective study of patients undergoing noninvasive venous testing to rule out phlebothrombosis. Venous duplex scans and Doppler studies...

  • Prophylactic use of LMWH plus intermittent pneumatic compression prevented DVT in hip or knee arthroplasty. Eikelboom, John W. // Evidence Based Medicine;Apr2005, Vol. 10 Issue 2, p48 

    The article cites a research study, which reveals that prophylactic use of low-molecular-weight heparin (LMWH) plus intermittent pneumatic compression prevented deep vein thrombosis (DVT) in hip or knee arthroplasty. The researchers concluded that in patients who have total hip or total knee...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics