dvt Flashcards
mx of dvt
Anticoagulation - either a Direct Oral Anticoagulant (DOAC), Low Molecular Weight Heparin (LMWH) or warfarin (which can be bridged with LMWH. NICE guidelines recommend DOACs such as Apixaban or Rivaroxaban as first line therapy.
Duration is typically at least 3 months.
Patients with active cancer should be anticoagulated for at least 3-6 months.
Patients with unprovoked DVTs should be considered for anticoagulation for over 3 months (typically 6 months).
Those with recurrent DVTs should be considered for life-long therapy.
Clinical feature Points
Active cancer (treatment ongoing, within 6 months, or palliative) 1
Paralysis, paresis or recent plaster immobilisation of the lower extremities 1
Recently bedridden for 3 days or more, or major surgery within 12 weeks requiring general or regional anaesthesia 1
Localised tenderness along the distribution of the deep venous system 1
Entire leg swollen 1
Calf swelling at least 3 cm larger than asymptomatic side 1
Pitting oedema confined to the symptomatic leg 1
Collateral superficial veins (non-varicose) 1
Previously documented DVT 1
An alternative diagnosis is at least as likely as DVT
what is high risk
high ris is 3 - striaght for doppler US within 4 hours
under 2 - D-dimer
