Vascular: DVT Flashcards
What is a VTE?
Formation of a blood clot in the venous system with potential to embolism causing a PE.
What is in Virchow’s triad?
Change in coagulability, stasis of blood, vessel wall injury
What are RF for VTE?
Immobility
Recent trauma
Long haul travel
Pregnancy
Hormone therapy containing oestrogen
Polycythaemia
SLE
Thrombophillia
What prophylaxis against VTE is given/carried out in hospital before surgical procedure?
VTE risk assessed
Prophylaxis given if risk is increased unless contraindicated.
Prophylaxis usually with LWMH - enoxaparin, dalteparin.
TED stockings given - unless contraindicated.
How does VTE present?
Unilateral calf or leg swelling
Dilated superficial veins
Calf tenderness
Oedema
Colour changes to leg
What is a Wells score?
Predicts risk of DVT or PE in patient presenting with symptoms
What investigations would you do for suspected VTE?
D dimer
Wells score
Doppler ultrasound
CT pulmonary angiogram
Why is a D-dimer done for suspected VTE?
Helps exclude DVT but does not confirm it, as other conditions can cause a raised D dimer score
Why is a doppler ultrasound done for suspected VTE?
Assess blood flow in the leg. Repeat 6-8days later if DVT suspected but initial scan -ve.
Why is a CT pulmonary angiogram done in pt presenting with leg swelling, calf tenderness and colour changes to the leg?
Identify PE
How is VTE initially managed?
Apixaban, rivaroxaban
After a DVT, how are they managed?
Long term anticoags - doac, warfarin, LWMH
What is deep venous insufficiency related to ?
previous DVT
