Dvt-N Risks and Diagnosis
FOCUS
Clots
Wai Khoon Ho
Deep vein thrombosis
Risks and diagnosis
Venous thromboembolism (VTE), comprising deep vein thrombosis and pulmonary embolism (PE), is the third commonest vascular disorder in Caucasian populations.1 In Australia, DVT alone (without concomitant PE) affects 52 persons per 100 000 annually.2 Timely management of DVT is important as it is a common cause of morbidity. Thromboses of the deep veins in the upper limbs and ‘unusual sites’, such as mesenteric veins, constitute less than 10% of DVT cases.2 As they are uncommon, this article focuses only on the risks and diagnosis of lower limb DVT. Deep vein thrombosis usually starts in the calf area.3 most thrombi confined to the deep veins below the popliteal trifurcation (distal DVt, Figure 1) probably resolve spontaneously without causing any symptoms. Distal DVt can extend to the popliteal and femoral veins and other proximal veins. (note that in some imaging reports, the term ‘superficial femoral vein’ is applied to that part of the femoral vein between the popliteal vein and the confluence with the deep femoral vein.4 the superficial femoral vein is therefore a part of the proximal deep venous system.) most patients present with symptoms when there is proximal vein involvement. About 50% of patients with untreated symptomatic proximal DVt develop symptomatic PE within 3 months. Despite adequate treatment, DVt can recur. About 10% of patients with symptomatic DVt develop severe post-thrombotic syndrome within 5 years.3
Background
Venous thromboembolism, comprising deep vein thrombosis (DVT) and pulmonary embolism, is common in Australia and is associated with high morbidity.
Objective
This article provides a summary of the risk factors for DVT of the lower limb and discusses the diagnosis of the condition using a diagnostic algorithm incorporating clinical assessment, D-dimer testing and imaging studies. It also briefly reviews the clinical significance of isolated distal
Clots
Wai Khoon Ho
Deep vein thrombosis
Risks and diagnosis
Venous thromboembolism (VTE), comprising deep vein thrombosis and pulmonary embolism (PE), is the third commonest vascular disorder in Caucasian populations.1 In Australia, DVT alone (without concomitant PE) affects 52 persons per 100 000 annually.2 Timely management of DVT is important as it is a common cause of morbidity. Thromboses of the deep veins in the upper limbs and ‘unusual sites’, such as mesenteric veins, constitute less than 10% of DVT cases.2 As they are uncommon, this article focuses only on the risks and diagnosis of lower limb DVT. Deep vein thrombosis usually starts in the calf area.3 most thrombi confined to the deep veins below the popliteal trifurcation (distal DVt, Figure 1) probably resolve spontaneously without causing any symptoms. Distal DVt can extend to the popliteal and femoral veins and other proximal veins. (note that in some imaging reports, the term ‘superficial femoral vein’ is applied to that part of the femoral vein between the popliteal vein and the confluence with the deep femoral vein.4 the superficial femoral vein is therefore a part of the proximal deep venous system.) most patients present with symptoms when there is proximal vein involvement. About 50% of patients with untreated symptomatic proximal DVt develop symptomatic PE within 3 months. Despite adequate treatment, DVt can recur. About 10% of patients with symptomatic DVt develop severe post-thrombotic syndrome within 5 years.3
Background
Venous thromboembolism, comprising deep vein thrombosis (DVT) and pulmonary embolism, is common in Australia and is associated with high morbidity.
Objective
This article provides a summary of the risk factors for DVT of the lower limb and discusses the diagnosis of the condition using a diagnostic algorithm incorporating clinical assessment, D-dimer testing and imaging studies. It also briefly reviews the clinical significance of isolated distal
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