Deep Vein Thrombosis: Introduction FeedbackA general introduction to Deep Vein Thrombosis.Source: Clinical Knowledge Summaries, 01 Apr 2013
Deep vein thrombosis (DVT) is the formation of a thrombus (blood clot) in a deep vein, usually in the legs, which partially or completely obstructs blood flow.
DVT has an annual incidence of about 1 in 1000 people.
Continuing or intrinsic risk factors include:
Previous venous thromboembolism.
Cancer (known or undiagnosed).
Being overweight or obese
Acquired or familial thrombophilia.
Chronic low-grade injury to the vascular wall (for example vasculitis, hypoxia from venous stasis, or chemotherapy).
Risk factors that temporarily raise the likelihood of DVT include:
Significant trauma or direct trauma to a vein (for example, intravenous catheter).
Hormone treatment (for example hormone replacement therapy).
Pregnancy and the postpartum period.
The most serious complication is pulmonary embolism.
The possibility of DVT should be considered if typical symptoms and signs are present, especially if the person has risk factors. Typical signs and symptoms are:
Pain and swelling in one leg (occasionally both legs).
Tenderness, changes to skin colour and temperature, and vein distension.
Other conditions which may present with similar signs and symptoms include:
Cardiovascular disorders such as superficial thrombophlebitis and post-thrombotic syndrome
Other conditions such as ruptured Baker’s cyst, cellulitis, and dependent oedema.
The two-level DVT Wells score should be used to assess the likelihood of DVT and inform further management.
For people who are likely to have DVT (based on the results of the two-level DVT Wells score), management includes:
Arranging referral for a proximal leg vein ultrasound scan to be carried out within 4 hours.
If a proximal leg vein ultrasound scan cannot be carried out within 4 hours of being requested, a blood sample should be taken for D-dimer testing; an interim 24-hour dose of a parenteral anticoagulant should be given; and a proximal leg vein ultrasound scan should be arranged (to be carried out within 24 hours of being requested).
For people who are unlikely to have DVT, a blood sample should be taken for D-dimer testing:
If the D-dimer test is positive, management options are as for people who are likely to have DVT.
If the D-dimer test is negative, an alternative diagnosis should be considered.
People with DVT require anticoagulant treatment in secondary care. On discharge they will require maintenance treatment with an oral anticoagulant drug for at least 3 months (provided there are no contraindications such as cancer or pregnancy) and compression stockings.
A person with DVT should be advised to:
Walk regularly after discharge from hospital.
Elevate the affected leg when sitting.
Refrain from extended travel, or travel by aeroplane, for at least 2 weeks after starting anticoagulant treatment.
Deep Vein Thrombosis: Guidance FeedbackThe most relevant search results for Deep Vein Thrombosis from producers of guidance information.
- Scottish Intercollegiate Guidelines Network, 10 November 2011
- Scottish Intercollegiate Guidelines Network, 11 June 2013
Venous thromboembolism: reducing the risk: Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital - guidance (CG92)National Institute for Health and Care Excellence, 01 January 2010
Venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing - guidance (CG144)National Institute for Health and Care Excellence, 01 June 2012
- Venous thromboembolism - NICE Pathways
- National Institute for Health and Care Excellence, 08 February 2012
- Finnish Medical Society Duodecim, 10 December 2013
- Finnish Medical Society Duodecim, 29 August 2014
Deep Vein Thrombosis: Commissioning FeedbackThe most relevant search results for Deep Vein Thrombosis from producers of commissioning advice.
Quality standard for diagnosis and management of venous thromboembolic diseases - quality standard (QS29)National Institute for Health and Care Excellence, 01 March 2013
Diagnosis and management of venous thromboembolic diseases - NICE support for commissioners and others (QS29) [PDF]National Institute for Health and Care Excellence, 28 March 2013
- National Institute for Health and Care Excellence, 01 June 2010
- National Institute for Health and Care Excellence, 27 June 2010
- National Institute for Health and Care Excellence, 14 May 2013
- QIPP, 09 February 2011
- QIPP, 03 August 2011
Information for the public
Deep Vein Thrombosis: Information for the public FeedbackThe most relevant search results for Deep Vein Thrombosis, from Department of Health accredited producers of patient information.
- Bupa , 30 April 2014
- NHS Choices, 03 June 2014
- Patient UK
- Patient UK
- NHS Choices, 06 November 2013
- Cancer Research UK, 27 October 2014
- NHS Choices, 08 September 2014
- Bupa , 19 May 2014
- NHS Choices, 02 October 2013
- NHS Choices, 22 January 2013
Deep Vein Thrombosis: Medicines FeedbackAppropriate medicines information for Deep Vein Thrombosis supplied by Datapharm, a leading source of trusted, credible information about medicines.
Deep vein thrombosis - Medicines Information
- Clexane (a brand of Enoxaparin Sodium)
- Dabigatran etexilate mesilate (a generic version of Pradaxa)
- Danaparoid (a generic version of Orgaran)
- Fondaparinux (a generic version of Arixtra)
- Heparin sodium
- Marevan (a brand of Warfarin)
- Menadiol sodium phosphate
- Sinthrome (a brand of Acenocoumarol)
- Streptase (a brand of Streptokinase)
- Syner-Kinase (a brand of Urokinase)
- Tinzaparin (a generic version of Innohep)
- Xarelto (a brand of Rivaroxaban)
- Zibor (a brand of Bemiparin Sodium)
Deep Vein ThrombosisOpen
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...sPlanChniC vein thrombosis Thrombosis of hepatic, portal and mesenteric veins is rare and most often associated...true for hepatic and portal vein thromboses) or local or systemic inflammatory...risk factors for postoperative deep vein thrombosis. ANZ j Surg 2004;74(12...Thrombosis, phlebitis, and varicose veins. BMj 1996;312(7025...Comparison between idiopathic deep vein thrombosis of the upper and...PM. How I treat rare venous thromboses. Blood 2008;112(13...cerebral vein and dural sinus thrombosis: results of the International...
Scottish Intercollegiate Guidelines Network, 10 November 2011
...incidence of line related symptomatic deep vein thrombosis with heparin (RR 0.43, 95...routinely to prevent catheter-related deep vein thrombosis in cancer patients. 14.2 TREATMENT...NHSScotland for the treatment of deep vein thrombosis (DVT), and prevention of recurrent...
Scottish Intercollegiate Guidelines Network, 11 June 2013
Guideline 118: Management of patients with stroke: rehabilitation, prevention and management of complications, and discharge planning - Full guideline
...safe and effective in preventing deep vein thrombosis (DVT) and pulmonary embolism...Physical methods for preventing deep vein thrombosis in stroke. Cochrane Database of...compression in reduction of risk of deep vein thrombosis in patients who have had a stroke...
Scottish Intercollegiate Guidelines Network, 10 October 2014
Heparin for the prevention of venous thromboembolism in acutely ill medical patients (excluding stroke and myocardial infarction)
...Hospital of Wales, Haemophilia and Thrombosis Centre, Cardiff, UK 2 University...venous thrombosis may occur in any vein in the body, although it usually occurs in the deep veins of the lower limbs. People admitted...LMWH versus UFH Efficacy Deep vein thrombosis (DVT) Six studies evaluated...Statistical method Effect size 1 Deep vein thrombosis 7 5511 Odds Ratio (M...
Cochrane Database of Systematic Reviews, 07 May 2014 - Publisher: John Wiley & Sons, Ltd
...encompasses a continuum, including both deep vein thrombosis (DVT) (the formation of clots in the deep veins of the body - predominately in the...which occurs when a clot in a deep vein breaks free and is carried to the...the inferior vena cava and pelvic veins by the enlarging uterus, and decreased...For women who have had a previous thrombosis in pregnancy, the risk of VTE increases...predisposes individuals to developing thromboses) (ACOG 2011; Alfirevic 2002; James...
Cochrane Database of Systematic Reviews, 11 February 2014 - Publisher: John Wiley & Sons, Ltd
...hypertension. Treatment of deep vein thrombosis (DVT) and pulmonary embolism...etexilate therapy. Treatment of deep vein thrombosis (DVT) and pulmonary embolism...COVER II testing the treatment of deep vein thrombosis (DVT) and pulmonary embolism...
27 June 2014 - Publisher: electronic Medicines Compendium - Publication type: Drug prescribing
Primary prophylaxis for venous thromboembolism in people undergoing major amputation of the lower extremity
...slower blood flow proximal to the ligated veins combined with the endothelial trauma to the veins during amputation predisposes amputees to a higher risk of deep vein thrombosis (DVT) than other surgical patients...may not prevent DVT in the proximal veins on the side undergoing amputation...
Cochrane Database of Systematic Reviews, 16 December 2013 - Publisher: John Wiley & Sons, Ltd
...79% reduction in the odds of deep vein thrombosis during the treatment period...the reductions in deep vein thrombosis with acute anticoagulation were...participants, and most of the deep vein thromboses detected were asymptomatic. There...systematically. In addition, deep vein thrombosis can lead to morbidity...thrombosis could occur, and deep vein thromboses may begin to develop. We were...because no trials sought deep vein thrombosis systematically after the treatment...
Cochrane Database of Systematic Reviews, 08 October 2008 - Publisher: John Wiley & Sons, Ltd
Direct thrombin inhibitors versus vitamin K antagonists or low molecular weight heparins for prevention of venous thromboembolism following total hip or knee replacement
...the venous system; it includes deep vein thrombosis (DVT) and pulmonary embolism...withdrew consent and had a proximal deep vein thrombosis objectively confirmed on postoperative...ximelagatran < 24 mg. We defined major deep vein thrombosis (DVT) as the combination of proximal...
Cochrane Database of Systematic Reviews, 14 April 2010 - Publisher: John Wiley & Sons, Ltd
Systemic treatments for the prevention of venous thrombo-embolic events in paediatric cancer patients with tunnelled central venous catheters
...cancer patients. VTE comprises both deep vein thrombosis (DVT) and pulmonary embolism (PE...is broad and varies from collateral veins in the skin to chronic superior caval vein syndrome (Van Ommen 2009). Description...embolism or VTE).mp. 3. deep vein thrombosis.mp. or exp deep vein thrombosis...
Cochrane Database of Systematic Reviews, 11 September 2013 - Publisher: John Wiley & Sons, Ltd
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