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
- 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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...computed tomography DD D-dimer DVT deep vein thrombosis/thromboses ED emergency department ELISA...echography and phlebography in deep venous thromboses of the lower limbs. Radiol Med...echographyplethysmography in deep venous thromboses of the legs. Ann Radiol (Paris...diagnosis of acute deep venous thrombosis. J Vasc Surg 1989; 9:725...noninvasive diagnostics of deep vein thrombosis of the lower extremities...functional exploration of the veins in the obese. Problems that may...
NIHR Journals Library - Health Technology Assessment, 12 February 2013
Dabigatran etexilate for primary deep vein thrombosis prevention post hip and knee surgery at NIHR Horizon Scanning Centre
...Briefing Dabigatran etexilate for primary deep vein thrombosis prevention post hip and knee surgery...2 Dabigatran etexilate for primary deep vein thrombosis prevention post hip and knee surgery Target group • Primary deep vein thrombosis (DVT) prevention post...
NIHR Horizon Scanning Centre, 01 August 2006
Oral direct thrombin inhibitors or oral factor Xa inhibitors for the treatment of deep vein thrombosis
...or oral factor Xa inhibitors for the treatment of deep vein thrombosis Record type Uncertainties being addressed in...or oral factor Xa inhibitors for the treatment of deep vein thrombosis (Protocols).Cochrane Database of Systematic...
UK Database of Uncertainties about the Effects of Treatments, 12 March 2014 - Publication type: Known Uncertainty
...compression stockings for prevention of deep vein thrombosis. Cochrane Database of Systematic...duration of anticoagulation after deep vein thrombosis: not yet. Journal of Thrombosis...1998) Non invasive diagnosis of deep venous thrombosis. Annals of Internal Medicine, 128...2004) Paediatric cerebral sinus vein thrombosis. A multi-center case...
British Committee for Standards in Haematology, 20 May 2011
...aspects of assays used in haemostasis and thrombosis I. Mackie 1,* , P. Cooper...aspects of assays used in haemostasis and thrombosis. International Journal of Laboratory...consensus by members of the Haemostasis and Thrombosis Task Force of the British Committee for Standards...
British Committee for Standards in Haematology, 17 September 2012
...replacement surgery. Treatment of deep vein thrombosis (DVT) and pulmonary embolism...replacement surgery. Treatment of deep vein thrombosis (DVT) and pulmonary embolism...ischaemic attack. Treatment of deep vein thrombosis (DVT) and pulmonary embolism...
Clinical Knowledge Summaries, 01 May 2013
Thrombophilia testing in people with venous thromboembolism: systematic review and cost-effectiveness analysis
...Source Treatment of a resolving deep vein thrombosis 183.46 See Appendix 5 Warfarin...cost-effectiveness analysis. The Thrombosis: Risk and Economic Assessment of...costeffectiveness of the treatment of varicose veins (REACTIV trial). By Michaels JA...diagnostic testing strategies for deep vein thrombosis. By Goodacre S, Sampson F, Stevenson...
NIHR Journals Library - Health Technology Assessment, 12 February 2013
...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
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
...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
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