الفهرس 
Coagulation
Treatment modalities of calf vein thrombosisOnly 14 pages are availabe for public view
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Abstract
Deep-vein thrombosis is the formation of solid mass within intact CVS (”thrombus”) in a deep vein.
It commonly affects the veins of the lower limb, such as the femoral vein or the popliteal vein or the deep veins of the pelvis.
There is a significant risk of the thrombus embolizing and traveling to the lungs causing a pulmonary embolism.
Virchow’s triad is a group of 3 factors known to affect clot formation: rate of flow, the consistency (thickness) of the blood, and qualities of the vessel wall.
Virchow noted that more deep venous thrombosis occurred in the left leg than in the right and proposed compression of the left common iliac vein by the overlying right common iliac artery as the underlying cause.
The diagnosis of DVT usually involves imaging and/or laboratory(Biological) tests after clinical assessment There may be no symptoms referrable to the location of the DVT, but the classical symptoms of DVT include pain, swelling and redness of the leg and dilation of the surface veins.
In up to 25% of all hospitalized patients, there may be some form of DVT, which often remains clinically inapparent No known blood or serum test confirms or excludes the diagnosis of DVT or PE. Also; tests of clotting function are at best, crude markers of avery complex system and usually do not correlate well with the risk of acute thrombosis.
The presence of D-dimer itself is non-specific, and the test cannot be considered diagnostic of VTE even when results are positive.
In patients with the clinical suspicion of DVT, duplex imaging is the usual initial test.
If the scan is positive, the patient is treated for DVT.
If the scan is negative, the patient should be classified according to the level of clinical suspicion of DVT assigned prior to venous duplex imaging Doppler ultrasonography, compression ultrasound scanning of the leg veins, combined with duplex measurements (to determine blood flow), can reveal a blood clot and its extent (i.e. whether it is below or above the knee). Duplex Ultrasonography,due to its high sensitivity, specificity and reproducibility, has replaced venography as the most widely used test in the evaluation of the disease. This test involves both a B mode image and Doppler flow analysis.
Virtually all vascular labs use the first criteria, the inability to collapse a vein with probe pressure as the primary diagnostic method.
Some use only this finding.
Meta-analysis has shown this sign to be 95% sensitive and 98% specific for proximal leg DVTs.
Anticoagulation is the usual treatment for DVT.
In general,patients are initiated on a brief course (i.e., less than a week) of heparin treatment while they start on a 3- to 6-month course of warfarin (or related vitamin K inhibitors). Low molecular weight heparin (LMWH) is preferred, though unfractionated heparin is given in patients who have a contraindication to LMWH (e.g., renal failure or imminent need for invasive procedure).
In patients who have had recurrent DVTs (two or more), anticoagulation is generally ”life-long.” The Cochrane Collaboration has meta-analyzed the risk and benefits of prolonged anticoagulation.