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Deep Vein Thrombophlebitis

Jaine McKenzie, MD, Patricia Martinez Quinones, MD and Keith O'Malley, MD, FACS Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Development of blood clot within the deep veins, usually accompanied by inflammation of the vessel wall

  • Major clinical consequences are embolization (usually to the lung), recurrent t...

DIAGNOSIS

  • Modified Wells criteria, a validated clinical prediction rule, is useful to determine pretest probability of having a DVT.

    • Active cancer (+1 point)

    • Calf swelling >3 cm compared to other l...

TREATMENT

MEDICATION

Consider starting therapy even before confirmation in patients with high pretest probability. 
  • Anticoagulation is mainstay of therapy. Patients with PE or proximal DVT, long-term th...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Resumption of normal activity with avoidance of prolonged immobility

  • Compression stockings not routinely recommended for prevention of PTS after acute DVT (4)[B] b...

REFERENCES

1
1 Dresang L, Fontaine P, Leeman L, et al. Venous thromboembolism during pregnancy. Am Fam Physician.  2008;77(12):1709–1716. {L-End} {L-End} [View Abstract on OvidMedline]
2
2 Bauman...

ADDITIONAL READING

  • Agnelli G, Buller HR, Cohen A, et al; for AMPLIFY Investigators. Oral apixaban for the treatment of acute venous thromboembolism. N Eng J Med.  2013;369(9):799–808. {L-End} {...

SEE ALSO

Antithrombin Deficiency; Factor V Leiden; Protein C Deficiency; Protein S Deficiency; Prothrombin 20210 (Mutation); Pulmonary Embolism 

CODES

ICD10

  • I80.209 Phlbts and thombophlb of unsp deep vessels of unsp low extrm

  • I80.299 Phlebitis and thombophlb of deep vessels of unsp low extrm

  • I80.10 Phlebitis and thrombophlebitis of unspecified fe...

CLINICAL PEARLS

  • Many cases are asymptomatic.

  • At time of DVT diagnosis, as many as 40% of patients also have asymptomatic PE.

  • Wells criteria are useful to determine the pretest probability of a DVT, but ...

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