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    Pembacaan Jurnal: Deep Vein Thrombosis: A Clinical Review

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    Hadi Tryadi
    This document summarizes a clinical review on deep vein thrombosis (DVT). It discusses that DVT occurs when blood clots form in the deep veins, most commonly in the legs. It affects approximately 0.1% of people per year. The summary reviews risk factors for DVT, signs and symptoms, diagnostic tests including ultrasound and D-dimer assays, and treatment options such as anticoagulation medications and compression devices. In conclusion, it emphasizes that DVT is an important preventable cause of morbidity and mortality that requires a diagnostic pathway to reliably diagnose.

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    Pembacaan Jurnal: Deep Vein Thrombosis: A Clinical Review

    Uploaded by

    Hadi Tryadi
    27 views22 pages
    This document summarizes a clinical review on deep vein thrombosis (DVT). It discusses that DVT occurs when blood clots form in the deep veins, most commonly in the legs. It affects approximately 0.1% of people per year. The summary reviews risk factors for DVT, signs and symptoms, diagnostic tests including ultrasound and D-dimer assays, and treatment options such as anticoagulation medications and compression devices. In conclusion, it emphasizes that DVT is an important preventable cause of morbidity and mortality that requires a diagnostic pathway to reliably diagnose.

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    deep vein trombosis

    Original Title

    DVT1

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    This document summarizes a clinical review on deep vein thrombosis (DVT). It discusses that DVT occurs when blood clots form in the deep veins, most commonly in the legs. It affects approximately 0.1% of people per year. The summary reviews risk factors for DVT, signs and symptoms, diagnostic tests including ultrasound and D-dimer assays, and treatment options such as anticoagulation medications and compression devices. In conclusion, it emphasizes that DVT is an important preventable cause of morbidity and mortality that requires a diagnostic pathway to reliably diagnose.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    27 views22 pages

    Pembacaan Jurnal: Deep Vein Thrombosis: A Clinical Review

    Uploaded by

    Hadi Tryadi
    This document summarizes a clinical review on deep vein thrombosis (DVT). It discusses that DVT occurs when blood clots form in the deep veins, most commonly in the legs. It affects approximately 0.1% of people per year. The summary reviews risk factors for DVT, signs and symptoms, diagnostic tests including ultrasound and D-dimer assays, and treatment options such as anticoagulation medications and compression devices. In conclusion, it emphasizes that DVT is an important preventable cause of morbidity and mortality that requires a diagnostic pathway to reliably diagnose.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 22

    Pembacaan Jurnal :

    Deep vein thrombosis: a clinical review

    Oleh : Aswin Yusuf

    Pembimbing Residen :
    Dr.Kenny Edward Yap

    Konsulen Pembimbing :
    dr. Rosie, Sp.BTKV

    Dibawakan Dalam Rangka Kepaniteraan Klinik


    Departemen Ilmu Bedah
    Fakultastas Kedokteran
    Universitas Hasanuddin
     The term thrombosis refers to the formation,
    from constituents of blood, of an abnormal
    mass within the vascular system of a living
    animal.
     When this process occurs within the deep
    veins, it is referred to as deep vein
    thrombosis (DVT).
     DVT is a major and a common preventable
    cause of death worldwide.
     It affects approximately 0.1% of persons per
    year.
     The overall average age- and sex-adjusted
    annual incidence of venous
    thromboembolism (VTE) is 117 per 100,000
    (DVT, 48 per 100,000; PE, 69 per 100,000),
     DVT in the lower limb can be classified as
    a) proximal, when the popliteal vein or thigh
    veins are involved
    b) distal, when the calf veins are involved
    • starts in the valve pocketsof
    the veins
    Thrombus • This is especially true for
    those that occur following
    formation surgery.

    • increased expression of
    endothelial protein C
    origin of receptor (EPCR) and
    thrombomodulin (TM)
    thrombus • decreased expression of Von
    Willebrand factor (vWF) n
    Manifestasi Klinis

    1. History and clinical


    examination are not 1. Homans’ sign
    reliable may be 1. The left leg
    2. Lower extremity demonstrable in :Pregnancy and
    DVT can be acute massive
    DVT
    symptomatic venous thrombosis
    or asymptomatic. 2. lack specificity
    Predispose
    to thrombus, endot
    helial
    injury
    Rudolph
    Virchow :
    Virchow’s
    triad stasis or
    blood turbulenc
    hypercoa e of
    gulability blood
    flow
    Risk :acquired or
    genetic

    risk of VTE that


    exceeds the
    acquired genetic separate
    effects of a
    single factor
    Clinical model : Wells and
    colleagues
    High -
    Low - moderate- probability
    probability probability
    Groups :
    Groups : Groups : 85% risk of
    5% risk 33% risk
    DVT
    DVT
    unlikely” if
    Wells and the clinical
    colleagues : score is <=1
    stratifying
    patients
    into two risk DVT likely” if
    categories the
    clinical score
    >1
    D-dimer highly sensitive
    (values up to
    poor specificity
    assays 95%)
    to prove VTE

    The negative safely


    predictive nearly 100%. rule out both
    value DVT and PE.

    False nflammation,
    pregnancy,
    Clinical
    usefulness :
    positive D- malignancy, decrease with
    dimer and the elderly. age

    prior to
    False negative after heparin administering
    D-dimer use, heparin to a
    patient
     Venous ultrasonography is the investigation of choice in
    patients stratified as DVT likely. It is noninvasive, safe,
    available, and relatively inexpensive.

    compression ultrasound (B-mode


    three types imaging only)
    of venous
    ultrasonography:
    duplex ultrasound (B-mode imaging and
    Doppler
    waveform analysis),

    color Doppler imaging


    alone.
     Venography is the definitive diagnostic test for DVT, but it is
    rarely done because the noninvasive tests (D-dimer and venous
    ultrasound) are more appropriate and accurate to perform in
    acute DVT episodes
    • constant intraluminal filling defect
    cardinal • abrupt cutoff of a deep vein
    sign

    • It is highly sensitive especially in identifying the


    location, extent
    Advantage • attachment of a clot and also highly specific

    • invasive and painful


    • exposed to irradiation
    major
    setback • allergic reaction and renal dysfunction
     The technique is based on measurement of the
    rate of change in impedance between two
    electrodes on the calf when a venous occlusion
    cuff is deflated
     Thisinvestigative modality has high sensitivity
    in detecting calf and pelvic DVTs and upper
    extremity venous thromboses.

     MRI is the diagnostic test of choice for


    uspected iliac vein or inferior vena caval
    thrombosis
    Mechanical
    intermittent graduated
    pneumatic compression venous foot
    compression stocking pump
    (IPC) device (GCS)
    Effective pharmacological agents for prophylaxis of DVT.

    Unfractionated low-molecular- 1.Fondaparinux


    heparin (UFH) weight 2. new oral
    heparins directselective
    (LMWH) thrombin
    factor Xa inhibitors
    inhibitors
     UFH or LMWH, or with fondaparinux.
     Thrombolytic therapy
     Vena cava filters
     DVT is a potentially dangerous clinical
    condition that can lead to preventable
    morbidity and mortality
     A diagnostic pathway involving pretest
    probability, D-dimer assay, and venous
    ultrasound serves as a more reliable way of
    diagnosing DVT.
     Terima Kasih

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