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hypercoagulability
Endothelial damage
RISK FACTOR
Statis Hypercoagubility Endhotelial damage
THROMBUS
PATHOGENESIS
ENDOTHELIAL DAMAGE
Exposure of tissue
Activation by
factor/subendhothelial Release PAI-1
inflammatory cytokines
matrix
THROMBUS
PATHOGENESIS
HYPERCUAGUBILITY
Coagulation
Inflamation cascade
activation
THROMBUS
CLINICAL SYMPTOMS
• Calf pain
• Tenderness
• Swelling
• Redness
• Homan’s sign
DIAGNOSIS
Vein Incompressibility
THROMBUS
VENOUS ULTRASOUND
Abnormal color dopler flow
D-Dimer
• Fibrin Normal D-DIMER < 500 ng/dl
degradation
product elevated
in active
thrombosis
• Negative test can
help exclude VTE
THERAPHY
Stop developing • Anticoagulan theraphy
thrombus
Limitting • Bedrest
• Raise the position of the foot
progressive limb • Compression stocking
swelling
THERAPHY
Unfractionated
heparin
LMWH
Pharmacologi
warfarin
theraphy
Anti factor Xa
Direct thrombin
inhibitor
THERAPY
Surgical thrombectomy
theraphy
PROGNOSIS
Without adequate treatmentlower extremity DVT has a 3% risk of
fatal PE
death due to upper extremity DVT is very rare.
Risk of recurrent DVT is lowest for patients with transient risk factors
(eg, surgery, trauma, temporary immobility)
Greatest for patients with persistent risk factors (eg,
cancer)idiopathic DVT, or incomplete resolution of past DVT (residual
thrombus).