Venous Thromboembolism

Presented by Sherif Mohamed Abd Elsamad

Definition of VTE ,[object Object]

Risk factors for VTE ,[object Object],[object Object],[object Object],[object Object],[object Object]

Risk factors for VTE (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Well’s risk score for VTE Variables Points Clinical Signs and Symptoms of DVT? (Calf tenderness, swelling >3cm, erythema, pitting edema affected leg only) +3 PE is the 1 ry Diagnosis, or equally likely +3 Heart Rate > 100 +1.5 Immobilization at least 3 days, or Surgery in the Previous 4 weeks +1.5 Previous, objectively diagnosed PE or DVT? +1.5 Hemoptysis +1 Malignancy with Rx within 6 mo, or palliative? +1

Well’s risk score for VTE (cont’d) Score Risk >6 High 2 to 6 Moderate <2 Low

Pathogenesis ,[object Object],[object Object],[object Object]

Symptoms & signs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Symptoms & signs (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Symptoms & signs (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Symptoms & signs (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Investigations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Investigations (Cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Investigations (Cont’d) ,[object Object],[object Object],[object Object],[object Object]

Hypercoagulability work-up ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hypercoagulability work-up (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Differential diagnosis ,[object Object],[object Object],[object Object]

Complications of VTE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management of VTE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Prophylaxis of VTE ,[object Object],[object Object],[object Object],[object Object],[object Object]

Prophylaxis of VTE (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Prophylaxis of VTE (cont’d) ,[object Object],[object Object],[object Object],[object Object]

Treatment of VTE ,[object Object],[object Object],[object Object],[object Object]

Treatment of VTE (cont’d) ,[object Object],[object Object],Event Duration First Time event of reversible cause (surgery/trauma) At least 3 months First episode of idiopathic VTE At least 6 months Recurrent idiopathic VTE or continuing risk factor At least 12 months Symptomatic isolated calf-vein thrombosis 6 to 12 weeks

Treatment of VTE (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment of VTE (cont’d) ,[object Object],[object Object],Agent Dose Streptokinase 250,000 IU as loading dose over 30 min, followed by 100,000 IU/h over 12 to 24 h 1,500,000 IU over 2 h Urokinase 4,400 IU/Kg as a loading dose over 10 min, followed by 4,400 IU/Kg/h over 12-24 h 3 million IU over 2 h Reteplase (rtPA) 100mg over 2 h 0.6mg/Kg over 15 min (max. 50mg)

Treatment of VTE (cont’d) ,[object Object],[object Object],[object Object],[object Object]

Venous Thromboembolism

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