Deep Vein Thrombosis
Acute or Chronic
ACUTE THROMBUS
Clotted blood within a vein that is less than 14 days old.
●
Injury to the inner layer of the vessel
●
Soleal Sinuses
●
Cusps of Venous Valves
CHRONIC THROMBUS
Blood clot in the vein that has been there for several weeks.
●
Obstructive Fibrous Cord
– Chronically Obstructed
– Recanalized ( partially or completely )
●
Increases risk of recurrent Acute DVT
Characteristics
ACUTE:
- Hypoechoic or slightly echogenic
-
Loosely attached thrombus
-
Spongy texture to thrombus
-
Dilated vein w/ total obstruction
CHRONIC:
- Hyperechoic or brightly echogenic
-
Well- attached thrombus
-
Rigid texture to thrombus
-
Contracted vein w/ total obstruction
-
Large collaterals
ACUTE THROMBUS
CHRONIC THROMBUS
echogenic clot
blood flow around chronic thrombus
Symptoms
ACUTE:
-
Pain
-
Warmth
-
Redness
-
Swelling
CHRONIC:
-
Discoloration
-
Peripheral edema (unilateral)
-
Heaviness of limb
-
Ulcerations
-
Varicosities
ACUTE vs CHRONIC DVT
https://youtu.be/o1s6OdkLQlA?feature=shared
TREATMENT
●
MEDICATIONS:
~ Anticoagulants- blood thinners to minimize growth & risk of new clots
~ Thrombolytics- destroys severe chronic clots
●
Catheterization Surgery- insert a thin tube to treat clot, a stent to dilate
vein, and or filter for any loose pieces breaking off of the clot
●
Thrombectomy- surgically remove thrombus
Normal Waveforms
DVT waveforms video
https://youtu.be/zFtlbk2
yzn8?feature=shared
Quiz Questions
1.
All of the following are characteristics of an Acute Thrombus except:
a). Strongly attached
b). Spongy Texture
c). Hypoechoic
d). Vein dilation with total obstruction
2.
The type of thrombus that is older than 14 days, has an obstructive
fibrous cord, & increases the risk for recurrent dvt’s is: ______________
3.
The following treatments are likely used in the presence of a dvt except:
a). Vitamin K
b). Anticoagulants
c). Thrombolytics
d). Catheterization Surgery
Article Links
https://www.ahajournals.org/doi/full/10.1161/circulationaha.113.002966#T1
https://www.healthline.com/health/chronic-thrombosis#takeaway
https://cdt.amegroups.org/article/view/17157/html
https://thoracickey.com/acute-lower-extremity-deep-vein-thrombosis-2/
https://www.researchgate.net/publication/221927423_Radiological_Imaging_a
nd_Intervention_in_Venous_Thrombosis