Diagnosis and treatment

of DVT
Dr K. Waqanisau
Diploma in O&G
CWM Hospital

Introduction

Venous thromboembolism diseases (VTE)

DVT

PE

Inpatient has higher risk of VTE

100x more

30,000 are hospitalised because of VTE

PE accounts for 10% of hospital death

Clinical practice guideline for the prevention of venous thromboembolism

in patients admitted to Australian hospitals

Diagnosis

Clinical (wells Score)

Blood test D Dimer

Imaging

Compression ultrasonography

Venography

Wells score

From the group health cooperative VTE guidelines 2011

Compression ultrasonography

It has a sensitivity of 97%, specificity 95% above the knee

Below the knee the sensitivity is 40 70 and specificity is ~ 50

Test is

Full compression of the vessel is positive

Incomplete is negative

venography

It the gold standard for diagnosis

But it invasive and is associated with risks

Very high sensitivity and specificity

NICE: VTE diagnosis and mangment

(June 2012)
Wells score

>1

D Dimer

USS

+ve

-ve

Follow as 1

-ve

Investigate
others

+ve

D - Dimer

-ve

Trestment

+ve

Investigate for
other causes

Rpt usscan 1
wk

Treatment