Iranvein Varicose Clinic Protocols for DVT

Our doctor will ask you questions about your medical history and perform a physical exam as part of your diagnostic evaluation. Immediately

a Duplex Ultrasound scan performed and the veins checked from groin to ankle.Depending on your condition, you may be admitted to the

hospital for DVT treatment, or you may receive treatment on an outpatient basis.

In special situations like   massive swelling the leg or in situations where a blood clot in the lungs (pulmonary embolism) has left the patient

very short of breath or with low blood pressure the patient hospitalized immediately and catheter-directed thrombolytic therapy or systemic

thrombolysis was considered. It is a nonsurgical treatment for DVT and Pulmonary Emboli that dissolves blood clots.

Vena cava filters are used when patient is in the danger of pulmonary emboli but the medication alone cannot prevent it. It can catch clots

as they move through the body to the lungs. This treatment will help prevent a pulmonary embolism, but will not prevent the development

of more clots.

Angioplasty is a nonsurgical treatment for DVT in some cases that is used to widen the vein after the blood clot has been dissolved. During

angioplasty, a small balloon at the tip of the catheter is inflated to stretch the vein open and increase blood flow. A stent may be necessary

at times and is placed during the angioplasty procedure to keep the vein open.

Some Information for the Doctors (Deep Vein Thrombosis DVT)

Initial treatment usually consists of LMWH, This. Followed by warfarin .Heparin should be continued for at least 5 days and can be stopped

once the Warfarin is at an appropriate level (INR of 2 – 3).

For patients with a first time DVT or PE:

Due to a reversible risk factor like surgery …., treatment with Warfarin is recommended for at least 3 month

_ Who have no identifiable risk factors, treatment should continue for at least 6 to 12 months.

Patients with a DVT or PE who have no identifiable risk factors should consider being tested for a clotting disorder. They should be treated

for at least 12 months, and possibly indefinitely.
In the case of a recurrent event, warfarin may be continued for life.

Thrombolysis can be considered if the clot is severely symptomatic, or if it life or limb threatening.

There are several interventional treatment options for acute deep venous thrombosis (DVT): catheter-directed thrombolysis with or without

mechanical device use is the preferred treatment option for patients with iliofemoral deep venous thrombosis who are otherwise healthy and

have no contraindication to receiving a thrombolytic drug. Successful and timely clot removal in patients with iliofemoral DVT results is less

post-thrombotic symptoms and an improved health-related quality of life.Vena Cava Filter can be used if blood thinners cannot be used, or if

they fail.

Post – thrombotic Syndrome:

An elastic compression stocking with a pressure of 30 – 40mmHg at the ankle (high grade compression) should be used for 2 years after an

episode of DVT. This helps to prevent long – term symptoms


This essay is translated by Mojgan Salmani

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