1、Peripheral Vascular DiseasePeripheral Vascular DiseaseAcute Deep Venous Thrombosisep venous thrombosis(DVT)nPulmonary embolism(PE)nPost-thrombotic syndrome Acute Deep Venous ThrombosisAcute Deep Venous ThrombosisAcute Deep Venous ThrombosisomsnMassive swellingnCalf pain,edema,erythema,fevernCyanosis
2、 with impending venous gangrene(phlegmasia cerulea dolens,股青肿)nSignsnProminent superficial veinsnHypertonia and tenderness of calfnHomans sign(pain with passive dorsiflexion of the foot)Acute Deep Venous Thrombosishy(“gold standard”,historically)nDuplex Ultrasonography nComputed tomography venograph
3、y(CTV)nD-Dimer AssaysAcute Deep Venous ThrombosisAscending May-Thurner syndromeAcute Deep Venous ThrombosisDuplex UltrAcute Deep Venous ThrombosisDuplex UltrNormalThrombosed popliteal veinAcute Deep Venous ThrombosisAcute Deep Venous ThrombosisD-DimeAcute Deep Venous ThrombosisLow-molecular-weight h
4、eparin(LMWH)Intermittent pneumatic leg compressionGraduated-Compression Stockings Oral Anticoagulants Acute Deep Venous ThrombosisherapynThrombolytic treatmentnIn patients with DVT,we recommend againstthe routine use of IV thrombolytic treatment(Grade 1A)nIVC filter placementnFor most patients with
5、DVT,we recommend againstthe routine use of a vena cava filter in addition to anticoagulants(Grade 1A)Eighth ACCP Conference on Antithrombotic and Thrombolytic Therapy,2008Acute Deep Venous Thrombosiss of treatment in patients with VTE are:nTo prevent death from PE nTo prevent recurrent VTE nTo prevent the post-thrombotic syndrome Acute Deep Venous ThrombosisAcute Deep Venous ThrombosisAcute Deep Venous ThrombosisPE and Inferior r Acute Deep Venous Thrombosis