Deep Vein Thrombosis and Others

Deep Vein ThrombosisDeep Vein Thrombosis

Deep Vein Thrombosis (DVT) occurs in the lower legs and can present with pain, swelling and temperature. DVT can result in patients having a pulmonary embolus (clot to the lungs) and dying. The other main complication is that of the post-phlebitic leg syndrome, this is basically, pain, swelling in the leg after a DVT and can lead on to leg ulceration. Patients presenting with a suspected DVT need to be properly assessed with a full history, examination, blood tests and ultrasound examination.

Treatment Options - These are dependent on the site and severity of the DVT

Medication
Injections of blood thinning agents e.g. heparin or tablets e.g. warfarin
Rarely in the UK the use of clot dissolving medicines (thrombolysis)

Compression
Hosiery to assist the veins draining the leg

Intervention
Insertion of a filter to prevent clot moving or surgery are very rarely needed

Outcomes

The majority patients who present with a DVT are managed initially by injections of blood thinning medicines followed by tablets and compression hosiery.

Leg ulcersLeg ulcers

These are common. The majority are related to problems with the veins.  Following appropriate investigations.

Treatment options involve:

Bandaging to aid ulcer healing

Surgery/Endoluminal Ablation/Foam Sclerotherapy to prevent the ulcer coming back after it has healed, with advice to wear compression hosiery.

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Klippel-Trenaunay Syndrome

This is a congenital problem, where patients present with a “birth mark”, a longer leg and abnormal veins. These patients require appropriate investigations and treatment tailored to their symptoms following full consultation.