1 / 48

Understanding DVT Assessment: Compression Techniques and Diagnostic Protocols

This guide outlines the diagnostic protocol for ruling out Deep Vein Thrombosis (DVT) using compression techniques with a Linear Array Probe. It emphasizes the importance of proper vein compression, highlighting the Superficial Femoral Vein (SFV) as a deep vein and using specific protocols with compression clips. The document also discusses the reliability of calf DVT diagnosis, monitoring strategies, and the use of Doppler ultrasound alongside compression for accurate assessments. Essential insights into normal and abnormal exam findings are provided.

gwydion-probert
Télécharger la présentation

Understanding DVT Assessment: Compression Techniques and Diagnostic Protocols

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. US reviewMarch 9, 2011

  2. Rule out DVT

  3. If the vein completely compresses there is no underlying clot.

  4. no clot clot

  5. Linear Array Probe (5-10 mHz)

  6. Patient reclines at 45o Hip externally rotated

  7. Note: SFV – “superficial” femoral vein is a deep vein!

  8. Just 2 key areas to compress

  9. Our protocol: 4 compression clips CF-saph bifurcation pop “trifurcation”

  10. A normal exam:

  11. Clip #1 CF-saph

  12. CFV – G. Saphenous Junction

  13. Clip #2 bifurcation

  14. Bifurcation: SFV and DFV

  15. Clip #3 pop

  16. Pop V

  17. Clip #4 “trifurcation”

  18. “trifurcation”: pop divides

  19. Some clots:

  20. DVT in CFV

  21. Clip: partially occlusive DVT

  22. movie: mobile DVT

  23. movie: DVT in CFV

  24. Movie: DVT in pop

  25. Chronic DVTs look different

  26. shrunken fibrotic (hyperechoic) collaterals recanalized Chronic DVT

  27. clip: lymph node

  28. The exam is simple!

  29. Stuff you don’t have to know:

  30. You can skip: the mid-thigh the calf Doppler

  31. mid-thigh: SFV

  32. Calf veins: OK to skip

  33. Calf DVTs - Unreliable to diagnose: < 70% sensitivity - Unclear significance: 75% resolve without treatment

  34. But what if you find a calf DVT? Plan A: anticoagulate Plan B: ASA only. Monitor for extension (Not all calf veins are equally important)

  35. Clip: calf veins

  36. Is Doppler needed? No. Compression is sufficient. Color can sometimes help identify vessels. Doppler can give false normals: eg non-occlusive DVT has normal augmentation.

  37. Doppler flow info: Augmentation: - squeeze the calf and blood rushes past the probe - implies no obstruction between calf and probe Respiratory phasicity: • - flow stops on inhale, goes on exhale • - implies no obstruction up in pelvis

  38. Venous flow (note respirations)

  39. phasic flow and augmentation

  40. What is “duplex”? 2 modalities together: U/S + Doppler

  41. Quiz!

  42. A C B

  43. A C D B

  44. A B

  45. Where on the leg are we?

  46. The End

More Related