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Anaesthesiology
Deep Venous Thrombosis
Built from Practical Ultrasound in Anesthesia
What’s inside
7 sections · 59 slides
Overview
- Topics covered
Introduction and epidemiology
What deep vein thrombosis is, how it harms, and how common it is
- Deep and superficial vein thrombosis
- Progression to pulmonary embolism
- 0.75–2.69
Risk factors and indications
Who develops DVT and when point-of-care ultrasound is the right test
- DVT risk factors
- DVT in the critically ill
- Indications for compression ultrasound
- Clinical signs that raise suspicion
- The Wells score
- The Wells Scoring System to Predict DVT Probability
- 96.1%
Equipment and scanning technique
Choosing the probe, setting depth and gain, and compressing correctly
- Transducer selection
- Knobology for deep-vein scanning
- Scanning technique
- Superficial femoral artery and vein before compression
- Compression ultrasound: normal venous collapse
Normal findings and landmarks
How patent veins appear, and the veins to scan in the limbs and neck
- Normal patent vein on compression
- Lower limb: first region (groin to thigh)
- The frog-leg scanning position
- Left common femoral vein and artery
- Sapheno-femoral junction
- Femoral bifurcation and venous confluence
- Distal superficial femoral vein
- Lower limb: second region (popliteal and calf)
- Popliteal fossa probe placement
- Popliteal vein and artery
- Thrombosed calf veins
- Lower limb: third region
- Upper limb: arm veins
- Brachial artery and brachial veins
- Basilic vein
- Upper limb: chest and neck veins
- Axillary vein below the clavicle
- Cephalic and axillary vein confluence
- Subclavian vein
- Subclavian and internal jugular confluence
- Brachiocephalic vein
- Internal jugular vein
Pathological findings and protocols
Recognizing DVT, choosing a compression protocol, and avoiding pitfalls
- “
- Sonographic appearance of DVT
- Thrombus at the femoral vein confluence (transverse)
- Deep vein thrombosis (transverse and longitudinal)
- Three CUS protocols
- Comparing the three CUS protocols
- Baker's cyst as an incidental finding
- Baker's cyst in the popliteal region
- Fibrin sleeve versus catheter thrombosis
Doppler for indeterminate cases
Color and pulsed-wave Doppler when compression cannot decide
- Indications for Doppler
- Doppler basics: PRF and angle
- Color Doppler settings
- Pulsed-wave Doppler waveforms
- Augmentation with calf squeeze
- Diagnostic pathway for DVT
- Key takeaways
- References
- References
- References
- References
- Practical Ultrasound in Anesthesia for Critical Care and Pain Management