Deep Vein Thrombosis (DVT )

 Virchow's Triad

        1.Hypercoaguble state 

        2. Stasis of vascular flow 

        3. Damage to vascular endothelium

    Risks - THR - 40-60 % ,who don't receive prophylaxis

                            10  %  (aymptomatic ) with  mechanical prophylaxis

                            2-8 % symptomatic 

                TKR - 20 % ( aymptomatic)

                            1.3 % symptomatic

    

What is your DVT prophylaxis policy ?

        Non -pharmacologic 

                            Anti-DVT stockings

                            Foot or calf pumps


     DVT Prophylaxis Calf Pump

        Pharmacologic

                            LMWH-equivalent to heparin

                            -greater bioavailability

                            -longer duration of effect

                            - little requirement for monitoring cost effective

                            Fondaparinaux Sodium (Arixtra)

                            - a synthetic pentasaccharide 2.5 mg subcut. qid ,post operatively

                            - improves risk benefit ratio for prevention of post operative venous                                                              thromboembolism

                              Warfarin -effective but cumbersome DVT prophylaxis regimen

                                Aspirin -not much evidence of its efficacy


                        

                            

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