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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