
Contents
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Definition Definition
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Clinical Features Clinical Features
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Anatomy and Physiology Anatomy and Physiology
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Diagnosis Diagnosis
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Specific Clinical Entities in Acute DVT Specific Clinical Entities in Acute DVT
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May-Thurner Syndrome May-Thurner Syndrome
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Post-Thrombotic Syndrome Post-Thrombotic Syndrome
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Phlegmasia Cerulea Dolens Phlegmasia Cerulea Dolens
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Phlegmasia Alba Dolens Phlegmasia Alba Dolens
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How to Approach the Image How to Approach the Image
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Pulmonary Embolism Pulmonary Embolism
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Pulmonary Angiography Pulmonary Angiography
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Chest Radiography Chest Radiography
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Ventilation/Perfusion (V/Q) Radionuclide Scans Ventilation/Perfusion (V/Q) Radionuclide Scans
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What Not to Miss What Not to Miss
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Differential Diagnosis Differential Diagnosis
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Treatment Treatment
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Anticoagulation Anticoagulation
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IVC Filter Placement IVC Filter Placement
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Thrombolysis Thrombolysis
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Iliofemoral Venous Thrombolysis Iliofemoral Venous Thrombolysis
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Systemic Thrombolysis Systemic Thrombolysis
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PE Catheter-Directed Thrombolysis PE Catheter-Directed Thrombolysis
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Mechanical Thrombectomy Mechanical Thrombectomy
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Surgical Embolectomy Surgical Embolectomy
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Clinical Issues Clinical Issues
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Further Reading Further Reading
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Cite
Abstract
This chapter discusses the clinical features, etiologies, anatomy and physiology, diagnosis, imaging findings, and key features of acute deep venous thrombosis (DVT) and pulmonary embolism (PE). Acute DVT can lead to PE, venous insufficiency, and post-thrombotic syndrome. Clinical features of DVT include leg pain, swelling and tenderness, whereas PE can result in chest pain, dyspnea, tachycardia and tachypnea. Ultrasound is the modality of choice for diagnosis of DVT, which is characterized by an echogenic, intraluminal filling defect resulting in a non-compressible vessel. CT pulmonary angiography is the diagnostic modality of choice for PE, characterized by an intraluminal filling defect. The mainstay of treatment of both of these conditions is anticoagulation. An IVC filter can be used if there is a contraindication to anticoagulation. Catheter-directed-thrombolysis can also be used. Catheter-based administration of thrombolytics is also a promising option for treatment of both submassive and massive PE.
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