Free-floating deep venous thrombosis. A retrospective analysis.
Duplex scan to diagnose deep venous thrombosis is an established technique. As experience accumulated, patients with free-floating thrombi were identified. A retrospective review of 65 patients was performed to study these thrombi, to evaluate treatment regimens, and to analyze patient outcome. A 26% incidence of pulmonary embolus occurred. However patients who had bilateral free-floating thrombi had a 42.8% incidence of pulmonary embolus. Receiving a 7-day course of heparin therapy with a partial thromboplastin time (PTT) at 1.5 times control was 53.2% of patients; 55.4% of the patients underwent follow-up examination, and the mean time to clot attachment was 9.2 days. Patients should receive anticoagulation for 10 days or until clot attachment. Patients with persistent, bilateral free-floating thrombi, or propagation of thrombus are candidates for potential caval interruption. Serial scans should be performed to monitor the thrombus for attachment or alteration.
Berry
R E
RE
Department of Surgical Education, Roanoke Memorial Hospital, VA 24033.
George
J E
JE
Shaver
W A
WA
D000368:Aged; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007866:Leg / Q000098:blood supply*; D008297:Male; D010314:Partial Thromboplastin Time; D011655:Pulmonary Embolism / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013924:Thrombophlebitis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods*
D006493:Heparin