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.
Department of Surgical Education, Roanoke Memorial Hospital, VA 24033.
R E
RE
Berry
J E
JE
George
W A
WA
Shaver
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