[Diagnosis and treatment of venous thrombosis].
In the diagnosis of deep vein thrombosis in ambulatory patients, the recommended initial steps are assessment of clinical probability (CP) and a sensitive D-dimer test. With a low CP and negative D-dimer, thrombosis can be ruled out. All other constellations require further investigation with imaging techniques. Compression ultrasonography is the first-line investigation. Low-molecular weight heparin is the treatment of choice for uncomplicated venous thrombosis. Secondary prophylaxis with a vitamin K antagonist is introduced in parallel as quickly as possible. The duration of treatment depends on the exposure and predisposing factors, weighing carefully the risk of recurrence on the one hand against the risk of bleeding on the other. If there are contraindications to anticoagulation with heparins or coumarins, various other anticoagulant drugs are available.
Hach-Wunderle
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Krankenhaus Nordwest--Gefässzentrum, Steinbacher Hohl 2-26, 60488 Frankfurt am Main. Hach-Wunderle@t-online.de
D000529:Complementary Therapies; D005338:Fibrin Fibrinogen Degradation Products / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D013927:Thrombosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D019043:Vascular Neoplasms / Q000188:drug therapy
D005338:Fibrin Fibrinogen Degradation Products; D005343:Fibrinolytic Agents; C036309:fibrin fragment D