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Free-floating deep venous thrombosis. A retrospective analysis.
R E Berry1, J E George, W A Shaver
1Department of Surgical Education, Roanoke Memorial Hospital, VA 24033.
Annals of Surgery
|June 1, 1990
Summary
Free-floating deep vein thrombi pose a significant risk for pulmonary embolism, especially when bilateral. Treatment involves anticoagulation, with serial scans monitoring clot attachment and guiding further intervention if needed.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
Background:
- Duplex ultrasonography is a standard method for diagnosing deep venous thrombosis (DVT).
- The identification of free-floating thrombi has prompted further investigation into their clinical significance and management.
Purpose of the Study:
- To analyze the characteristics of free-floating thrombi.
- To evaluate treatment strategies for these thrombi.
- To assess patient outcomes, including the incidence of pulmonary embolism.
Main Methods:
- Retrospective review of 65 patients with identified free-floating thrombi.
- Analysis of treatment regimens, including heparin therapy.
- Evaluation of follow-up examinations and time to clot attachment.
Main Results:
- A 26% incidence of pulmonary embolism was observed.
- Patients with bilateral free-floating thrombi had a higher incidence of pulmonary embolism (42.8%).
- Mean time to clot attachment was 9.2 days following anticoagulation.
Conclusions:
- Anticoagulation for 10 days or until clot attachment is recommended.
- Patients with persistent, bilateral, or propagating thrombi may require caval interruption.
- Serial duplex scans are crucial for monitoring thrombus evolution.