Diagnosis And Management Of Deep Venous Thrombosis In The Emergency Department

Although the clinical presentations of deep venous thrombosis are notoriously subtle and nonspecific, risk stratification tools such as the Wells clinical model have improved the efficiency of the diagnostic evaluation. The emergency clinician may be guided down several pathways, including D-dimer assays and/ or ultrasonography. New oral anticoagulants offer alternatives to the traditional heparins and vitamin K antagonists in the treatment of deep venous thrombosis. This review examines the current literature, evidence, and guidelines in the diagnosis and management of deep venous thrombosis. It also explores some of the controversies and developments regarding risk stratification, adjusted D-dimer thresholds,special populations, isolated distal deep venous thrombosis, upper extremity deep venous thrombosis, outpatient treatment, and the new oral anticoagulants.