The management of the limb in acute venous thrombosis

This review addresses the management of the limb in patients with deep vein thrombosis. The concepts that underline such treatment are reviewed and the importance of objective diagnosis before the institution of long term therapy is stressed. Management is considered in relation to the extent of segmental venous involvement and to the use of Heparin, Streptokinase, Warfarin and surgical therapy. There is a lack of adequate and comprehensive follow up data on the limb in patients with deep vein thrombosis and in particular there are few objective studies relating to the short and long term sequelae as far as valvular function is concerned. There is uncertainty concerning the appropriateness of continuing compression therapy and the value of such therapy in reducing long term morbidity. The importance of recognising the potentially severe ischaemic consequences of massive venous thrombosis are described, together with an outline management plan. The importance of short and long term follow up studies of the limb is stressed particularly in relation to potential changes in methods of treatment.