Acute DVT/PE Program
Patients diagnosed with acute deep vein thrombosis (DVT) and /or pulmonary embolism (PE) now have an option for comprehensive management. This program is designed to evaluate each patient for the full extent of their condition. 30% or more patients with deep vein thrombosis also have silent pulmonary embolism at presentation. A diagnosis of pulmonary embolism after starting anticoagulation can be inappropriately interpreted as failure of anticoagulation therapy. It is also useful to perform laboratory testing for hypercoagulable states before starting Coumadin therapy which can interfere with interpretation of some test results.
DVT/PE treatment also has become more complex. Home therapy is frequently possible for many patients. Some patients are candidates for thrombolytic treatment to reduce post-phlebitis complications. Other special circumstances include calf vein thrombosis, upper extremity venous thrombosis, and superficial venous thrombophlebitis.
Vena cava interruption is a consideration for patients who are unable to receive anticoagulation due to bleeding risk or have failure of anticoagulation therapy. Retrievable vena cava filters are used for many young patients with isolated thrombotic events.
The DVT/PE program follows these patients for both filter retrieval as well as to manage their postphlebitic states.
Preventive management of postphlebitic syndrome starts at the time of diagnosis of acute deep venous thrombosis. Early compression treatment helps reduce long-term disability and can potentially eliminate postphlebitic leg swelling and venous ulcers.
This program is based on the American College of Chest Physicians' published guidelines for management of patients with acute DVT/PE.